Hoarding: A Challenging and Potentially Dangerous Dementia-Related Behavior

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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?” When they were younger, 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 their collecting behaviors intensify as they age, especially if dementia is present. Many individuals with Alzheimer’s disease (AD) tend to experience an increased desire to collect things—even items that are used, broken, dirty or worthless. This behavior is sometimes referred to as hoarding.

Why Dementia Patients May Become Hoarders

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, it is then considered pathological hoarding.

These and other aspects of a person’s pre-dementia personality may be magnified by the disease. A person who was already prone to anxiety may begin to collect and save items to cope with the aging process and the possibility of outliving their resources. As their faculties decrease, these compulsions may intensify further.

These actions often signify a desire for reassurance and security in the face of deep fears and anxiety experienced by many individuals living with Alzheimer’s disease and other related dementias. For example, an elderly woman with AD may begin collecting tissues because they are soft and give her comfort. Her caregiver begins to find tissues stuffed in pockets, purses, furniture, closets and even the bathtub.

Another dementia patient may refuse to throw anything away, resulting in piles of garbage or junk spread throughout their house. 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 often become more and more important to them as a source of control and a misguided connection to reality.

These behaviors may manifest due to insecurity, anger, and confusion that increase as brain function decreases. A person with dementia may even begin to collect things that do not belong to them in order to calm those fears and anxieties.

Sometimes individuals may appear to “hoard” due to confusion about how to handle particular tasks, rather than a simple desire to collect things. For example, a messy accumulation of mail may actually be the result of your loved one losing the mental capacity to sort these items, throw away the junk and process bills and other correspondence. For this same reason, a senior may also stockpile medications because they forget the recommended frequencies and/or dosages.

Ways to Manage Hoarding Behaviors

All of these scenarios pose hazards to dementia patients and even their caregivers. A significant hoard of items piled on floors and stacked on furniture can cause falls and illness. Improper medication management can lead to dangerous over- or under-doses. Unopened mail can result in unpaid bills, lapsed health insurance and shut off utilities. Fortunately, 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. Try to be understanding of their need to exert some sort of control on their life and seek out security. If their hoarding is annoying yet innocuous, such as collecting tissues, it may be best to ride out the behavior. As with many dementia behaviors, this compulsion to collect things may eventually pass.

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 logic and reasoning, you may be able to work with them to thin out their “collection.” If they cannot, then a caregiver may have to take it upon themselves to quietly go through and dispose of hoarded items incrementally and hope that their loved one does not notice. This may seem underhanded, but sometimes caregivers must be a little deceptive and make difficult decisions to safeguard their loved ones’ wellbeing. This is especially important if the hoarding behaviors may jeopardize a senior’s health.

Provide Interesting Activities

AlzOnline suggests that, due to frontal lobe deficits, individuals with dementia 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, sorting beads, etc. These activities should help to redirect their attention and minimize their focus on “collecting.” The time you spend with a loved one will also create valuable memories, which will help sustain you as you make this journey together.

Create Memory Boxes

One technique that has proven successful is creating a memory box: a designated place to keep the “special things” a dementia patient likes to collect. 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 “police” their accumulation. If your loved one enjoys collecting multiple things, you can make a series of boxes to store them. This may take up a great deal of space, but at least it is organized and the mess is contained.

Secure Your Valuables

Unfortunately, when a loved one hoards items indiscriminately, important belongings are bound to get misplaced, sometimes temporarily, and in some cases permanently. To complicate matters further, hoarding behaviors may also be coupled with the tendency to hide things. Lock away anything of value, such as money, credit cards, jewelry or heirlooms. Replacing these things with less expensive replicas can make this process easier on your loved one. This way they can still enjoy their possessions and feel some sense of control without risking losing the real thing. It might be wise to secure certain rooms of the house as well to keep your loved one from relocating or adding to their contents.

Monitor Hiding Places

Find your loved one’s favorite hiding places. These might include drawers, underneath cushions and furniture, and in pockets or closets. Many dementia patients tend to squirrel away their personal belongings or even other people’s possessions in order to keep them “safe.” Conduct a sweep of these hiding places periodically. Be forewarned that many dementia patients consider garbage cans to be prime hiding spots for things, so it may be wise to check the trash before taking it out or begin securing receptacles in the house.

Talk to Your Loved One’s Doctor

Check with your loved one’s physician if you believe their behavior is interfering with their quality of life or endangering their health. Medications such as anti-psychotics and anti-depressants may help 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.

