March 11, 2022
Reading Time 7 min.

Hoarding Behaviors in Seniors: How to Manage them Better

Hoarding behaviors can be an alarming sign for the elderly. 

We might think that it’s their way of being sentimental. Or it might just be something they do to cope. 

So how do we know if your elders are showing signs of abnormal hoarding behaviors

And what can you do to help manage it? 

Why do elderly people hoard?

According to the American Psychiatric Association, hoarding disorder affects 2.6 percent of the population. 

And it comes with a higher incidence among individuals over 60 years old.

Some keep everything from old newspapers to clothes and furniture. 

Others even hoard animals, which can be dangerous and unsanitary.

Often the reasons for hoarding remain unclear.

Here are some of the more common causes for hoarding behaviors in seniors.

Intense Personal Attachment

Alice has always been passionate about helping the less fortunate. 

In her time, she owned a tailoring business that donated clothes to orphanages. 

It was the least she could do, growing up as an orphan herself. She supported one orphanage close to her home. 

Image from Toronto Star

And over the years, she has helped orphans give good impressions for job interviews and other events. 

She wasn’t lucky enough to start her own family. But the people she helped treated her as a motherly figure in the community. 

Now that she’s 80 years old, she’s living on her own with a caregiver to help her now and then. 

Recently, her visitors have noticed more clothes piling up at one corner of her house. They thought little of it at first. But as they visited more often, the pile seems to grow. 

A friend asked her what she planned to do with it, and she mentioned she was saving it for the orphanage in the area. She just hasn’t sorted it out yet. 

A few months later, there was almost no space to sit in Alice’s house. Her friends volunteered to clean it out for Alice, but she declined. 

She insists on doing it herself.

Stressful Life Events or Traumas

Evelyn has been married to John for 59 years. 

They were a happy couple. John was ‌a good chap, always greeting people on the streets with a smile. 

On their 60th wedding anniversary, John suffered a heart attack and didn’t survive. He left Evelyn the house with their pet dog. 

Evelyn was calm and collected at first. She had nieces and nephews visit often, and she would tell stories of the past. 

One day, while her niece visited, Evelyn started telling the story of her five-year-old daughter, Julia.


It surprised her niece to hear this. She always thought that Evelyn and John never had children. 

Evelyn then stood up from her chair and showed her a room full of dolls, toys, clothes, and other knickknacks she’s been collecting all these years. 

Now that John was gone, Evelyn had a lot of time in her hands. So she started collecting stuff. 

Her niece noticed there was something different from Evelyn that she hadn’t noticed before. 

At 90 years old, she had talked as if John was still in the house. It was subtle at first, but her niece realized ‌Evelyn was talking about a time long passed. 

Now that John was gone, it looks like Evelyn’s mind has taken her back to her youth. And it was specific to the time when they were preparing for Julia’s 6th birthday. 

Looking at the room, Evelyn has been collecting the trinkets for years. Some have collected dust, while the others are still packed in their original boxes. 

This left Evelyn’s niece wondering, how many years has she been storing ‌these things?

Mental Health Conditions

Michael has been struggling with mental health issues since he was younger. 

As a surviving veteran, he’s been diagnosed with PTSD when he returned home from the war. And he found comfort in collecting things. 

He experienced war, so he’s been collecting survival gears for a few years. He even created a bunker in case another war breaks out. 

His wife has been understanding about this. After all, she was a nurse during the war, and that’s how they met. 

But once she took a glimpse of their basement, it was filled to the brim with sleeping bags, extra clothes, tents, and other gear. Some were already broken and torn, but Michael insists that it’s will still be useful. 

Unfortunately, Michael’s wife couldn’t take it anymore. So she filed for divorce. 

Weeks after, a social worker visited Michael’s house. She was surprised to see how messy the whole house was. 

The house was dark and smelled rancid. The dishes were stacked in the kitchen sink. And Michael himself was out of it. 

The social worker asked how he was, and Michael said he was doing "OK". 

What are the 5 stages of hoarding?

Most would think mess and clutter is common. And we get to wonder, at what point does it become hoarding?

Fortunately, the National Study on Compulsive Disorganization created a scale to categorize hoarding levels.

It's helping professionals and their families understand the severity of these hoarding behaviors.

Level 1

This is the least severe level of hoarding. 

Most storage areas in the house are full of things that aren't supposed to be there. 

Closets, cabinets, and bookshelves are filled.

