How to Handle Hoarding Behaviors in Dementia Patients
By Aprill Jones
Has your loved one always been a bit of a pack rat, or someone who believed in "saving for a rainy day" or "waste not want not?" Or, as younger versions of themselves, did they like to collect things, such as dolls, coins, and other items considered valuable and worth accumulating? If so, you could start to see the "collector" element of their personality reach an extreme as they age. Many individuals with Alzheimer's disease tend to experience an increased tendency to collect things; even items that are used, broken, dirty or of no value. This behavior is sometimes referred to as hoarding.
For example, an elderly woman with Alzheimer's may like to collect tissues because they are soft. Her caregiver begins to find tissues stuffed in pockets, purses, couches, closets and even the bathtub. Another person may collect twist-ties from bread bags. And yet another may refuse to throw anything away, resulting in piles of garbage or junk spread throughout their house. This clutter is a dangerous hazard that could easily be tripped over.
Compulsive hoarding is a psychological disorder often seen in individuals with obsessive-compulsive personality disorder or tendencies. If these behaviors begin to interfere with everyday activities and life, it is then considered pathological hoarding.
When Collectors Become Hoarders
Certain aspects of a person's pre-dementia personality may be magnified by the disease. A person who was already prone to experiencing anxiety may begin to collect and save items to cope with the aging process and the possibility of outliving their resources. Adding a neurodegenerative disease to the mix may compound these behaviors even further.
These actions often signify a desire for comfort and security in the face of deep fears and anxiety experienced by many dementia patients.
Others will hold onto items because they fear their memories will be lost without tangible evidence of the past. As dementia patients lose track of what is happening in the present, those items could become more and more important to them.
These behaviors may manifest due to insecurity, anger, and confusion that increase as brain function decreases. Additionally, a person with dementia may begin to collect things that do not belong to them in order to calm those fears and anxieties.
Confusion Can Cause Hoarding
Sometimes individuals with dementia hoard due to confusion about how to handle a particular situation, rather than a simple desire to collect things.
For example, what looks like a messy pile of mail may be the result of your loved one losing the capacity mental for sequential tasking. It is important for a family member or caregiver to sit with them and go through those stacks to avoid missing important notices and letting bills go unpaid. They may need assistance with the process of looking at bills, writing the corresponding checks and getting them mailed.
A senior may also stockpile medications because they forget why they are taking them, or don't remember the recommended frequency and/or dosage. Rather than asking for help, they hide the medication away somewhere out of embarrassment.
Ways to Stop Your Senior Parent's Hoarding
When an elderly parent is exhibiting hoarding behaviors due to Alzheimer's or dementia, there are some techniques that you can use to try to manage them.
Be Kind and Gentle
Do not use harsh language, keep your tone positive and try to be patient. Remember, your loved one is not doing any of this on purpose. Their actions are cause by the decreased functionality of their brain.
When appropriate, you can try to reason and talk through selecting items to dispose of and give away. If your loved one is still at a stage in the disease where they can appreciate logical reasoning, they may be able to give up much of what they have collected.
Provide Interesting Activities
AlzOnline suggests that, due to frontal lobe deficits, your loved one may need more intensive, interesting and distracting activities to help curb their compulsive habit. This could include tasks like organizing a drawer, labeling old photographs, etc. The time you spend with a loved one will also create valuable memories, which will help sustain you as you make this journey together.
Memory Box Technique
One technique that has proven successful is creating a memory box: a special place to keep "special things." Pick out and decorate the box together and store it in the same place all the time. If your loved one likes to collect bread ties, for instance, they can keep them in the box and you'll be able to periodically "police" the box as those items accumulate. Important items such as eyeglasses, wallets, etc. can be labeled and put in the box for safekeeping, and as a method to help keep track of these important items. When your loved comes to you looking for a personal belonging, you can help them by saying, "Why don't you take a look in your box?"
Secure Your Valuables
Lock away anything of value to you, such as money or jewelry and secure certain rooms of the house to keep your loved one out.
Monitor Hiding Places
Find your loved one's favorite hiding places. These might include drawers, underneath cushions and beds, and in pockets or closets. Many dementia patients tend to squirrel away their personal belongings or other people's possessions in order to keep them "safe." Check these hiding places periodically. Also be sure to check the trash before taking it out.
Talk to Your Doctor
Check with your loved one's doctor if you believe their behavior is interfering with their daily life. Medications such as anti-psychotics and anti-depressants may keep anxiety and compulsions at bay.
Although it is challenging at times, losing your temper or demanding change will not help mitigate these behaviors. Patience, creative thinking, and a sense of humor are crucial for interacting with a loved one who has dementia.