Hoarding: An Intractable Problem

by Joan Blumenfeld, MS, LPC

My 85-year-old client, Mike, was a charmer. Even though he was becoming increasingly confused and forgetful, he had a way about him. He was articulate, gracious and a good conversationalist. He had many interesting stories to tell about his family history and his many years curating a world-class museum of Islamic Art.

Mike was attractive, though a little down at the heels in his attire. He carried a bunch of keys on dirty strings around his neck. Some were to the door of his apartment and his mailbox, some for his car, and some which no longer held any recognizable purpose. Mike’s old friends had either passed on or moved away, and his family lived at a great distance. Mike had consequently become seriously isolated.

And worse yet, Mike was a hoarder. He didn’t collect things that had any intrinsic value, like coins or antiques or stamps. Instead, he hoarded old newspapers: The New York Times, The Wall Street Journal, the local town paper. He saved outdated calendars with photos of sports heroes and mountain landscapes and sailing craft.

He collected dozens upon dozens of greeting cards that he thought he might want to send to friends, but somehow never did. There were solicitations from every wildlife organization on the planet; from every Indian reservation in the USA; from local and national charities of every description; not to mention bank statements from years back and, most threatening of all, unpaid bills and import renewal notices of all sorts. In fact, papers were stacked several feet high on every available surface in Mike’s apartment, except for the kitchen and the bathroom.

Mike could not bear to part with one single scrap of paper. He felt an urgent need to keep everything . . . just in case. He thought that one day he might want to read an interesting article he’d overlooked or donate to a charity he’d forgotten about. The very thought of cleaning out his apartment was completely overwhelming, even paralyzing.

Needless to say, Mike’s family members were beside themselves with worry and frustration. It was clear to them that Mike would be safer and altogether better off if he were moved to an assisted-living facility, which would see to his meal preparation, medication compliance and all his driving needs, as well as overseeing the areas where Mike’s confusion and forgetfulness might prove dangerous. But Mike stubbornly refused to move.

It was at this point that the family introduced me to Mike, hoping beyond hope that I could get the place cleaned up, get some help in the house and, ultimately, get Mike to move into a facility. A tall order indeed!

Mike really didn’t want me in his home or in his life at all. He was sure the family had put me up to getting into his apartment so I could sweep it clean of all his treasured papers. Slowly but surely I had to establish a trusting relationship with Mike, so we could talk about how he was living and see if we could find any common ground for improving the quality of his life.

Instead of actually visiting Mike, I made frequent phone contact. We had long chats about the weather, world affairs, politics (on which we luckily agreed) and other areas of interest to Mike. I became his best (and only) phone pal and he generally seemed glad to hear from me.

I visited occasionally with my therapy dog, whom Mike welcomed, and I brought him his favorite chocolate chip cookies. I enticed Mike with a scrapbook of photos taken from the internet: exquisite Iranian tile work, antique carpets from Turkey and tapestries from Iraq, as well as other intriguing tidbits of Middle Eastern art trivia. Eventually Mike let me visit him more regularly and even take him marketing, to the doctor or to his favorite restaurant for dinner.

With Mike’s permission and cooperation, we eventually began to sort through the mountain of papers. Mike allowed me to gather about 30 trash bags full of papers to throw out. But it was a pyrrhic victory. Within a week or two, all those papers were replaced by new ones and more.

We talked about the advantage of having some assistance in his home to help with meal preparation and driving, but Mike steadfastly refused to have anyone intrude on his private, cluttered space. We even visited a couple of assisted-living facilities, one of which he actually liked. But there was no way to get him to commit to a move.

In the end, the family whisked Mike off to visit them in Colorado and never brought him back to Connecticut. They moved him into a lovely assisted-living facility near them. Later I heard that, after a month or two, he settled into his new home and was doing reasonably well; which is probably as good an ending to this tale as one could hope for.

Hoarding is now being classified as a complex mental heath disorder. It’s a condition that seriously impacts the quality of life and safety of the hoarder and has a devastating effect on the family. The best solutions seem to occur in the rare instances when the person who hoards has some insight into the seriousness of the problems and is willing to participate in long-term psychotherapy, combined with appropriate medication.

Pearl of wisdom: Adult Protective Services and Health Departments can be helpful with hoarders. The court can sometimes be involved through the appointment of a conservator. Two excellent books about hoarding are: Stuff: Compulsive Hoarding and the Meaning of Things, by Randy Frost, PhD, and Gail Stekettee, PhD, and Digging Out: Helping Your Loved One Manage Clutter, Hoarding and Compulsive Acquiring, by Michael A. Tompkins, PhD, and Tamara L. Hartl, PhD.

 

Joan Blumenfeld, MS, LPC is a Geriatric Care Manager in private practice in Fairfield County, CT. For information, visit her web at www.joanblumenfeld.com. © Joan Blumenfeld 2012.



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