Hoarding Committee

The Council on Elder Abuse Hoarding Committee meets once per month after the main Council on Elder Abuse meeting. Anyone is encouraged to attend to join the conversation about how to provide support and resources to individuals who hoard or collect. 

Information about Hoarding: 

What is Hoarding Disorder?

A diagnosis of Hoarding Disorder requires all three of the following:


1. A person collects and keeps a lot of items, even things that appear useless or of little value to most people.
2. These items clutter the living spaces and keep the person from using the rooms as they were intended.
3. These items cause distress or problems in day-to-day activities.

Clutter


Clutter is defined in the [1] DSM-5 as “a large group of usually unrelated or marginally related objects piled together in a disorganized fashion in spaces designed for other purposes (e.g. tabletops, floor, hallway).” 

While clutter is the most easily visible marker of a hoarding disorder, a home can be cluttered for a wide variety of reasons.  Hoarding disorder is only considered when the clutter results from excessive acquisition and difficulty getting rid of things.

The location of the clutter is also an important factor.  It is common for most people to have cluttered storage areas, such as basements and attics. Instead, HD involves clutter that takes over the living spaces of the home (kitchens, living rooms, bedrooms, hallways, etc.) and keeps them from being usable for everyday living – cooking, eating, relaxing, sleeping, moving freely through the house, etc.

Collecting


In contrast to people with hoarding problems, collectors typically keep their possessions well-organized, and each item differs from other items to form interesting and often valuable groupings. An important purpose of collecting is to display the items to others who appreciate them.  People with hoarding disorder are seldom able to accomplish such goals.


Hoarding disorder differentiates from collecting in that collecting is organized and systematic, despite some collectors having similar quantities of possessions as those with hoarding disorder.  Collecting does not produce the clutter, distress, or impairment that hoarding disorder does. 


Squalor
Squalor (or “severe domestic squalor”) refers to unsanitary conditions in the home. Squalor is most often found in elderly persons who have additional mental challenges, such as dementia. Squalor can sometimes occur as the result of Hoarding Disorder, and sometimes occurs without. With a hoarding disorder, squalor occurs when the items saved include spoiled food and/or when animals are present.  Most often,  squalor results from the neglect of normal cleaning activities.


Subtypes & Related Disorders


Animal Hoarding


Animal hoarding occurs when an individual has a large number of animals but fails to meet the animals’ basic care needs (for example, failing to providing food and water, clean environment, and/or veterinary care).  Animals in hoarding situations often live in poor environments, suffer from malnutrition, severe overcrowding, and/or extremely unsanitary conditions. People who hoard animals often do not recognize the harm they are causing the animals.  They may continue to acquire additional animals and/or strive to maintain their current number of animals despite the animals’ deteriorating health.


Animal hoarding may have similar symptoms to Hoarding Disorder such as:  difficulty discarding, clutter in the home, and squalor conditions may be present. However, animal hoarding results from different processes and responds to different kinds of treatment.


OCD-Based Hoarding


A person may appear to have Hoarding Disorder when really they have obsessive compulsive disorder (OCD).  This can occur when the apparent hoarding behaviors are the result of OCD symptoms. 

Examples: contamination obsessions may prevent someone from touching things that have fallen to the floor, creating clutter in the home.  A person who feels they must check and recheck documents may ignore piles of papers to avoid their checking rituals.


Here are some other differences between saving and clutter due to OCD and Hoarding Disorder:


1. In OCD, the individual does not get any pleasure from saving things. The resulting clutter they find to be unwanted and highly distressing.
2. Individuals with OCD are much less interested in the items they save. They have few sentimental attachments or beliefs about the value/worth of the items themselves.
3. Excessive acquisition of items is rare among those with OCD-based saving and clutter.

Statistics:

 

  • It is estimated that around 2% – 6% of the population suffers from hoarding disorder.
  • Appears to affect men and women at similar rates.
  • Believed to be a universal phenomenon with consistent clinical features in all races, ethnicities, and cultures around the world.
  • Hoarding symptoms appear to be almost three times more common in older adults (ages 55-94 years) compared to younger adults (ages 34–44 years), although hoarding symptoms can occur in young children as well
  • Hoarding symptoms begin to appear early in life and continue throughout the entire lifespan, increasing in severity with each passing decade if untreated:
    • Ages 11–15 — symptoms may first emerge
    • By the mid-20’s — symptoms begin interfering with every day functioning
    • By the mid-30’s — individual demonstrates clinically significant impairment and is likely to meet full criteria for a diagnosis of Hoarding Disorder.
  • Around 75% of individuals who have Hoarding Disorder  have a co-occurring mental health condition.

Symptoms and Behavior


• Inability to throw away possessions.
• Severe anxiety when attempting to discard items.
• Great difficulty categorizing or organizing possessions.
• Indecision about what to keep or where to put things.
• Distress, such as feeling overwhelmed or embarrassed by possessions.
• Suspicion of other people touching items.
• Obsessive thoughts and actions: fear of running out of an item or of needing it in
        the future; checking the trash for accidentally discarded objects.
• Functional impairments, including loss of living space, social isolation, family or
        marital discord, financial difficulties, health hazards.