Clutter Concerns: Hoarding and Dementia

February 22, 2023

There are many reasons why a person might begin collecting items in their home, but if you notice your loved one developing uncharacteristic hoarding habits, this could signal a much bigger problem. Hoarding is a behavior characterized by the excessive accumulation of objects and difficulty discarding them. It has long been associated with mental health conditions such as obsessive-compulsive disorder and attention deficit hyperactivity disorder. And, hoarding can also be an early indicator of dementia. 

Decision-Making Difficulty

People with dementia may struggle with decision-making and organization. This can lead to hoarding as they try to cope with the changes they may be feeling and experiencing. This likely happens because they cannot remember they already have it. For example, if you do not remember that you have an unopened can of shaving cream under the bathroom sink, there is a good chance you may think you need to buy another can the next time you visit the store. And the following time you stop by the store, you may do it again, after you’ve already asked your partner to add it to their shopping list. And when you’re doing online shopping, you might add yet another can of shaving cream to your cart, because the short-term memory of purchasing all the other cans has already faded from your mind. It is easy to see how this rebuying and saving behavior can spiral very quickly. And, yes, it can become frustrating to care partners as they struggle to understand why a once frugal person has become a compulsive spender. 

Hoarding may lead to financial stress. As people continue to overspend on items they do not need it can slowly drain their finances leading to financial instability and debt. The difficulty in this is that it starts off gradually.  The spent money often isn’t missed until it’s too late and has accumulated into larger amounts of lost money. And because the items they purchase tend to be smaller priced items they often go overlooked—especially when they are masked with other grocery or shopping receipts. 

Digital Clutter

Nowadays our clutter isn’t just limited to the physical world, but may also spill over into our digital world. Our very own marketing communications manager, Clare shared this personal experience about her father who was diagnosed with vascular dementia. “When my tech-savvy father first began struggling with basic computer skills and asked me for help, I was shocked to find his computer desktop a complete mess of pictures and documents that covered the entire screen. He could no longer navigate the digital folder system he’d always used and began saving everything to his desktop so he could find it more easily,” she recalled.  “In retrospect, it was one of the many clues he was unknowingly giving us that something was wrong.” 

Fear of Letting Go

People with dementia tend to become overly attached to certain Items for no apparent reason, even if they are worn out or no longer useful. They can be innocuous items like papers or napkins, or more significant such as clothing, knick-knacks, or other household items.  They may also feel the need to squirrel away certain items because they perceive them to be valuable, or because they believe someone else may steal them. You may notice them picking up small, seemingly meaningless items of little to no value around the house and keeping them stashed away like treasured heirlooms. It’s not uncommon for this to be done with small bits of food from a meal—which caregivers will find weeks later after it has spoiled, molded or rotted inside a drawer or clothes pocket.  

Caregiver Stress

As the disease progresses, hoarding behaviors become more pronounced and potentially harmful to the individual’s health and safety. Insisting they declutter, or worse, secretly taking these items away will only upset them and may negatively affect your caregiver relationship. “What tends to happen is that you’ve tried to solve the problem by arguing and by threatening and by demanding and it hasn’t worked,” said Michael Tompkins, a psychologist, co-director of the San Francisco Bay Area Center for Cognitive Therapy and author of Digging Out: Helping Your Loved One Manage Clutter, Hoarding & Compulsive Acquiring. “And so, the result is the relationships get very damaged, and there’s a lot of resentment and mistrust and hurt feelings.”  

It is important not to shame or criticize people for their behavior. While this behavior makes the living environment messy, and potentially hazardous, it’s important to remember this kind of hoarding is not intentional but is actually a symptom of their dementia.  

Next Steps and Behaviors to Look For

Hoarding behavior can also lead to social isolation, impaired mobility, and increased risk of injury. Hoarders often have difficulty moving around their homes, and the added clutter makes it challenging for caregivers to provide adequate care.  

If you suspect your loved one’s sudden hoarding tendencies, or their unusual departure from organization, is related to dementia, please seek medical advice and support. A healthcare professional can assess the symptoms and provide a more concrete diagnosis, as well as offer guidance on how to manage the new change in behavior. This may include tips on creating a safe and organized living environment, providing reassurance and support, and involving the individual in decision-making. 

Because there is currently no cure for dementia, early detection and intervention can help manage some of the symptoms. Identifying these lesser-known early signs is crucial to making immediate improvements in the quality of life both for the person with dementia and for others who may be living with them. 

It is important to note that not everyone who hoards has or will develop dementia. Nor does everyone with dementia display hoarding behavior. However, if you have noticed a marked increase in collecting things or buying triplicates, it might warrant a discussion with their primary care physician or internist.  

With the right support and understanding, it is possible to take steps to better manage certain behaviors that can help improve the quality of life for those who are living with dementia, as well as their family and caregiving network.