Clutter
& Hoarding Addiction
Pathways
to improving health
Recognizing and Responding to Clutter Addiction and Compulsive Hoarding in Older Adults
Wednesday, February 24, 2010
8:30 AM to 4:40 PM
Many older adults acquire excessive amounts of seemingly useless items, then have trouble letting go of them. When does collecting turn into pathological hoarding? What can be done when an older person lives amongst so much stuff that it interferes with activities of daily living and creates a safety hazard? Many older hoarders are reluctant to accept help as well as not ready for behavior change. How do we help the older clutter addict face their fear, guilt, shame and denial? How do we deal with the complex issues presented by older hoarders with dementia? Presenters will discuss the prevalence and demographics of hoarding as well as the latest research findings on hoarding and elders. Specific intervention and treatment strategies will be shared.
Participants will be able to:
- Discuss the prevalence and demographics of hoarding behavior.
- Recognize clinical issues and symptoms associated with hoarding behavior.
- Identify intervention strategies designed to treat hoarding in older adults.
Morning Plenary Session 8:30 AM to Noon
Moderator
Patrick Arbore, EdD, Director,
Center for Elderly Suicide Prevention and Grief-Related Services, Institute
on Aging
Keynote Speaker
Emily B. Saltz, LICSW, CMC,
Director, Elder Resources, Newton MA
Hidden World of Hoarders
This presentation will provide an overview of hoarding behavior in the older population. Ms. Saltz will discuss the prevalence and demographics of hoarding and will present the latest research findings on hoarding and elders. Also included will be a discussion of the clinical issues and symptoms associated with hoarding behavior, including the relationship between hoarding and dementia, and specific intervention and treatment strategies. Case studies will be used to illustrate the complex ethical dilemmas that arise in serving this "hidden" population.
Panelists
Interventions and Treatment for Hoarding Behaviors: What Are They, For Whom Do They Work, and When Should They be Utilized?
Monika Eckfield, RN, MSN, PhD
Candidate, Hartford Center of Geriatric Nursing Excellence, University
of California, San Francisco
Research on what treatments work best when working with older adults with hoarding and cluttering behaviors is scarce. However three approaches, Cognitive Behavioral Therapy, Motivational Interviewing, and Harm Reduction all show promise for improving the living situations of older adults. In this presentation, Ms. Eckfield will give an overview of these techniques, when they are appropriate to use, who is in the best position to implement them, and which consumers are most likely to benefit from them.
Interview with Catherine Kritzer, Recovering Hoarder and Consumer
Afternoon Workshops 12:45 to 2:15 PM
1A. First-Hand Accounts: Insights from Interviews with Older Adults Who Have Hoarding and Cluttering Behaviors
Monika Eckfield, RN, MSN, PhD Candidate, Hartford Center for Geriatric Nursing Excellence, University of California, San Francisco
"I've crowded myself out" is the way one 80 year old woman described living in her severely cluttered apartment. In this workshop you will hear about the experiences of older adults from their perspective. Based on a groundbreaking qualitative study in which 20+ adults age 65 and older were interviewed, this workshop will give health and social service providers new insights into the lives of their clients. New ideas about interventions, including how to integrate cognitive behavioral therapy, motivational interviewing, and harm reduction techniques, will be discussed.
Participants will be able to:
- Identify two ways that older adults say that hoarding and cluttering behaviors form a barrier to living the way they want to live.
- Describe two ways in which they may be able to help older adults make their homes more livable.
- Describe key words or phrases to listen for that may indicate the individual's readiness for various interventions.
2A. Coordinated Community Response to Hoarding: Collaborative Efforts Produce the Most Effective Intervention
Catherine Kritzer, Recovering Hoarder and Consumer; Carol Lucchese, MS, Social Worker, Adult Services, Marin County Department of Health Human Services; Captain Cindy Machado, Animal Services Director, Marin Humane Society; Alexandra Matthews, PhD, Psychologist in Private Practice; Joanne Merjano, BSN, RN, PHN, Adult Protective Services and In Home Supportive Services, Adult Services, Marin County Department of Health and Human Services; Gail Mosconi, LCSW, Shelter Plus Care Coordinator, Marin Housing Authority; Sue Zee Poinsett, MA, Professional Organizer; Mark Vanderscoff, Deputy Public Guardian, Public Guardian's Office, Marin County; all members of The Hoarding Alliance of Marin
The Hoarding Alliance of Marin will present a panel discussion with various community members and providers to demonstrate how a community can come together to address the issue of hoarding and cluttering. We will discuss the formulation of our Alliance, procedures and responses we are developing and the importance of including a variety of people for the most effective response.
