The impact of hoarding on older adults

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Hoarding is a multifaceted, complex problem that can stand in the way of accessing needed community home health care, especially for older adults. (File photo)
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By Bennie Blackley

Hoarding is generally defined as the excessive acquisition of large quantities of objects and items that obstruct the living spaces in a home, and the inability or unwillingness to discard the excess objects.  Hoarding is not limited to any age, race, gender or nationality. Hoarding behavior can begin early in life, but it is more prevalent in older adults. The increased prevalence of hoarding by older adults negatively impacts their access to in-home personal care services.

Bennie Blackley

Ms. X is an 80-year-old citizen who has been diagnosed with chronic conditions that impair her ability to take care of her medical needs on her own. After a hospitalization, her physician recommended home health services to provide assistance in her home. Ms. X refuses the recommended home health services. A family member reveals that Ms. X is afraid to allow care providers into the home who may expose Ms. X as a hoarder. 

This scenario is an unfortunate reality for some older adults in the community who need in-home assistance. Hoarding is a multifaceted, complex problem that can be a barrier to access to needed community home health care. Some home health agencies are encountering homes that are too cluttered, too unsanitary, too unsafe or too hoarded to provide assistance to seniors who need help with daily living activities.

Elderly citizens with hoarding behavior present a special challenge regarding in-home personal care service provisions. Hoarded conditions increase the risk of falls and increase the risk of illness due to an unsanitary living environment. Hoarding prevents the use of living space for the intended function. Activities such as cooking, sleeping in a bed, using the bathroom, physical movement, bathing and grooming are difficult for the resident and difficult for caregivers who attempt to provide assistance with these activities. For some older adults, home health services such as physical therapy, occupational therapy or having a home health aide or nurse visit must be delayed or terminated due to hoarding-related, unsafe conditions in the home.     

Hoarding, particularly when it results in safety and health hazards, can be difficult to address and resolve. The City of Alexandria has a multidisciplinary approach to addressing hoarding. The Alexandria Hoarding Task Force is comprised of the following agencies: Code Administration, Adult Protective Services, Child Protective Services, Mental Health Services, City Attorney, Fire Department and Animal Control.

These agencies work collaboratively with citizens to address hoarding and offer professional supports. Hoarding resources are identified and recommended to citizens to assist in resolving safety issues. Resolving home safety issues caused by hoarding reduces risks to citizens and the community and enables older adults who are medically impaired to have access to options for in-home care when needed. 

For more information regarding home safety resources email the Alexandria Hoarding Task Force at hoardingtaskforce@alexandriava.gov or for in-home care information call the Division of Aging and Adult Services at 703.549.5999.

The writer is a Family Services Specialist II in the Alexandria Division of Aging and Adult Services.

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