Discussions of MS symptom management tend to focus on individual symptoms such as spasticity, vision problems, numbness, weakness, cognitive difficulties, impaired balance, etc. Discussions rarely address MS-related problems that exist outside of our bodies, such as social isolation, embarrassment, safety concerns, organizational skills, or overall quality of life.
As the holidays quickly approach, I look around the house and wonder how in the world will I be able to get it "˜ready’ in time for drop-in visits from friends and family. As I’ve shared before, I am reluctant to accept "˜good enough’ and desire to have things clean and orderly, but that’s not always so. One thing that has perpetually stayed on my to-do list is creating an organized, dust-free, and clutter-free home. I recognize that it may be a fantasy in the short term, but one which might be accomplished over time.
Recently I read an article in the International Journal of MS Care that hit home, "Clutter Management for Individuals with Multiple Sclerosis" by Jennifer Tamar Kalina from the MS Care Center of the New York University Langone Medical Center, New York. In the article, Ms. Kalina discusses the clutter management group program which has been offered at their MS Center for over 8 years. She describes in detail how incorporating clutter management interventions into MS care programs can enhance the quality of life and functional independence of people living with the disease.
Clutter has a profound impact on individuals living with chronic diseases such as MS, with detrimental effects on physical, financial, social, emotional, and cognitive functioning. Many common MS symptoms, such as decreased mobility, visual or cognitive impairment, fatigue, and depression, may contribute to clutter accumulation as well. Clutter removal interventions may increase patients’ participation in vocational and leisure activities, social pursuits, and other meaningful occupations.
The program at NYU consists of four steps for managing clutter: 1) make the time, 2) prioritize, 3) set easily accomplishable goals, and 4) reward clutter removal.
Step 1: Make the Time
Finding an hour to remove clutter can be hard, but spending 15 minutes each day is more manageable and can result in significant progress over time. Kalina emphasizes, however, that the 15 minutes devoted to decluttering is in addition to time spent on daily chores around the home. Decluttering time is devoted to special tasks, such as going through a closet and preparing to donate unworn clothing.
Step 2: Prioritize
When dealing with clutter, it is important to introduce changes slowly and in small steps to reduce anxiety and improve the chance of success. The thought of organizing an entire home, or even a room, can be overwhelming and many people give up before they even begin. Prioritizing what is most important can help get the process started and determine where to begin.
Step 3: Set Easily Accomplishable Goals
Although people may be enthusiastic when embarking on a new journey such as decluttering a home, it is critical to focus on slow, incremental change accomplished by setting small, achievable goals. A 3-hour task may take two weeks to complete at 15-min/day, but afterwards it will be easier to move on to the next project. Spending short intervals of time decluttering is more productive and conserves time, patience, and energy.
An initial step to tackling clutter is sorting items, from a limited and manageable area, into one of five categories:
. Trash - damaged items which can no longer be used, sold, or donated.
. Good Homes - items that others may enjoy or benefit from rather than be buried or forgotten in your own home.
. Selling - valuable items that may be sold. But if not sold within a short time period, they should be resorted into another category.
. Storage - functional items that are not used on a regular basis. The container should be labeled clearly and like items grouped together.
. Keeping - functional items used regularly or select items with sentimental value.
When determining how to sort an item, it may be helpful to consider the following questions, while keeping the ultimate goal of a clutter-free, functional space in mind.
. Is the item still functional (not broken)?
. Are you actually going to use the item in the future?
. Will you remember that you own the item?
. Will you know where the item is located?
Do you have the physical space for the item?
If the answer to one or more of these questions is "no," then you should consider how discarding the item may affect your life.
Step 4: Reward Clutter Removal
Clearing an area or a room has natural intrinsic rewards, such as a feeling of accomplishment or pride. However, extrinsic rewards, such as taking a warm bubble bath, getting a manicure, or any other special treat designed to reinforce positive behavior, are valuable to reward success.
In the present study, anecdotal reports indicated that the clutter management intervention program offered by the MS Care Center in New York helped participants reduce clutter at home. The program promoted a more realistic attitude toward "possessions" and helped patients establish a sense of accomplishment in controlling their environment. Participants also reported fewer falls, felling less isolated, increased ease in finding their medications, and a general sense of cognitive clarity in accomplishing activities of daily living. Researchers are developing outcome assessments to objectively measure these effects, as well as the prevalence of clutter within the MS population, for future study.
"Cut Clutter" at Organizedhome.com. (http://organizedhome.com/cut-clutter)
"Get Organized Introduction to Organizing Your Home" by Sarah Aguirre at Housekeeping.about.com. (http://housekeeping.about.com/cs/organizing101)
"20 Tips to Help You Get Rid of Junk" by Paula Spencer Scott at Caring.com. (https://www.caring.com/articles/getting-rid-of-seniors-junk)
Kalina JT. Clutter Management for Individuals with Multiple Sclerosis. Int J MS Care. 2014;16:117-122. DOI: 10.7224/1537-2073.2013-035