Participants will be able to:
- Learn how to set up a task force in your community, identify prospective members and develop goals, procedures and resources.
- Understand the basic components of hoarding and most effective approaches to treatment.
- Identify effective ways to collaborate with other providers for the best outcome.
3A. Muddy Waters: How APS Navigates Safety and Ethical Issues with Older Clients Who Hoard and Clutter
Cindy E. Bircher Rasmussen, LCSW, Supervisor, Adult Protective Services, San Francisco City and County Department of Aging and Adult Services;
Erika Falk, PsyD, Director, Geriatric Assessment and Psychological Services, Institute on Aging
Participants will learn about the intersection of Adult Protective Services (APS's) mandate with clients who have hoarding and cluttering behaviors. Several case studies will illustrate how APS's understanding of and strategies for dealing with the problem has evolved by describing both successful and less successful outcomes. APS's evolving framework for conceptualizing and responding to cases will be discussed. Emphasis will be placed on how APS works toward compassionate responses that generate options for the client while keeping an eye to safety hazards. Situations requiring neuropsychological evaluations and possible conservatorships will be illustrated through case examples.
Participants will be able to:
- Better understand APS's role and interventions with clients who hoard and clutter.
- Have heightened awareness of depression and other mental health issues affecting hoarding and cluttering behaviors.
- Understand when a neuropsychological evaluation may be needed and how it works.
Afternoon Workshops 2:30 to 4:00 PM
1B. A Closer Look at Hoarding Behavior
Patrick Arbore, EdD, Director for Elderly Suicide Prevention and Grief-Related
Services, Institute on Aging
In this workshop, participants will have the opportunity to view a film entitled "Packrat", which is an informative video that will help us identify and better understand hoarding behavior. Not only does the clutter take a toll on the individual hoarder but this addictive behavior also affects family members, community members and professionals as well. For some reason, hoarding behavior elicits intense feelings on the part of others. What professionals should and should not do will be addressed. Communication skills will be identified to help professionals address the underlying feelings of guilt and shame that be part of the hiding behavior of older hoarders and clutter addicts.
Participants will be able to:
- Learn communication skills to open up conversation about hoarding.
- Understand how hoarding affects family members.
- Learn to focus on ways to support the hoarder to change their behavior.
2B. Clinical Supervision Workshop: Share Your Most Difficult Hoarding Cases
Emily B. Saltz, LICSW, CMC, Director, Elder Resources, Newton, MA
Emily Saltz will facilitate a group supervision session on hoarding. Bring your "worst case scenarios" and get advice from your colleagues. Learn which intervention strategies have worked (and which have not!). Get support from your peers in what promises to be a lively and informative group discussion.
Participants will be able to:
- Share clinical strategies for dealing with complex hoarding cases.
- Learn valuable resources for dealing with elders who hoard.
- Get professional coaching to resolve difficult clinical issues related to hoarding.
3B. Animal Hoarding - The Unfortunate Reality
Captain Cindy Machado, Animal Services Director, Marin Humane Society
The world of animal hoarding is often misunderstood and brings with it many extreme challenges, especially for older adults. Intervention can often be difficult. At what point are too many animals too many? This workshop will give participants an overview of the problem and solutions to help solve these dilemmas.
Participants will be able to:
- Identify a potential animal hoarder.
- Identify common problems with animal hoarders.
- Determine enforcement solutions and community strategies for animal hoarders.
4:10 to 4:40 PM Closing Session
Facilitator
Patrick Arbore, EdD, Director, Center
for Elderly Suicide Prevention and Grief-Related Services, Institute on
Aging
Mind, Body, Spirit: Pathways to Improving Health
