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When Karen was a teenager, she remembers her home being cluttered and her mother never throwing anything away. Many items in their house were useless like the six broken toasters gathered on the kitchen counter or the thousands of old magazines piling up in the basement. Fast forward 30 years…the house where Karen grew up is so filthy that she can’t bring her own children over to visit their grandmother.

The popular A&E television show “Hoarders” has raised awareness about the historically hidden problem of senior hoarding that Karen is facing. But often families as well as professionals can still be quite judgmental about it. After all, how hard could it be to discard “trash” accumulating in your house? But it’s not that simple for those suffering from a compulsive hoarding problem. They often don’t view their belongings as “trash.” Overcoming compulsive hoarding can be as difficult as tackling an eating disorder, gambling problem, substance abuse issue or other addiction.

Hoarding can be much more dangerous for an older person than a younger one because of normal age-related changes. For example, because of slowed reflex and reaction time as well as diminished vision, excessive clutter can create serious fall risks. Further, older adults’ diminished taste and olfactory perception can lead to consumption of spoiled food and therefore food poisoning. DSM-5, the psychiatric handbook that recognizes all mental health conditions, recently classified hoarding as a clinical disorder. DSM-5 also indicates hoarding disorder occurs most frequently in the 55-plus population.

So what can you do if your older loved one is struggling with a compulsive hoarding problem?

1. Gain a better understanding of hoarding. If your older loved one truly has a compulsive hoarding problem, you probably don’t view it quite the way he or she does. Books like “Buried in Treasures: Help for Compulsive Acquiring, Saving, and Hoarding (Treatments That Work)” by Tolin, Frost & Steketee or “Digging Out” by Tomplins & Hartl can provide insight into your older loved one’s problem.

2. Share the Institute For Challenging Disorganization Clutter-Hoarding Scale with your older loved one. You can download it for free at This scale categorizes clutter/hoarding problems from levels I (low) to V (severe). It may help for the person hoarding to view the scale and objectively identify how his or her home would be categorized. This may be the first step to encouraging your older loved one to consider the treatments the Institute For Challenging Disorganization recommends.

3. Celebrate small victories. When an older adult who hoards takes small steps toward harm reduction, it is a victory. So often families think that pulling up a truck and hauling stuff out of the house when their loved one is at the hospital or out of town is the answer. But this is absolutely the worst thing you can do. This type of strategy can not only be considered theft but it can be very traumatic for the person who hoards. Slowly but steadily removing items from the home and decreasing the items brought in is a better long-term plan.

4. Call your local county Adult Protective Services (APS). APS investigates abuse and neglect (including self-neglect) of vulnerable older adults. If your older loved one meets the criteria, an APS worker may be able to investigate the situation and offer resources. But keep your expectations in check. Not every elder hoarding situation is appropriate for APS to investigate. Even if APS does investigate, they usually don’t have a quick fix for hoarding.

5. Take action if your older loved one has advanced dementia. While generally an older adult who hoards has to choose to accept help, an advanced dementia diagnosis is often the exception. If your loved one has been diagnosed with advanced Alzheimer’s disease or another irreversible dementia, you may want to seek legal advice. You may be able to obtain power of attorney or even guardianship to ensure your loved one is safe when he or she can no longer make decisions.

Jennifer FitzPatrick, MSW, LCSW-C is the founder of Jenerations Health Education, a gerontology instructor at Johns Hopkins University & an education consultant for the Alzheimer’s Association. For more information go to www.jenera

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