By Dr. Nora DeVoe, Ph.D.
Geriatric Care Manager


Older Adult Hoarding: Part 1

Hoarding- estimated to affect about 5% of the population- can be dangerous to anyone, particularly when it spirals out of control. But for certain groups, it can create dire circumstances. In fact, the risks associated with hoarding are more likely to be a serious threat to the health and safety of older adults.

There are a number of potential risks associated with hoarding, some of which seem to be exacerbated by age. The primary problem is that hoarding creates mobility risks- difficulty moving around the residence because of the accumulation of items. Since physical mobility may already be an issue for older adults with health concerns such as arthritis or back problems, hoarding compounds it.

In particular, late life hoarding poses a significant fall risk by creating trip and fall hazards throughout the home. Other risks include fire hazards, poor hygiene and nutrition, and poor sanitary conditions. Hoarding can make it challenging to move around the home, and, therefore, the use of basic facilities can be impeded. Individuals might no longer have easy access to their bathtubs or showers or even to their refrigerators. Hoarding sometimes makes it impossible to open doors or windows, which is when fire hazards become a serious risk. There have been reports of first responders who have not been able to gain easy access to a victim due to hoarding.

Hoarding can also lead to disorganization or an increased likelihood of losing things. For an older adult, this can create a serious issue if they lose medications or misplace important medical and household bills in many piles of belongings they have created. Oftentimes, people with hoarding problems save almost everything, so it becomes quite difficult for them to distinguish items that are important from those that are not. Something as simple as sorting mail becomes an overwhelming task.

To put it simply, hoarding can make the home environment hazardous- even if the individual was once able to manage it just fine. Those piles and piles of newspapers and papers were once easy to step over but now pose a serious threat. It is important to recognize that hoarding can affect men and women of all ages. The trouble with older adults is that the hoarding disorder is exacerbated by issues relating to their age, such as vision, a decline in their energy level, or even the onset of chronic health problems. Whereas they were once able to still function with their hoarding tendencies, their age has now made it increasingly hazardous to their well-being.

People with hoarding disorder excessively save items that others may view as worthless. They have persistent difficulty getting rid of possessions, with distress linked to parting with items. This leads to clutter that disrupts their ability to use their living or work spaces. The cause of hoarding remains unclear. However, genetics, brain functioning, and stressful life events are all being studied as possible causes. It is not a problem that starts when the individual is older. Most people can trace behaviors back as far as childhood or their teenage years. While some experts say it is unclear whether the hoarding habits themselves worsen with age or simply that the individual's ability to cope with the hoarding habits worsens, there is no question that the disorder has a greater impact on older adults.

Research has found that the prevalence of hoarding disorder diagnoses increases linearly by 20% with every 5 years of age. People with hoarding disorder are also likely to experience other mental health disorders including depression, anxiety, obsessive-compulsive disorder, and ADHD, among others.

Next time we will discuss the risk factors that make hoarding behaviors more likely and what possible treatment options there may be.

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Nora DeVoe is a Gerontologist specializing in Eldercare and Caregiver issues. She may be reached at (716) 667-7299.  

Dr. Nora is a ....