1. Elderly Hoarders: Beyond Reality Television Georgia J. Anetzberger, PhD, ACSW, LISW

2. Definition of Hoarding a pattern of excessively collecting and saving useless things that results in an inability to use living spaces for their intended purpose, interferes with daily functioning, and creates risk for the individual

3. Hoarding vs. Collecting vs. Cluttering

4. Profile of Elderly Hoarders female median age mid-70s unmarried homeowner lives alone socially isolated

5. Hoarder Traits long term behavior lifestyle choice mentally competent indecisive perfectionist avoidance disorganized procrastination sentimental lacking insight

6. Commonly Hoarded Things printed information containers clothing food items from someone’s trash animals

7. Common Hoarding Places living room dining room bedroom hallway bathroom

8. Potential Consequences of Hoarding for Hoarders embarrassment or shame avoiding having others into the home difficulty finding things conflict with family or neighbors over clutter limitations of movement or use of home health or safety risk eviction premature institutionalization

9. Hoarding Truths It often runs in families. It may be associated with certain mental disorders. It may be triggered by a traumatic event. It isn’t common. It’s rarely reported.

10. Local Newspaper Headlines on Elderly Hoarding Loner’s death brings guilt pangs East Cleveland police rescue woman, 85 Woman found in condemned home Woman living without electricity is hurt in fire

11. A Focus on Animal Hoarding Key Statistics 700-2,000 cases per year 46% age 60+ 39 median number of animals

12. Distinct Features of Animal Hoarding more than the usual number of companion animals inability to provide even minimal standards of: nutrition sanitation shelter veterinary care denial of care inadequacies and their consequences

13. Commonly Hoarded Animals (in hierarchal order) cats dogs birds small mammals reptiles horses cattle, goats, or sheep

14. Recent Local Newspaper Articles on Elderly Animal Hoarders Number and Type of Animal 30 miniature Dobermans 20 cats 92 cats 21 cats 30 dogs 18 cats 53 cats 50 cats Age of Hoarder 74 72 74 80 86 64 90 71

15. Types of Animal Hoarders overwhelmed caregiver rescuer/savior breeder-hoarder exploiter-hoarder

16. Those Most Likely to Encounter Animal Hoarding Situations animal control officers adult protective services workers police officers social services workers municipal agency staff others

17. Approaches for Addressing Hoarding public health issue social problem self-neglect situation animal rights concern mental health disorder medical syndrome

18. Barriers to Effective Intervention with Hoarders high hoarding recidivism rate hoarders refusing or restricting entry or help hoarders denying that they or their animals are suffering due to hoarding no single agency responsible for hoarding lack of mandatory reporting of hoarding situations laws protecting residents from being ousted from their homes clutter interfering with service delivery difficulty in getting the public to take hoarding cases seriously

19. Legal Interventions with Hoarding: Various Intents protecting the hoarder  adult protective services  civil commitment  guardianship protecting the public  health, safety, and housing codes preventing cruelty  humane treatment of animals preserving the rights of hoarders  fair housing criminalizing hoarding  no state law

20. Clinical Interventions with Hoarders: What Has Been Found Useful early recognition and introducing alternative behaviors peer support groups service coordination hoarding-specific community task forces partial hospitalization

21. medications behavioral techniques carefully defined successful outcomes use of before and after photos

22. Scales for Assessing Hoarding Hoarding Scale Savings Inventory Revised Savings Cognition Inventory Yale-Brown Compulsive Scale

23. Suggestions for Working with Hoarders use a gentle approach let the person tell her/his own story treat the person with respect and dignity understand the meaning and attachment to possessions remain calm and factual offer specific assistance give the person a sense of control

24. refer for medical and mental health evaluation and other community resources focus first on organizing possessions and very little on discarding them later address more threatening issues be reassuring and go slowly involve the person in seeking solutions work with other agencies and the person’s family and friends maintain realistic expectations about the hoarder’s ability to change