Who are hoarders and clutterers? Television shows like Mission Organization and Hoarders on A&E TV have brought to the forefront this behavior that is often observed but rarely addressed. On a more sobering note, it has opened our eyes to thousands who may find themselves living with fear, isolation, shame and self-neglect. The elderly are particularly at risk due to debilitating mental or physical decline, or a transmission of a pre-existing, underlying mental condition, such as obsessive-compulsive behavior manifesting itself into old age. Is this a problem? For many, their hoarding habits boarder on eccentricity, uniqueness or a Bohemian lifestyle. For others, it is facing eviction notices, visits by social workers, the police, and definitely the resident manager.
Dr. Harry Moody of the Institute for Human Values in Aging, International Longevity Center in New York, says, “Hoarders are refusing to let go of the past.” He posited that our capitalist society of “more is best” contributes to our “collecting our way into immortality.”
Hanging onto our past creates a dead sea— water pours in, but no water flows out. We need to understand the process of holding on, and letting go early. Referring to Erik Erikson’s last two stages of life, Generativity vs. Stagnation, and Integrity vs. Despair, we equate Generativity to generosity, or the giving of ones self (and one’s stuff), and Integrity to the feeling of peace within one’s self after having accomplished what was meaningful in life. Contrarily, we face Stagnation and Despair when, as a result of hoarding, we experience feelings of being “stuck,” resentment, a sense of not having reached our goals in life; at worst, time has run out, as we face mortality in the last life stage. To attain the stage of Generativity and Integrity successfully, we need to be giving and receiving many “thanks” instead.
Interestingly, there is a difference between hoarding and cluttering and collecting. According to Dr. Monika White, President and CEO for Healthy Living, clutter has a disorganized environment. Collections are usually interesting, inherited or things that have order and value.
On the other hand, hoarders usually collect large quantities of the same item, of no evident value, or too much of an item that eventually gets ruined, such as 100 rolls of wet toilet paper or written materials (newspapers, magazines). Hoarders also often express the “my neighbor is trying to poison me” syndrome. The individual is usually single, delusional, paranoid, isolated, suspicious and litigious. Many also suffer from some kind of impairment such as hearing or vision loss. They face eviction by being a nuisance, making false complaints of fumes or radio static, or mistaking entries and theft; yet, there is rarely evidence to warrant official action.
The prevalence of hoarding is unknown because it is a very BIG secret. Doctors, lawyers, anyone can be a hoarder. Between 18 to 42 percent of hoarders are diagnosed with obsessive-compulsive behavior. Twenty percent have dementia, mostly female and single.
White says that hoarding and obsessive-compulsive behavior are partly genetic and partly learned. Hoarders tend to mimic the lifestyle their parents with obsessive-compulsive disorder, have some degree of dementia, past experiences of deprivation, sentimental attachment to items, or a strong need to keep in control. The individual is unable to move on, perpetually living in the past. Hoarders are usually more competent than not, often extremely intelligent and witty.
It’s important that hoarders are protected against discrimination and violation of their rights to self-determination. In order for agencies such as the Adult Protective Services (APS) to intervene, a written psychiatric evaluation that supports a protective order and a judge’s decision must occur first. Further, social workers and other health and welfare professionals must determine that the least restrictive alternatives have been tried, and the individual lacks capacity to the point of endangering him/herself or others because of the hoarding behavior.
If you know someone who struggles with hoarding, document all your concerns, observations and complaints. Keep note of your actions and calls. Establishing a track record is essential from any perspective; legal, social or medical.
Call the following organizations for help:
Hawai‘i Department of Elderly Affairs Division: 768-7700
Honolulu Gerontology Program: 543-8468
Catholic Charities Hawai‘i: 521-4357
Adult Protective Services: 832-5115
Lei Shimizu, MSW, LSW Coordinator Information & Assistance Services, Elderly Affairs Division Department of Community Service City & County of Honolulu