Seniors who have hoarding disorders (HDs) or excessive amounts of clutter in their homes often face barriers when trying to access home care services. In a new report, the Senate Aging Committee highlighted instances across the United States where aging service providers encountered challenges caring for older adults who hoard or who have messy homes.
“As Americans grow older, the disproportionate prevalence of HD among older adults has national implications,” the committee wrote in its report. “The number of older adults in the United States is expected to increase from roughly 54 million in 2019 to over 94 million in 2060. Because HD disproportionately impacts older adults, experts worry that aging ‘could fuel a rise in hoarding in the coming decades.’”
The report included dozens of letters from senior care stakeholders highlighting the challenges that accompany hoarding disorders. These letters were in response to a request for information that aimed to better understand the impact of hoarding disorder on local communities. Nonprofits, social services organizations, state and local governments and other organizations were encouraged to offer feedback.
A common thread among many responses was that seniors with too much clutter in their homes can have a hard time finding a home care provider. Oftentimes, providers will decline to offer care due to the safety risks posed by mold, infestation or dangerous objects, one letter pointed out.
“Hoarding is often only one of the issues the adult is experiencing, and the hoarding can be a barrier for the adult to access other services,” Emily Bremer-Thomas, an adult and aging supervisor from Virginia, wrote in one letter to the Senate Aging Committee. “For instance, it can be difficult to find a home health agency or skilled services provider such as physical therapy to agree to come into the home. Additionally, it increases the isolation of older adults because they do not want other people to come into their home and see the hoarding.”
Another letter pointed out that, while it is important for seniors to receive care in a safe, clean environment, clearing out excessive clutter in a client’s house can be a costly task.
“Our agency provides services in the home to help individuals age in place,” Milene Maurin, an aging care management professional working for the Westmoreland County, PA, Area Agency on Aging, wrote in another letter. “The home health providers will not provide services to an older adult until the hoard is gone. Often with a hoard comes other safety issues like insects, rodents, waste and unhealthy animals. All of which are an additional expense to correct.”
Oftentimes, older adults who suffer from hoarding disorders will avoid necessary care services entirely, another provider noted.
“Those with HDs often refuse to allow services in the home, such as home health care, personal care aides, home maintenance,” Kerri Anzulewics, the assistant director of the Lackawanna County, PA, Area Agency on Aging, wrote to the Senate Aging Committee. “Oftentimes these professionals refuse to go into a home wherein hoarding exists due to safety hazards and inability to access areas to allow tasks to be completed.”
Meanwhile, there are few resources available to help older adults with HDs manage messes in the home. In its report, the Senate committee said that the government can and should do more to help people manage HDs. It included recommendations for the Administration for Community Living, National Institutes of Health and Department of Housing and Urban Development to advance this goal.
