Thursday, June 4, 2009

To Keep or Not to Keep

Writing and keeping up with a blog is hard work. I find more often than not that I'll get an idea, even think about it for a bit, then just never get around to actually writing anything. I've been re-inspired this week, thanks to the daughter of a former client. She and I have had several emails about the blog, and networking, our facebook page, and networking, our website, and networking. But the thing she said that inspired me the most is that she feels the information I provide is easy to understand about practical topics.

Now that I'm inspired to write, what to write about...

...So, I'm going to muse a little bit about the issue of hoarding, because it's on my mind a lot lately, for more than one reason.

I learned a couple of years ago from my childhood best friend (I'll call her Ann) that her mother had become a hoarder. At the same time I also learned from Ann that her mother had been diagnosed with a rare form of cancer, and was not expected to live much longer. As we talked, I learned that Ann's mother, in an effort to control vermin, sprinkled Sevin dust everywhere in her house. Now, Sevin dust is a dangerous pesticide, and according to Ann, it was not possible to go anywhere in the home without coming into contact with Sevin dust, and her mother lived in it. It was no surprise to learn that the type of cancer her mother had has a strong correlation to chemical exposure. While no doctor had suggested the Sevin exposure caused the cancer, Ann, being in health care, firmly believed the exposure caused the cancer.

Around the same time I found out that a former neighbor also had a problem with hoarding. When her son went in and cleared out more than 20 trash bags full of her stuff, she basically disowned him. By her son's report, there wasn't even room on her bed for her to sleep, and her husband had all but left her.

I am currently working with a gentleman with similar issues, and his friends and family are struggling to help him deal with making the decision to move, which means sorting through a lifetime of belongings, and deciding what stays and what goes.

What I know about hoarding is that not enough is known about it. I went to a very informative presentation on hoarding at the American Society on Aging conference in March. The speakers reported that while hoarding has been commonly understood to be related to obsessive compulsive disorder, current research is finding a strong link to depression and dementia. Some researchers now believe that the changes in the brain that come with depression and dementia make it difficult for people to distinguish between "important" stuff and trash, so they just keep it all. Of course this is a major simplification, but it does make sense.

The other thing I learned is that for family to go in and just toss stuff out is often the worst way to deal with the problem, as my neighbor's son found out. Hoarders are often very attached to their stuff, even things that are obviously trash to the rest of us. When all that stuff is gone, the hoarder grieves, and I have heard of instances where psychiatric treatment was required, although that rarely repairs the damage done to the family relationships. We saw a film clip from the movie My Mother's Garden, which is a very poignant documentary about a family's struggle with this problem.

So how do you deal with it? It seems that often the best way to deal with the issue is to use a "good cop/bad cop" type of strategy.

The good cops are family members, friends, mental health professionals and other support systems. The bad cops can be code enforcement, law enforcement or Adult Protective Services (APS). Basically, the bad cops spell out why things need to be cleaned up and what will happen if it doesn't happen. The good cops then provide support, encouragement and assistance to help the hoarder maintain control of the situation while they clean things up. This is certainly a very labor intensive method, as my client's family and support system knows, but it can work.

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