There's only light clutter, and all doorways and staircases are accessible at this stage. 

Level 2

A level 2 hoarder gets anxiety about their hoarded things. And this causes them to avoid visitors. 

And it’s the point where typical hoarding behaviors become obvious.

You can notice the clutter accumulating the walkways. It's also noticeably excessive in one or more rooms.

And some mold can be seen in bathrooms and kitchens.

Level 3

At this level, hoarders usually have very poor hygiene. They also experience emotional distress.

They’re very defensive of their living arrangement when confronted. 

And they often justify their living situation because they can't see the risks in their home.

Other signs you'll notice are narrowed hallways. And possibly as excessive number of pets.

A home area will show light structural damage. Some even have a visible flea or spider infestation.

Level 4

Those who reach this level of hoarding can go weeks without bathing. 

They usually suffer from mental health issues. And they can't see that their situation is unsanitary or dangerous.

Some signs you'll see here are rotting and spoiled food in the kitchen.

Also, there are at least three areas with excessive animal waste.

Mold is noticeable throughout the home. And multiple rooms have become unusable.

Level 5

This is the most severe form of hoarding.

And those suffering from it may not live in their own homes. 

Human and animal waste are frequently in containers that remain around the home.

They also have major fire hazards throughout the home. We often see the walls as broken and crumbling.

And sometimes, there's no electricity or running water due to neglect.

It’s very clear that it causes a lot of problems for the person who has the disorder.

To have a proper diagnosis, a mental health professional does a psychological evaluation.

Here, your loved one might be asked about a habit of buying and saving. 

Pictures and videos of their living environment can also help. 

As part of the interview, they may also ask about other mental health disorders.

They’ll also use the criteria for hoarding disorder, Diagnostic and Statistical Manual of Mental Disorders (DSM-5), from APA.

Risks and diseases caused by hoarding

Hoarding has several risks. 

But the main issue is that it affects mobility. It makes it harder for seniors to move around the house. 

And it's even difficult if they deal with health issues like back problems or arthritis.

It leads to trip-and-fall dangers and fire hazards.

It can also make them unable to locate common and needed items. 

And this can be a big problem if they lose their medication or misplace important medical and household bills. 

For some seniors, it leads to family stress and conflicts. 

According to a 2012 report, hoarding behavior and dementia often co-exist.

Dementia is a general term that describes impaired cognitive functioning. And it affects the brain's learning, memory, and decision-making areas.

Seniors who suffer from it may also have major behavioral changes. 

That's why it's common for them to have angry outbursts at seemingly random times. And this makes caring for them difficult.

If you're experiencing this, here are my tips on how to deal with irrational elderly parents.

Dementia can be caused by several factors. 

But a group of medical diseases, like Alzheimer’s, can also cause it.

So is hoarding an early sign of dementia? More often, it happens in the early and middle stages of dementia.

But it can also occur at any stage.

As it progresses, they can no longer make healthy decisions. Or see the hoarding for what it is. 

And at its worst, they may not recognize friends or family members.

Read more about Alzheimer's disease here.

Treatment for hoarding behaviors in the elderly 

Treating hoarding behaviors can be difficult.

It's because they don't realize the negative effects of hoarding. Or they don't believe they need treatment. 

But there are several ways to treat hoarding in the elderly.

One way is to refer them to therapists or psychiatrists with experience in treating the disorder. 

They'll be able to help by providing cognitive-behavioral therapy. To date, this has been the primary treatment. 

It includes patient education and goal setting. 

They train individuals to focus on organizing behaviors. And they help them in decision-making practices.

They also provide motivational interviewing, so patients get engaged in behavior change.

Professional organizers and private care managers have also helped in some circumstances. 

Check out these videos from professionals helping hoarders clean.

They frequently collaborate with mental health specialists. 

And it's ensuring that they meet the mental health needs while cleaning up the patients’ environment.

For these patients, a long-term partnership with a skilled professional is required. 

And this includes monitoring and regular housekeeping services.

Also, treatment should address any co-existing mental conditions. 

This includes depression, anxiety, ADHD, PTSD, or obsessive-compulsive disorder.

It's also best to talk with their physician about medications that may help enhance the general quality of life. 

Final thoughts 

Hoarding behaviors can have significant affects on the health and safety of older adults.

But what's important is that there are professionals you can always call for help.

And the best way to manage hoarding behaviors is to catch them in their early stages.

That's all for today.

Take care, keep mom safe and have a great day!


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