When hoarding becomes a safety issue

Toward the end of her life, the woman had trouble getting down her basement stairs. Mobility was not the problem. All the used Styrofoam take-out containers, paper bags, pickle jars and milk bottles collecting on the landing were.

No use throwing away perfectly fine, but a bit moldy bread, she explained. Those carryout boxes make great bird-feeding trays to place on the grass. And, well, you never know when you'll need a pickle jar, such a fine receptacle for holding flowers or bacon grease. Her adult children would just shake their heads, calling it her Great Depression gene, while silently hoping they too didn't possess such an intense need to hold on to everything that entered their homes.

"It's not a problem if your grandmother collects Styrofoam carryout containers or pickle jars," said Janice L. Obrand, professional organizer and owner of Wheeling-based In Working Order. "But when stuff is piled up and it becomes a safety issue like getting down the stairs to do laundry, that's an issue. When the house becomes unsafe, that's when it becomes a problem."

Clutter accumulates in our homes like dust on dining room tables or snow on sidewalks. No matter what our age, we tend to accumulate and hold onto our stuff. But when does clutter or avid collecting become compulsive hoarding?

The difference is that a collector loves to show off a collection, but it isn't about sharing with a hoarder -- it's about accumulating, Obrand said. "When seniors are saving empty medicine bottles, old mailing boxes, that's hoarding."

Hoarding or saving excessively can be attributed to emotional factors, like saving things after a loved one's death; environmental or situational limitations, such as the inability to get to stores frequently; or psychiatric disorders, such as obsessive compulsive disorders, explained Lance Reinke, a doctor of clinical psychology and a neuro-psychology resident partnering with Central DuPage Hospital in Winfield.

"Compulsive hoarding is a psychiatric disorder that is not that common with the elderly population," Reinke noted. "People with obsessive compulsive disorders use actions to calm anxiety. Most of the time when you're talking to older individuals, they're not aware at all that it's become a problem. People with OCD know it's a problem."

Reinke said when someone begins to save excessively later in life, it might be a sign of larger health problems like dementia, brain injury due to stroke, depression, chronic pain or illness or grief. Stroke damage affecting the right prefrontal cortex of the brain can bring on hoarding behaviors because that part of the brain is connected to OCD or hoarding.

While there's no medication that can effectively eliminate such behavior, there are strategies to help elderly people de-clutter their minds and homes.

"If an older person is focusing too greatly on items from a departed loved one, find ways to keep them occupied in other pursuits," Reinke suggested.

Take time to listen to their stories but also help make them aware that such excessive saving isn't normal.

"It's OK to ask them why they feel they must save all these things," Reinke said. "If they can tell you why they're hiding or hoarding items, if they are aware of their intention, then it's more of a psychiatric problem. If they have trouble articulating, it may be more of a cognitive problem."

A primary physician can help with techniques to refocus an older adult or provide a reference to a psychologist like Reinke.

Living with such excessive clutter and disorganization builds stress. Cleaning up and clearing out is one of the best stress busters for anyone of any age.

"When you have clutter, even having a great day can make you feel anxious. Clutter has a significant psychological impact on our ability to function in our environment," Reinke said. "If an older adult will accept help with clean up, by all means, provide it, so their home can be a place of peace."

That's where folks like Obrand come in. Not a fan of all the organization shows on TV these days -- forcing people to get rid of things they love is just mean, she says -- her mission is to help people have safe homes filled with things they love, can find and can use. Many professional organizers are trained to work with older adults, providing neutral third-party support and strategies for involving them in the clean up. Obrand knows that taking on such a chore isn't easy for anyone.

"Seek help. Don't do this alone. Ask a friend or hire someone," Obrand says. "I tell my clients that June Cleaver didn't keep her house in perfect order. Her prop man did."

Find an organizer

• National Association of Professional Organizers, www.napo.net.

• Janice Obrand, (847) 541-3324 or inworkingorder.com.