Addressing hoarding in senior housing: Non-traditional level II fieldwork

Hoarding disorder is the persistent difficulty getting rid of or parting with possessions due to a perceived need to save them despite actual value (American Psychiatric Association, 2013). For an individual with hoarding disorder, attempts to discard possessions create considerable distress (American Psychiatric Association, 2013). Higher rates of hoarding, or hoarding behaviors, are seen in adults aged 61 and older, with up to 15% of individuals in this age group demonstrating hoarding-related behaviors (Ayers et al., 2015). The largest population of hoarders among older adults are individuals who are female, unmarried, and live alone (Kim et al., 2001). Hoarding behaviors may be partly due to executive functioning deficits relating to decision making, categorization, and organization; excessive emotional attachment to possessions; a tendency towards behavioral avoidance; and faulty beliefs about the nature of possessions (Ayers et al., 2015). Hoarding behaviors in older adults can impact—or be impacted by—functional impairments, cognitive deficits, physical conditions, and psychological conditions (Kim et al., 2001). Hoarding behaviors lead to excessive clutter buildup within an individual’s living space, which can result in the inability to sleep in their bed, cook in their kitchen, or sit in their living room, and can directly impact their ability to be safely mobile (Clarke, 2019). Extensive clutter is associated with significant impairments that can interfere with basic hygiene and poses a serious safety threat for elderly clients (Kim et al., 2001). These safety concerns include physically maneuvering in their space, as well as the increased risk of insects, rodents, and fires (Gleason et al., 2021).