You may be familiar with the popular television show Hoarders, but there is often a difference between those individuals and people with dementia. If you have dementia, you are likely hoarding things because of the anxiety of understanding that you might lose something.
Hoarding for a person with dementia may be more likely to happen in the early and middle stages of dementia and often stems from trying to have some control in their lives. People with dementia may be driven to search or rummage for something that they believe is missing.
The person with dementia is trying to make sense of their reality and what is happening. By hiding and hoarding things, the person may be trying to have some control of their situation. They may feel they need to stockpile items.
Hoarders also reported significantly less confidence in their memory, more catastrophic assessments of the consequences of forgetting, and a stronger desire to keep possessions in sight. Results provide initial evidence of learning and memory impairment and poor memory confidence in subjects with compulsive hoarding.
Hoarding usually starts around ages 15 to 19. It tends to get worse with age. Hoarding is more common in older adults than in younger adults.
Some researchers believe hoarding can relate to childhood experiences of losing things, not owning things, or people not caring for you. This might include experiences like: Money worries or living in poverty in childhood. Having your belongings taken or thrown away by someone.
These results suggest that hoarders' decisions about possessions are hampered by abnormal activity in brain regions used to identify the emotional significance of things. “They lose the ability to make relative judgments, so the decision becomes absolutely overwhelming and aversive to them,” Tolin says.
Mental health conditions most often associated with hoarding disorder include: Obsessive-compulsive personality disorder (OCPD). Obsessive-compulsive disorder (OCD). Attention-deficit/hyperactivity disorder (ADHD).
Research shows that while many people who are compulsive hoarders have attention deficit disorder (ADHD or ADD), the reverse is not true. People with ADD are not typically hoarders. Nor are they on some kind of disorganization spectrum that ends up in the mental disorder called hoarding.
The initial start of hoarding symptoms is thought to happen in childhood or adolescence (typical onset is around age 16) and it is chronic and progressive.
They cringe at the prospect of being judged as broken, flawed, or inadequate by others. They already believe it is probably true. How could it not be when they tell themselves the very same things? This leaves them in a chronic state of feeling overwhelmed.
Hoarding symptoms appear to be almost three times more common in older adults (ages 55-94 years) compared to younger adults (ages 34–44 years), although hoarding symptoms can occur in young children as well.
What Tolin discovered is that a hoarder has abnormal activation in the insula and anterior cingulate cortex (ACC) of the brain, areas that regulate emotional responses to objects. The insula and ACC tell us whether an object is important to us or not.
This can lead to feelings of helplessness, frustration, anger, and vulnerability among family members. And finally, conflict can arise if family members get so frustrated with the hoarding that they attempt to clean or organize the home, especially if they do this without the individual with HD.
The Mini-Cog test.
A third test, known as the Mini-Cog, takes 2 to 4 minutes to administer and involves asking patients to recall three words after drawing a picture of a clock. If a patient shows no difficulties recalling the words, it is inferred that he or she does not have dementia.
Some of the more common triggers for dementia like a change in environment, having personal space invaded, or being emotionally overwhelmed may be easier to handle if you mentally practice your response before you react.
The five-minute cognitive test (FCT) was designed to capture deficits in five domains of cognitive abilities, including episodic memory, language fluency, time orientation, visuospatial function, and executive function.
Some individuals with hoarding disorder may recognize and acknowledge that they have a problem with accumulating possessions; others may not see a problem.
Conclusions: Hoarding symptoms are associated with increased emotional contagion and decreased cognitive empathy. Empathy may be an avenue for understanding and treating interpersonal difficulties in hoarding disorder.
Don't refer to their possessions as 'junk' or 'rubbish'. This shows that you don't understand their connection to the objects or why they want to keep them. They will be less likely to open up to you if you talk about their things this way. Don't focus on a total clean-up.
Touching Items Without Permission: Hoarders have an unnatural attachment to the things that they have gathered. If a person tries to move the possessions without the hoarder's consent, the hoarder can become emotionally upset or angry.
Selective serotonin reuptake inhibitors (SSRIs) and serotonin/norepinephrine reuptake inhibitors (SNRIs) are most commonly used to treat hoarding disorder. A recent meta-analysis shows that treatment response to pharmacotherapy is similar to the response in obsessive-compulsive disorder (OCD).