Elderly Hoarders: Intervention Strategies
Have you noticed that an elderly loved one is living in an extremely cluttered, unsanitary environment? Have you watched as his once merely disorganized home has become downright unsafe? Perhaps you've decided that an intervention is necessary in order to protect your loved one from injury, illness or social isolation. It's time to take action, but how?
Is it time to intervene?
As a family member, you might be anxious to jump in and start tackling the clean-up project at hand. However, without recognizing that the hoarding problem is both a health/safety issue as well as a mental health issue, a well intentioned family member can quickly become frustrated or even make the situation worse.
Geriatric Care Managers and Mental Health Professionals specializing in geriatric care can be invaluable in helping a family adequately assess the situation.
These professionals can assist in the following key areas:
Obtain requisite assessments: general physical, mental evaluation including mental capacity survey.
Help family members build a positive and trusting relationship with the hoarder.
Provide treatment for any underlying conditions such as depression, obsessive/compulsive disorder, psychosis.
Eliminate immediate safety risks in the home before aggressively treating the hoarding behavior.
Work with community agencies like adult protective services, elder care service companies to develop a coordinated response to the problem.
After completing a full evaluation, a geriatric professional may assign a capacity/risk category to your loved one in order to determine whether intervention is necessary and to what degree. A person's capacity is defined as his ability to understand the consequences of his/her actions or inaction. Risk refers to the likelihood of harm, injury or loss within the individual's circumstances. For example, if the geriatric professional determines that your loved one is in a High Risk situation but possesses High Capacity, he will likely recommend no intervention and support the client's right to self determination. This may be very difficult for family members to accept when they are sincerely concerned with a loved one's living conditions. Conversely, in a High Risk/Low Capacity situation, aggressive intervention will be recommended, including legal guardianship, if necessary to protect the individual.
While several different treatment options exist, there is no easy solution to the problem, no "silver bullet". Traditional treatment approaches may include medication, cognitive behavioral therapy and harm reduction strategies. The cognitive therapy involves working with the individual to improve decision making skills and to develop strategies to categorize and sort items according to need and priority. This approach requires sustained effort and acceptance by the hoarder. The harm reduction approach is less aggressive and emphasizes helping the hoarder to live more safely rather than stopping the hoarding behavior altogether. Research indicates that traditional methods have limited success with older hoarders whose denial of the situation poses a real barrier to effective treatment.
Which tactics are most successful?
Dealing with a family member with a hoarding problem can be incredibly difficult and frustrating for the average person. Successful intervention depends on careful assessment and planning prior to any action.
Geriatric professionals recommend the following guidelines when considering intervention:
Say "no" to quick fix strategies. Recognize that hoarding behavior develops over long periods of time and can not be resolved overnight. Keep expectations realistic and in check.
Success depends on trust. Efforts should be focused on building positive, trusting relationships with the hoarder. He/she must believe that you are there to help and not to simply take away their things.
Empathy is key. Hoarders are typically sensitive and prone to feeling "judged". Trying to see their belongings through their eyes is essential for cooperation.
Set specific, achievable goals. Encourage your loved one to help set the goals by offering choices. Maintaining a sense of control over the situation is of paramount importance to the hoarder. Setting immediate and short term goals to address a particular crisis like potential eviction is a good start. Longer term goals can be set after the initial goal is met.
Recognize negative feelings and your limitations. Perhaps the sights, smells and scale of the project is just too much for you to handle. Your feelings and emotions could get in the way of your effectiveness. Recognize your limitations and recruit someone else to help.
Surprises are not fun to a hoarder. Professionals do NOT recommend removing belongings without the hoarder being present. Forced or surprise clean-outs can be traumatic and cause a set back in progress.
Don't go it alone. Hoarding is a complex mental and health crisis. Dealing with it calls for a team of professionals working together to address an intractable problem. Mental health professionals, physician, adult protective services, fire prevention and building safety professionals, and home care agencies may all play a role in getting a difficult situation under control. Ask for help.
If the challenges of family and career are making life overwhelming and difficult to care for a loved one in need of assistance, we can help. Today’s families have very busy lifestyles so many times family members want to help and in many cases try to help but generally it is only a matter of time before it all becomes overwhelming trying to juggle too many tasks at one time. For most just knowing that companies like ours are here when you need support and an extra set of caring hands make the process less stressful and smooth.
Should a loved one need help, call us today 770-442-8664!
Easy Living Services, Inc.
Providing Home Care to Atlanta families since 1994