FROM CLUTTER TO HOARDING

What can a person do when they think a loved one has an unhealthy amount of stuff in their living space? A recent LinkedIn discussion on hoarding got me to thinking, What are the issues raised by such a situation? And how can family members disentangle from their own feelings about clutter for long enough to know how to broach the topic, or even whether it is appropriate to say something?

As both a caregivers’ and Elders’ advocate, I can see both perspectives. As the discussion developed, I saw not only how easy it would be, in the heat of the moment, for us to sidestep the issues of an Elder’s individual right to choose, I also saw how very fuzzy the line is for most of us between “normal” clutter and a compulsive health issue.

If a caregiver asked my advice as a caregiver’s coach, I would first ask questions to identify the context of the situation, such as:

• Is your loved one’s behavior diminishing her/his enjoyment of life? Or would (s)he be dismayed at the idea of having their clutter being gone?
• Is the situation, right now, a serious health hazard?

If the caregiver were unsure of whether a health hazard existed, or if the loved one’s clutter was actually providing a healthy comfort, I would tend to think that any intervention would be inappropriate, though an explorative conversation with the Elder might be of help. Before speaking, it would be important to be very clear as to one’s feelings and motivations, and so I would ask the caregiver:

• How much of the “problem” rises from Your discomfort with clutter? What does it mean to you?
• Does some of your discomfort come, perhaps, from seeing your Elder behaving in perhaps an uncharacteristic way? Does it, let’s say, look like “slipping?” Or losing control? (Anyone applying this sort of judging attribution probably won’t be effective in starting a respectful conversation.)
• Are you capable of broaching the topic with your loved one solely out of an intent to support her/him in having the lifestyle (s)he wants? Are you capable of separating your own feelings about it, from your desire to be of service?

The LinkedIn discussion ultimately gave helpful guidance in discerning the difference between “normal” clutter and chronic hoarding. Everyday accumulation of stuff is not to be confused with the mental illness of hoarding. When thinking about a loved one’s propensity for clutter, it pays to know the line between normal clutter and chronic hoarding. Learn more rather than risk overstepping the personal rights of your loved one. Visit The National Study Group on Chronic Disorganization (NSGCD) at www.nsgcd.org where they’ve identified a five-level hoarding scale to help determine a person’s level of need, as well as the level of training required of those seeking to help them. Levels 1 and 2 are degrees of normal clutter. Levels 3-5 represent behaviors ranging from mild compulsion to mental illness to health hazard. These last three levels may require the help of professionals (with the Elder’s agreement) such as professional organizers or mental health professionals. For health hazard situations, if respectful conversation hasn't worked, before calling the health department try to rally the family to stage an intervention.

My advice? Each of us at any age has a right to make our own lifestyle choices, so tread carefully when considering taking action on behalf of a loved one. Talk to your Elder first, then family. Get support for yourself, and ask advice of professionals. But if your loved one is level 1 or 2, with no apparent hazard to their health or well-being, let them be. Each of us has our own standards of neatness and cleanliness. And consider this: creation of clutter and upset about it are rarely about the stuff.