Hoarding workshop set at St. Vincent College
You can debate whether most reality television has any positive effects, but geriatric/psychiatric nurse Linda Shumaker says a show like A&E's “Hoarders” can be a useful teaching tool.
“I haven't seen it, but I see it as a positive, because it's brought the issue of hoarding into the public forefront,” says the Harrisburg resident who does private consulting through her firm, Optimize Aging.
“When I speak, I ask who's seen the show, and all hands go up,” she says. “That's a positive. The more knowledge there is out there, the more people are seeking help, and that means more money for research and more funding for medications and therapy.
“It's fascinating how things have moved forward in the past five years, and I do credit the hoarding show for that.”
Hoarding disorder was recognized as a separate diagnosis in the Diagnostic and Statistical Manual of Mental Disorders 5, published in 2013. Criteria for all forms of officially recognized mental illness listed in the guide are defined by the American Psychiatric Association, widely recognized as the authority of record on mental health issues in the United States.
Prior to that, hoarding was considered to be a feature of obsessive-compulsive personality disorder.
Shumaker will be at St. Vincent College on March 29 to discuss hoarding behaviors, demographics, assessments and interventions during a program organized through the Indiana County Link to Aging and Disability Resources.
A morning session will provide continuing education credits to professionals, while an afternoon session will be open to members of the public.
While Shumaker's practice addresses many issues related to the elderly, she is especially interested in ethical and social policy issues related to the care of those with behavioral health problems.
“The important thing to remember about hoarding is that it's not easily treated,” she says. “And even when it's treated, it's still there. It's an ongoing issue.
“You see people who are being treated but still hoard, and people who are high-functioning out in the community but still hoard. It's hard to understand that there's an emotional attachment to these items, even if it looks like trash to us,” Shumaker says
The Institute for Challenging Disorganization, a nonprofit educational organization that assists people challenged by chronic disorganization, offers a five-level Clutter-Hoarding Scale to explain the progression of the disorder.
At Level I, all areas of a home are accessible, safe and clean; there is no excessive clutter or number of pets, and no evidence of rodents or insects. As the scale progresses, the increasing number of possessions and pets lead to diminished accessibility and use of the home, along with problems of safety and sanitation.
At Level V, rooms, plumbing and appliances cannot be used for their intended purposes, or even accessed, due to clutter. Vermin, human waste, rotting food, mold and mildew generally will be present.
“Psychiatrists unfortunately often end up just prescribing antidepressants (to treat hoarders), when what's more beneficial is an interventionist coming into the home to develop a relationship,” Shumaker says.
Building trust is a major issue in helping a hoarder let go of possessions, says Vickie Dellaquila, owner of North Hills-based Organization Rules Inc., whose services include help with residential organizing, senior downsizing, chronic disorganization and hoarding. Dellaquila is certified through the Institute for Challenging Disorganization in assisting hoarders.
Generally, the hoarder isn't the one to seek help, Dellaquila says.
“We're usually contacted by a loved one, like an adult child or a spouse,” she says. “Sometimes a therapist or agency is contacted to make sure a person is OK.”
It's a giant step in the right direction when a hoarder even allows an interventionist into the home to make an assessment, she says.
“These are people who have trouble letting go to begin with; it's a big thing to let someone into their home,” she says. “For them to trust us takes time. We're not therapists, we try to ask open-ended questions and tell them they're very brave for opening up to us.”
Hoarding is not a function of gender or income level, Dellaquila says: “You'll find it in men and women, younger and older, very wealthy people and people who have next to nothing otherwise. They're often people who have had collections when they were younger, and then a traumatic life event triggers hoarding.
“A death, divorce or depression exacerbates it. Often it gets to the point where people are ashamed of the state of their homes. They won't let people in. They know they need help but are ashamed to ask for it.”
Author Eve Schaub explored her own hoarding tendencies while cleaning out what was called the “hell room” in her family's Vermont home. She documented the process in “Year of No Clutter: A Memoir,” published March 7 by Sourcebooks.
The family's hoard built up over almost two decades but was confined to one 567-square-foot upstairs room.
“I found out more and more that most people have some kind of hoard, even if it's just a junk drawer, a closet or a room,” Schaub says. “My house is not the kind of house where you can eat off the floor, but it's not a typical hoarding house, either.
“Through the process, I was thinking about clutter and what it means and why we keep things,” Schaub says. “I think a lot of it is about fear.”
As an illustration, Schaub says there was never an item out of place in her “neatnik” grandmother's home but, after her death when family members looked through the house, they found a closet packed with canned and packaged foods.
“She was a child of the Depression, so obviously she was afraid of being hungry. Her hoarding had to do with a fear of deprivation. I've been diagnosed with OCD — my thoughts bounce around and around in my brain and I can't let them go. In my case, I'm terrified of forgetting my family history.
“I came to realize that decluttering isn't something you do, and then you're done,” Schaub says. “It's a lifestyle. You have to practice it over and over, by getting rid of things day by day, not putting something away so you don't have to deal with it. It's like exercising a muscle that has atrophied.
“I was struggling with thinking, ‘How will I know when I'm done?' One day I was looking for my girls and I called out, ‘Where are you?' They called back, ‘We're in the art room!'
“That was the original purpose for that room. That was the moment when I realized we'd achieved our goal,” she says. “But at the end, I say Martha Stewart wouldn't be impressed. There are still boxes piled up and family photos to organize.”
“(Hoarding is) not something that's really cured,” Dellaquila says. “It's managed. Some people want help and do great initially but still have some backsliding. It helps if they continue to see a therapist.
“If you have heart disease, you have to manage it. If you have a mental health issue, you have to manage it. You have to work on your triggers to keep it at bay.”
Shirley McMarlin is a Tribune-Review staff writer. Reach her at 724-836-5750 or firstname.lastname@example.org.