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53 Comments

If you do, I'd like to read that book! I need to laugh, and you're funny.

What's with our parents? I keep thinking, why do I have to clean up their messes? I've been cleaning out their attics, the garage, etc., all my life. But they won't. And can't. And no one else will. So we take loads of stuff to the curb on garbage day when Mom goes to appointments. Then we drive back home. She asks, "Where's my...?" We threw that out, Mom. "How dare you? This is my house! That was my..." Yeah, your broken, burned, old, torn, nasty, ugly... OK, maybe I should wait till she dies. Then it may be more fun. I can toss the stuff with no repercussions. Except, with all that stuff, it could be a fire hazard, and we really need to sell the house. Just walking through some areas is a maze at present, with waist-to-shoulder high piles. And the mice absolutely love it. How can you show a house like that? And how can they live in a house like that?

Mom's TV broke, so she stacked another on top. She won't let me trash the new one, because she said, "I need it for a table." A stuffed animal got burnt by being placed too close to a gas heater, and I threw it away. You'd think I stole a prized possession. I should have kept it for evidence.

The hoarding of food makes me angry. I can't stand the waste. Then it gets freezer burnt or expires. Hoarding is a terrible character defect and longstanding problem with them. The dementia and Alzheimer's just exacerbated it.

Ditto on the margarine containers, and the mail, and the overdue and shut off notices. Don't forget the twisty ties, the aluminum pop tops, rubber bands, empty film containers and pill bottles, and every thing they never use but will never part with because "we just might need it someday." They even save styrafoam packing "peanuts" and bubble wrap and boxes. (Not to pack up anything and throw it away, mind you. Just to save them, "just in case...")

With recycling, every label must be soaked off, and each little item must be placed into the proper receptacle. I'm surprised they recycle anything at all
Oh, i forgot the margarine containers...very important item to put behind the bed...one never knows when one might need that (???). My mom-in-law also saves every bit of mail. When I cleaned out her house, I was throwing away electric bills from the '80's. I even found an electric bill from 1953 (the year I was born...I kept that one!) I organized a lot of her important papers in an expandable file that she never uses....just piles the mail (even junk mail) up on the shelves in her closet. When she missed making a payment on something, gee!, the bill couldn't be found in all the paperwork mess. Then when she asks me to help her find these things, I start at one pile and work to the next....all the while listening to her say," Oh, I wouldn't have put it there!" If I find an object in some weird place, she's always defensive, like "Well, I didn't put it there!" (As if some other family member si sneaking into her room and deliberately moving things...it's never her fault, of course. :/ ) It's hard to throw out stuff in her room because she's always in it! As soon as I try to counsel her on where to put things, that's her moment to advise me that she's going back home to live. Sorry, lady! That ship sailed a long time ago! I swear I should write a book.
Here's another one: all my mom-in-law wants to eat lately is potato salad (no mayo...just potatoes crunched up with boiled eggs...so yukky). For one thing, we have a gas stove and she wears this ridiculous cloth shawl while cooking. She cooks while we aren't home, so I have a terrible fear of her lighting up and the house along with her. Then, she makes this potato "salad" with 2 giant potatoes and two eggs...eats about a handful and leaves the rest on the counter, in a paper towel covered bowl. I come home, put that into a container...never to be touched again till I throw it away. Yesterday I asked her...PLEASE...just make one potato and one egg because the stuff gets thrown away. Naturally she interprets that request negatively...like I'm telling her she can't make potatoes. She pours the pot of water down the drain and does the martyr thing. Oh, and now she should just move home because she feels she's a "burden".............same old Groundhog Day speech that is eternal...."want to move home...gotta move home....a church lady can take care of me at home....maybe I would like to try a nursing home" (!!!!!!). I have to hold myself back from yelling, "OK! LET ME KNOW WHEN THE CHURCH LADY IS ON BOARD AND I'LL HELP YA MOVE!!!!!". She's 96.....will we still be having this conversation 10 years from now??? Oh help me, Lord.

Oh, Anne, I found a Harvest Gold toaster in my Dad's garage from the 70's....along with all 4 Beatles bobblehead figures and massive amounts of tools and parts and things that could not be identified. It wasn't a garage...it was a giant 4 room time capsule. We have been trying to get that house ready to sell for 4 years. Now we missed the "bubble" but it's on the market by April 1 or I will surely go mad.