Hoarding and Hiding Behaviors in Dementia
We all have possessions. These are the things we value and that make us feel good. We look after them, admire them and sometimes we collect them - but some people hoard.
When people with dementia or mental health issues were hidden away in large impersonal institutions some had belongings but many did not. Over time their things were lost, stolen or forgotten. Sometimes small mobile objects replaced what they had lost in their previous lives. Pockets or handbags were stuffed with paper, food and tobacco and sometimes even human waste. This amazing article called Abandoned suitcases reveals the private lives of asylum patients and is a poignant glimpse into the possessions of people who lived and died in such hospitals in the last century.
The Need for Possessions
Hoarding or hiding things is comparatively common in people with dementia. To some extent we maintain our identity through personal belongings but in dementia the loss of judgement, increased confusion and memory loss can have marked effects. A simple receipt might be viewed as an important document, a stone as an object of value, a stranger as a close relative. Sometimes the inability to recognise what should be thrown out can cause problems, yet there often remains a need for possessions and keeping them safe. Paranoia may also accompany dementia. Some people with dementia become very suspicious and hide objects that they believe may be stolen by relatives or thieves. This can make getting rid of rubbish very difficult and exacerbate an already difficult situation.
Status offers no protection from dementia, hoarding and hiding. In his later years King Henry VIII of England hid little piles of coins in a variety places because he feared his money was being stolen.
Coping with hoarding or hiding
Because objects that are hoarded or hidden often give the person a sense of security and/or safety it would be cruel and upsetting for caregivers to have them removed.
The golden rule of managing hoarding or hidden property is to leave as much as possible unless it is a health hazard. Lots of clutter can cause falls, be a fire hazard or obstruct light. Older people with dementia often have mobility and vision impairment so the added risk posed by lots of stuff blocking walkways and stairways can be a threat to their health.
Try to get rid of clutter by removing it with the permission of person who is hoarding or hiding things. Use short explanations about the risks they pose. Try and get them to choose what to throw away and what to keep.
Some belongings can be boxed up as an activity in which conversation, tea or food is shared. They can then be stored safely. This may not work if the person then goes through them when you leave, but to minimize their distress it is worth trying.
Any stuff that has to be thrown out should go into the garbage away from the area to prevent it being brought back.
Do not de-clutter too much at a time and involve different members of their family if possible so that they do not associate one person with what can be a very upsetting situation for them.