a cluttered kitchen

When taking care of older family members, it’s natural to be surprised when there is a change in behavior—something in your loved one that you don’t recognize. And even if you’re able to show compassion and understanding when they are forgetful, or can no longer walk on their own, or even become depressed, it can be quite disconcerting or disheartening if all of a sudden you begin to see their homes filled with trash, notice they’ve stopped bathing, or discover they are avoiding care out of a sudden distrust of doctors, caregivers, or even you. However, if you keep a few things in mind, it can make it easier for you as you work towards a solution with family, caregivers, and physicians.


1) Know They’re Not Doing It on Purpose

It’s important to understand that older adults who have begun hoarding and not taking care of themselves are not doing it out of personal choice or rebellion, but may be displaying signs of a condition commonly associated with Alzheimer’s disease and dementia called, Diogenes Syndrome, or Senile Squalor Syndrome.

Signs and symptoms of this syndrome include extreme self-neglect, social withdrawal, domestic squalor, compulsive hoarding, apathy, and lack of shame. They may also become catatonic, exhibit self-imposed isolation, and begin to possess a deep suspicion of doctors and authority figures, which makes them unlikely to seek and follow medical advice.

However, not all hoarding is due to Diogenes syndrome, but can still be rooted in a deeper cause: loneliness, anxiety, and depression can all contribute to the behavior and should be addressed with compassion and care.


2) Understand They May Have Lost Certain Brain Functions

A family member with diagnosed dementia or Alzheimer’s disease may lose their capacity for sequential tasking. For example, they may no longer be able to manage bills and paperwork in the house, and as they are more and more overwhelmed, leave the papers to accumulate.

Some older adults may stockpile medications because they no longer have the ability to remember why they are taking them, and not wanting to seem unable to care for themselves, hide the medication instead of asking about it.

In addition, they may struggle with remembering where to put things, get lost in their homes as they move objects from one place to another, and not remember where things are kept or where they can find them. It is incredibly overwhelming for an older adult with a loss of brain function to keep things in order, and may feel embarrassed to ask for help with something that was once such a simple task.


3) Hoarding May Stem from Grief

Approximately one third of all Diogenes Syndrome cases begin with a close personal loss, triggering the syndrome.  

It’s even more common for those suffering from depression at any age to show more apathy, neglect personal care, or be willing to manage things within their surroundings. If they are not showing signs of paranoia, helping them move past their grief in a loving and caring way, may improve their condition greatly, and hoarding can be avoided.    


4) It Could Be a Senior Form of Obsessive Compulsive Disorder

Some older persons who were diagnosed at an early age with Obsessive-Compulsive Personality Disorder, or OCD, may find an increase in the severity of the disease after the age of 65. If so, compulsive hoarding may be a result.

If this is the case, a psychiatrist can help the family and their older loved one move past the clutter with therapy or medication to gain their freedom from the disorder once more.


5) Being Present and Patient Is the Best Medicine

Whether older family members are in the beginnings of Diogenes syndrome, suffer from OCD, or have become depressed, anxious, or fearful, gentle and loving persistence in getting them to accept care is key. And home care and community care are the most effective in managing the situation over hospitalization.

It is important to note that in the worst cases—where paranoia and distrust have occurred, and where Diogenes syndrome has severely taken hold—loved ones are at an increased risk of death. Know it is not their choice, and that it is a form of suffering. Compassion is indeed key to their safety, happiness, and relationships.


Written by Elise McMullen-Ciotti, staff writer at Hometeam

Disclaimer: You should always check with your doctor or professional healthcare provider before starting or changing any medical treatment. All information provided on The Caregiver Space, including this post, is for general informational purposes only and is not a substitute for professional or medical advice.

Image by Michael Basial, via Flickr

Written by Hometeam
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  1. I believe that people hoard because of some traumatic event that occurred in their life. People criticize the hoarder and say unkind things about them, but there is an underlying reason why a person hoards.

  2. It’s difficult to remain kind and understanding when this behavior can often put those that hoard, and others around them, in physical danger. Not too mention the depression that is so often associated with hoarding. Living like that is not good for anyone’s physical or mental health.

  3. One should always respond with kindness and understanding that you may never understand.

  4. My mother was a hoarder. We used to joke she was only missing the feces and dead mice. When we had to clear away her belongings after a flood, we found the dead mice and, by then, she was just covering the dog’s messes with paper towels. Dementia made her hording worse. But, I’ve done a lot of studying on the subject because I, too, have hoarding tendencies. I recently learned that not only is hoarding triggered from trauma, but can be learned and can be genetic. Yes, you can biologically be predispositioned to be bald and a hoarder! The one thing I can completely understand about my mother (who didn’t hoard trash), her hoarding is echoing in me because we both treasure the memories associated with the pieces. When we touch them, it literally triggers memories that aren’t triggered if they are gone. We are afraid of losing those tactile totems of our memories. Finding ways to capture them may help. I find pictures hollow reminders. Tried it. However, finding someone who loves the item as much as I do, who can have their own memories associated with it can ease the difficulty of letting go. Knowing something is going to help another can also help. The creation of new memories that are positive allows the release of the fear of losing the old ones – at least for me.

  5. Maybe we hoard because living life has made us see that so many things are bound to be taken away that we want to hold on to everything.

    • When collecting gets to the point of risking safety….. time to clean


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