Christopher Kellogg first noticed the problem years ago when he was the director of a 138-bed long term elder care facility in Somerset County: it was oddly difficult to keep packs of sugar, wash cloths, coffee stirrers, and pens in stock. It turned out the problem was that the residents had access to as many of these items they wanted, and some of them were stockpiling the stuff as if there was about to be a shortage of coffee stirrers.
“It was extremely challenging,” Kellogg says. Kellogg, who is a licensed social worker and elder care expert, was just beginning to realize the true extent of a psychological disorder known as hoarding.
The disorder has been popularized by reality TV shows such as Hoarders, which shows a team of experts attempting to help people who fill their houses with random junk to the point they become uninhabitable. Occasionally, a case of hoarding makes the news. Kellogg mentions the Collyer Brothers, a pair of New York City residents who filled their Fifth Avenue mansion with 140 tons of furniture, musical instruments, books, newspapers, and other miscellaneous objects.
On March 21 1947, a passerby noticed a strange odor coming from the house and police broke in to find Homer Collyer dead in an alcove surrounded by boxes and newspapers. Police started removing junk from the house and on April 8 they discovered the body of Langley Collyer 10 feet from his brother. He had been crushed by falling trash.
Most cases don’t get that bad, but hoarding can seriously impair people’s lives, and Kellogg says it is especially prevalent among senior citizens. A related disorder is Diogenes Syndrome, a disorder named after an ascetic Greek philosopher, in which sufferers cannot manage their finances, and health, and refuse to accept assistance from other people.
Kellogg will speak at Artis Senior Living of Princeton Junction at 861 Alexander Road, Princeton on Wednesday, October 24 from 9:30 to 10 a.m.. The facility, which houses a memory care unit, opened in January. For more information on the talk, visit www.artismgmt.com, call 69-454-3360, or e-mail firstname.lastname@example.org.
According to a 2013 USA Today report, Hurricane Sandy exposed the hoarding problems of many New Jersey residents. Hoarders hit by the storm had no choice but to allow emergency workers into their homes, and FEMA refused to help clean up their homes until they cleaned up their hoards.
But by the time a hoard attracts the attention of authorities, Kellogg says, it’s already extremely difficult to deal with. Sometimes, when hoarders reach the point of unlivability, well meaning family members stage “interventions” where, in an act of tough love, they cart off the junk themselves, sometimes with the help of friends or church members. Unfortunately, Kellogg says, this is not effective as the hoarder typically replaces the lost items with new junk within a matter of months. Hoarding is a problem of psychology, not one of items, and he says it takes a multifaceted approach to treat it. And it’s much easier to deal with if it’s caught early.
“Hoarding generally begins in a person’s 20s and each decade it gets worse,” he said. “In their 20s it starts to interfere with functioning, in their 30s you have major impairment, and the older you get, the more debilitating it becomes.”
Kellogg grew up in Connecticut where his father was a surveyor and his mother worked in the advertising department of a newspaper. He earned his undergraduate degree at Wesleyan and his master’s specializing in gerontological studies at Boston University. Afterwards, he ran a sub-acute and long term care facility for 18 years. Today he is a consultant with Nightingale NJ Elder Care Navigators, who specializes in helping families make informed decisions about elder care, and also gives educational talks at assisted living facilities.
He says catching hoarding early and dealing with it has a much better chance of success than waiting until it gets extreme. This is much more difficult when the hoarder lives in a home by themselves. It’s possible for a hoarder to hide the problem from their friends and relatives for years simply by not inviting them in. In an apartment health inspectors, building inspectors, and fire inspectors all have more power to get authorities involved earlier on.
Kellogg says different genders and age groups have different patterns of hoarding. Women tend to purchase hoarded items, while men go for freebies as much as they can, he says. Men also sometimes hoard tools. Older generations hoard paper products. A typical conversation between a counsellor and a hoarder might go like this:
“Why do you need to hold on to that receipt?”
“Because I might need to return the hat.”
“Where is the hat?”
“I don’t know where it is right now.”
“That receipt is from 1989 …”
Kellogg says a conversation about a single piece of paper could go on for half an hour or more.
Problems can become exacerbated when a hoarder has to leave their home for an assisted living facility. Downsizing isn’t easy at the best of times, but when there is a hoard of junk to deal with it becomes extremely difficult.
Helping hoarders or sufferers of Diogenes Syndrome overcome the mental illness is a complex process, Kellogg says. Sometimes medication can help. Usually it takes a lot of effort by a lot of professionals to help them improve their lives.
Talking to the hoarder requires a soft touch, often ignoring the elephant in the room — the piles of stuff — until a good rapport is established. When it’s time to talk about the problem, Kellogg recommends avoiding using the word “you” so as to avoid being accusatory.
Sometimes, hoarding is not a psychological illness. Mary Underwood, vice president of memory care for all of Artis’s facilities, says dementia patients often begin hoarding items simply because they cannot remember what they need and what they don’t.
For example, Underwood recently visited a client whose home was full of church bulletins going back years. There was no need to keep them, but she couldn’t remember what day it was, so each of them could have been the current bulletin.
Underwood advises being patient and empathetic in these situations. “Many people feel like I should just go in and just take things out and they’re not going to remember it.” But that’s not always the best approach, she says. “A person with dementia still recognizes their loss of control.”
Instead, Underwood recommends approaching the situation in a way that allows them to retain control: telling them to choose which half of a pile of papers to get rid of.
“So many times in the world of dementia, we take control away from the person. This is giving them some sense of control of their lives.”
And it’s not always necessary to make them throw away unneeded items. She says if the items are not posing a fire hazard or a trip hazard, it’s best to just let them keep their stuff even if it’s not what the caretaker would prefer.
“We need to approach the situation with a lot of empathy,” she says. “We’re so quick to look for a solution for things, but it really takes time to understand why this is happening in order to help.”