Hoarding Behavior in Seniors: Seeking Help for a Loved One

Collecting scrap and bringing it home to pile up..?

Hello Dr.
Shen: I have a long-standing issue that I seek your professional opinion on.
My mother-in-law is sixty years old and has a habit of collecting junk and hoarding it at home without organizing it, which has filled several rooms and even the balcony, creating a dirty environment.
Despite repeated attempts to persuade her, she refuses to listen and responds with loud reprimands.
She has a bad temper and often raises her voice, believing that her actions are justified, and she is very resistant to seeking medical help.
We have communicated with her countless times to no avail, and the neighbors view her with disdain.
She has received several fines from the Environmental Protection Agency and has even been reported in the news, but she remains indifferent to these issues and continues her behavior.
Recently, her actions have escalated; she stays up all night collecting items and only takes short naps on a chair during the day, which is quite concerning.
My mother-in-law lost her spouse at a young age, and her children do not live with her due to work and other reasons, but they provide her with monthly living expenses, ensuring she is financially secure.
Dr.
Shen, could this be a form of mental illness? How can we, as her younger relatives, help her? Thank you very much.

Bi Bi, 30~39 year old female. Ask Date: 2009/01/30

Dr. Shen Zhengnan reply Geriatrics

Hello, there are several possible situations regarding the behavior of elderly individuals collecting scrap: 1.
If this habit or related work existed during their youth, it may be a continuation of their original behavior into old age, which, due to a decline in cognitive abilities, could lead to excessive hoarding.
2.
If such behavior did not occur previously and only emerged in old age, while there are no economic hardships, then the underlying causes of this behavior warrant further investigation.
I suggest: 1.
Please observe if there are any abnormalities in the elderly person's other daily activities, such as their memory, ability to maintain personal hygiene, or if their clothing and appearance are disheveled.
Are there any social or recreational activities, or are they socially isolated and not interacting with family and friends? If the elderly person exhibits behaviors of collecting scrap and hoarding along with the aforementioned conditions, it is likely that they may need psychiatric assistance.
2.
Regardless of whether there are mental health issues, based on the current situation, it appears that the elderly person is quite resistant to your intervention.
I recommend A.
Having other relatives intervene, as the inherent dynamics of a daughter-in-law relationship may pose limitations.
B.
The approach to intervention should ideally be empathetic, meaning it should come from a place of understanding and concern.
Gaining the elderly person's acceptance before further intervention is more likely to be received positively.
For example, family members can occasionally accompany the elderly person while they are out collecting, observe the entire process, and assist them in organizing the collected waste, showing that the family does not deny their behavior but rather wants to help.
3.
If the elderly person is already experiencing memory issues, ongoing emotional distress, or other unusual behaviors, it is necessary to seek medical attention.
If the elderly person is resistant to psychiatric care, you can indirectly encourage them to see a doctor by referencing their related physical and mental symptoms.
4.
Lastly, please remember that whether healthy or ill, elderly individuals facing the aging process are prone to feelings of loneliness, anxiety, depression, and fear.
These emotions require time to adjust, especially for those living alone.
Beyond material support, all elderly individuals need the care and support of family and friends to navigate this process.
Shen Zhengnan

Reply Date: 2009/01/30

More Info

Hoarding behavior, particularly in seniors, can often be a complex issue that intertwines psychological, emotional, and sometimes even physical health factors. Your concern for your mother-in-law's well-being is commendable, and it’s essential to approach this situation with empathy and understanding.

Hoarding disorder is classified as a mental health condition characterized by persistent difficulty discarding or parting with possessions, regardless of their actual value. This behavior can lead to clutter that disrupts living spaces and can pose health and safety risks. In older adults, hoarding may be exacerbated by feelings of loss, loneliness, or depression, especially if they have experienced significant life changes, such as the loss of a spouse, as you mentioned with your mother-in-law.

Given that your mother-in-law is exhibiting signs of hoarding, such as collecting items excessively and refusing to discard them, it is crucial to recognize that this behavior is often not just a simple preference for keeping things. It can be a manifestation of deeper psychological issues, including anxiety, depression, or even a history of trauma. The fact that she reacts defensively to discussions about her behavior suggests that she may not fully understand the implications of her actions or may feel threatened by the idea of change.

Here are some steps you can consider to help your mother-in-law:
1. Educate Yourself and Family Members: Understanding hoarding disorder can help you approach the situation with more compassion. Research the condition, its causes, and its effects on individuals and families. This knowledge can guide your interactions with her.

2. Open a Dialogue: Instead of confronting her about the clutter directly, try to engage her in a conversation about her feelings. Ask her about the items she collects and what they mean to her. This approach can help her feel understood rather than judged.

3. Encourage Professional Help: While she may be resistant to the idea of seeking help, gently suggesting that she speak with a mental health professional could be beneficial. You might frame it as a way to discuss her feelings of loneliness or anxiety rather than focusing solely on the hoarding behavior.

4. Involve a Third Party: Sometimes, hearing concerns from a neutral party can be more effective than from family members. Consider involving a therapist or a social worker who specializes in hoarding disorder. They can provide a professional perspective and may be able to connect with her in a way that family members cannot.

5. Set Boundaries: While it’s important to be supportive, it’s also crucial to set boundaries regarding what is acceptable in shared spaces. This can help maintain a safe and healthy environment for everyone involved.

6. Seek Support for Yourself: Caring for someone with hoarding disorder can be emotionally taxing. Consider joining a support group for families of hoarders, where you can share experiences and gain insights from others in similar situations.

7. Gradual Decluttering: If she is open to it, suggest starting small. Perhaps you can help her sort through one area or category of items at a time. This can make the process feel less overwhelming and more manageable.

8. Be Patient: Change takes time, especially for someone who may not see their behavior as problematic. Celebrate small victories and remain patient throughout the process.

In conclusion, hoarding can indeed be a sign of underlying mental health issues, and your mother-in-law may benefit from professional support. By approaching the situation with empathy, understanding, and patience, you can help her navigate this challenging behavior while also ensuring her safety and well-being. Remember, it’s essential to take care of your own emotional health as well during this process.

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