Transcript Hoarding - Oncourse

Hoarding
Abby Wagner, Marie Sartori,
Adam Coleman, David Cotterman,
Maryam Noorzad, Lindsey
Gamrat, Morgan Lewis, Aaren
Hampton, Katie York, Liz Farra
What the Research Says...
• "Compulsive hoarding is a progressive
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and chronic condition that begins early in
life."
"Left untreated, its severity increases with
age."
Most compulsive hoarding symptoms
were reported as being in midlife, but
results found most cases began in
childhood or adolescence
(Ayers et al, 2010).
What is Hoarding?
• Two behaviors associated w/ hoarding:
o Excessive collection of items
o Inability to discard or rid these items
• Common items hoarded:
o clothes
o newspapers
o junk mail
o books
o craft items
(International OCD Foundation, 2010)
What is Hoarding?
YES.....
EVEN ANIMALS!!!!
(Mayo Clinic, 2011)
What is Hoarding?
• Debilitating, chronic
disorder
• Disorganized clutter that
creates chaos in homes
leading to:
o Cramped living conditions
o Unsanitary conditions
o Exits being blocked
o Rooms unable to be used
o Difficulty moving around
(International OCD Foundation, 2010)
(Mayo Clinic, 2011)
(Ayers et al, 2010).
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Who Hoards?
Hoarding may be a symptom of OCD, but
many people who hoard do not have other
OCD-related symptoms
Hoarding can affect anyone, regardless of
age, sex or economic status. It's not clear,
though, how common hoarding is.
People who hoard do not see it as a problem
so treatment is difficult
Due to lack of understanding of cause there
is no known prevention
(Mayo Clinic, 2011)
Risk Factors
• Little is understood as to what causes
hoarding but researchers have identified
risk factors:
o Age: usually starts in adolescence and gets
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worse with age
Stressful life events
Family history
Alcohol abuse
Social isolation
• Late onset hoarding may be idiopathic or
secondary to other conditions
Signs and Symptoms
o Cluttered living spaces
o Inability to discard items
o Keeping stacks of newspapers, magazines or junk mail
o Moving items from one pile to another, without discarding anything
o Acquiring unneeded or seemingly useless items, including trash or
napkins from a restaurant
o Difficulty managing daily activities, including procrastination and
trouble making decisions
o Difficulty organizing items
(Mayo Clinic, 2011)
Focus on age at onset:
compulsive hoarding in elderly
• Elderly hoarding can be more difficult to diagnose and is not well
understood
• Study conducted by Ayers et al (2010) interviewed 18 adults over
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age 60
o Asked patients about major life events and to rate their
hoarding symptoms
o Used a number of different tools to conduct structured
interviews, including Mini International Neuropsychotic
Interview (MINI)
Findings: onset actually occurs most often in childhood and
adolescence
o Compulsive hoarding behaviors increased with each decade of
life; it is a progressive, chronic condition
o Only 16% of participants met criteria for OCD, but mood and
anxiety comorbidities were common
 Should be considered a separate disorder from OCD
Implications
Goal is to stick to treatment; sticking to your
goals and treatment plan will ensure the
most probable outcome. Examples
-Keeping up on personal hygiene/bathing
-Proper nutrition
-Compliant with medications
-Living a healthy, enjoyable life
(Mayo Clinic, 2011)
Implications
Reach out to others
-Hoarding lifestyle can cause people to
become isolated and have a sense of
loneliness which in turn can lead to more
hoarding.
Nurses should encourage socialization
-If people are feeling overwhelmed and
don't want people in their house, they
should be encouraged to socialize outside
the house with friends and family.
(Mayo Clinic, 2011)
Current Treatments
• Therapy
o Psychotherapy
 Cognitive Behavior Therapy most commonly
used.
• Medications
o SSRIs
 Paxil
 Not everyone responds to medication
(Mayo Clinic, 2011)
Prognosis
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Initially obtaining treatment may prove difficult in itself
Barriers to treatment may include:
o Hiding symptoms/denial
o Less public awareness of hoarding and OCD
o Lack of training of health professionals (may be
misdiagnosed)
o Difficulty finding a therapist
o Not being able to afford therapy
On average, it takes 14-17 years after the problem
starts for someone with an OCD disorder
to get the right
(International OCD Foundation, 2010)
treatment
Prognosis (cont.)
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Treatment is challenging and often results in mixed
success
Cognitive Behavior Therapy is often most successful
Underlying disorders and potential causes of the hoarding
need to be treated
Ideally, a combination of treatment options tailored to the
specific patient will help them learn to live a normal life and
be a productive member of society
(Mayo Clinic, 2011)
Videoclip
CBS News interview with "Hoarding:Buried Alive" women and a psychologist
https://www.youtube.com/watch?v=RvlHdx7-M6g
Resources
• International OCD Foundation (2010).
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About hoarding. Retrieved from
http://www.ocfoundation.org/hoarding/about.aspx
Mayo Clinic (2011). Hoarding. Retrieved from
http://www.mayoclinic.com/health/hoarding/DS00966
Ayers, C., Saxena, S., Golshan, S., & Wetherell, J.
(2010). Age at onset and clinical features of late life
compulsive hoarding. International Journal Of Geriatric
Psychiatry, 25(2), 142-149. doi:10.1002/gps.2310