Living areas stuffed with possessions can uproot senior citizens if they live in senior apartments or need home health or emergency services.
Community services professionals say hoarding may be the consequence of physical limitations on managing personal property or the result of dementia or mental illness. Regardless of the cause, elders may need to seek assistance before space limitations inside the home create a crisis.
Kara Donovan, deputy director at the Niagara County Office for the Aging, said it is not uncommon for community workers to find a problem with accumulated possessions inside seniors’ homes.
“I know hoarding is a huge issue in Niagara County,” she said. “There’s more out there than people realize. Houses that don’t even look like there’s a hoarding issue — then you walk in and you’re shocked.”
“Sometimes it’s due to the disability that an older adult may be facing,” said Kathy Kanaley, social work supervisor for the Center for Elder Law and Justice which serves Erie and Niagara counties. “You can’t be judgmental. We try and find out how they got into these situations. We want to keep people independent in their homes as safely as possible. But part of that is — can they access their kitchen and bathroom?”
The Center for Elder Law and Justice offers a program in which trained volunteers visit seniors to help them develop a personal budget. Some volunteers have had difficulty meeting elders due to hoarding, Kanaley said.
“We’ve had cases through our money management program in Niagara County where there were concerns about the safety of our volunteer going in,” she said. ”We have been in homes where you can’t even walk on the floor. There’s paper and junk, and interspersed with that is clothing. There’s leakage of pipes, water, and mold. You have to walk on your tiptoes.”
Hoarding is defined in the Diagnostic and Statistical Manual of Mental Disorders as “persistent difficulty discarding or parting with possessions, regardless of their actual value. The difficulty is due to a perceived need to save the items, and to the distress associated with discarding them.” The behavior is often triggered by loss and stressful life events.
According to graduate work by Rhonda Dipronio at the Center for Elder Law and Justice, 2% to 6% of the population suffers from hoarding disorder. Hoarding symptoms are almost three times more common in adults over age 55 than in younger age groups.
Years of accumulating things can cause serious problems when an elder is being discharged from the hospital, or when a landlord gets involved, said Helen Ferraro-Zaffram, senior attorney at the Center for Elder Law and Justice. A patient may need to continue physical therapy or receive home nursing care to return to their residence. This may not be possible if there is significant obstruction inside the home.
“If it’s unsafe for those people to go in, they’re not going to get the kind of care they need,” Ferraro-Zaffram said. “Home care comes in to do their assessment and determines it’s unsafe for their professionals to be there. So the client ends up back in the hospital because they can’t get the care.”
A landlord may become concerned about a fire hazard and seek an assessment of the senior’s apartment from code enforcement or the fire department.
Entrapment and injury from collapsing piles of objects can become an emergency that triggers intervention from authorities. The living space can become so cumbersome that the senior remains isolated inside, unable to get assistance.
“No one knows the elder is suffering,” said Darlene DiCarlo, director of the Office for the Aging.
Added deputy director Donovan, “We’ve had case managers get involved and literally clean up peoples’ houses. It was just one of those situations where they (senior) couldn’t do it. They asked for help. It was totally life-changing for them.”
Meghan Lutz, commissioner of the Niagara County Department of Social Services, said if her department receives a report about a senior who may be hoarding, a staff person would reach out to them.
“We would touch base with any friends or family that would perhaps be able to help them with that,” she said. “If someone is just hoarding and collecting things, it’s kind of their choice to do that.”
“It is unsafe when it could cause physical harm to someone,” Lutz said. “The house is deplorable if they are unable to move, they can’t access their toilet, bathtub, sink, or refrigerator. We’re always going to look to communicate with their family and friends to see if they can step in for that kind of situation.”
Ferraro-Zaffram of the Center for Elder Law said some people have accumulated things because a family member has passed away and they were left with personal possessions.
“They never get around to giving things to Goodwill,” she said. “Or, if it’s true hoarding, there’s that attachment. ‘It was Mom’s, so I can’t give it away.’ ”
Adult Protective Services may be involved in an investigation, Lutz said. Social services has partnerships with agencies, including Western New York Independent Living and Pinnacle Community Services, which may be involved. Social services professionals can use standard assessment criteria to determine the severity level of a hoarding problem.
For seniors stuck between a hospital and their unsafe home, professional cleaning services with hazardous materials capabilities may be needed due to mold, leaking products, and animal waste,” Kanaley said.
“It’s not cheap to clean out a hoarder’s home,” she said. “Depending on the situation, it could run into thousands of dollars.”
Seniors needing help can call the Niagara County 24-hour crisis services line at 716-285-3515 or free confidential support and guidance.