Hoarding

I thought I'd start an area here for people to Comment or just read ... and in a year and a quarter, over 1,000 people read this topic! No comments, so that lets us know this is an area of interest to people.  I'll then work on providers who would have insight about this to get more information and resources.  

I know several therapists who have mentioned they have family members who have unsafe houses, and that we don't remember seeing this in the past so much; occupational therapists and physical therapists do 'home assessments' with people who are returning home after a stay for rehabilitation in facilities.  Outpatient therapists could do a home assessment as well, to assess safety, though I didn't get orders from doctors ever for this, and repeatedly would include it in my marketing/education to them.  As time went on, I realized increasingly the way to help the patients/public is to educate and market to them and help them navigate what they are needing to obtain from the other providers, including those with prescription pads that get insurance involved in paying for things for their benefit.  I bet if I were a sharply dressed salesperson with some kind of incentive for the providers, they'd perk up their ears and pens and start writing those types of orders; in the time they had with patients it was not a priority, however.  And there I was trying to make a living in the big building with them where they'd said 'we'll want and need an occupational therapist'.  Sadly, the ONLY time any of the doctors contacted me was when they had knowledge someone with extremely bad dementia was driving to appointments, then they'd want me to get involved.  However, that's not paid for by insurance! But it would get the time 'waster' out of their office and to mine.  It's sad, but that was my experience, for what it is worth.    

I missed those opportunities to see how someone was functioning in their home! It's the most enriched place to figure out something about someone, when you think of it. You know that just by going to other people's houses.  

One of my PT teammates came to my house for dinner and walked in and said 'I'd always wondered what your house was like and I was right! It's eclectic and REALLY neat!'  (not as in clean/neat but cool neat). That was back before I started Lumigrate, which entailed purchasing equipment and furniture and renting space for the first year or so, then I moved all that to my house and garage and it's been a process of selling and giving and repacking/organizing a whole lot of stuff into what used to be my eclectic and 'neat' place!  Now it has a workstation right in the middle of where I used to have space for people to talk while I was preparing food in the kitchen.  And that's okay, we work around it.  I'll admit that I have difficulties getting rid of information related to my work: I have a trove of things that I have written in classes for years and years, which are invaluable and irreplaceable.  Much of what I might want to look up about occupational therapy isn't on line.  

When I moved here five years ago I was somewhat chided by friends helping me move related to all the old statements I had related to bills and I took the opportunity of the big trash dump to throw out stuff and then wouldn't you know it, my landlady tried to tell me I'd not paid last month's rent when I moved in there and I didn't have my checks there to look at on a weekend; the bank had to spend hours trying to figure something out for me I'd have been able to do in a few minutes.  

The more 'complex' your life becomes with a business, the more 'stuff' you have. But in my family there is a tendency for this, and while I followed my mother's simplicity and neatness, with the waning of free time and energy for periods of time when my health was 'down the drain', my habits have changed!  I'm not really sure yet if it's for the better or not; I think so.  I believe I am spending my time the way I feel is important, but sometimes I wonder if I'm once again needing to do some course correction and be more 'selfish' in order to have my home be my 'special place' again.  

apparent in the years of feast and famine with money in our lifetimes lately, or is it something that has increasingly become an issue.  Nature or nuture?  

People who have been following me on facebook have known that I am a supporter of the show 'Intervention' on A&E, in particular when it related to pain medications and addicitons of those substances and pain management issues.  After that show follows one on hoarders.  Other networks have similar shows.  (TLC, for intance on hoarding, and HBO has other intervention and addictions/ treatment shows.)

Larry King Live has this as the sole topic today (the last day of winter 2010-- so SPRING CLEANING TIME I wonder if they planned that timing), and in summary it reminds me of when alcoholism was being recognized in decades past for what we now believe it to be and it had to come out of the beliefs that were held previously about it.  There appears to be a genetic component, and it is thought to correlate or be a form of obsessive compulsive disorder.  The items can have a lot to do with the past or things they might need for the future, so the person is not living in the present well.  There tends to be an event that occurred that made them go from being able to not let it get out of hand to getting out of hand.  Having education about it, for everyone surrounding a person with this problematic behavior, is critical, and they say it is 'definitely a treatable disorder' through cognitive behavioral therapy that is taylored for compulsive hoarding.  Medications can be utilized as part of treatment as well, per the guest on the show tonight. 

I'd like to see what integrative medicine concepts bring to the table on this subject; I know I've seen studies that if schizophrenic-inclined youth are given fish oil and other nutritional interventions plus behavioral therapy for themselves and family, the likelihood is significantly decreased that the adolescent goes into schizophrenia.  When you look at the overall category of obsessive compulsive disorder, it's very prevailant.  As theories about mental health/ behavioral health have changed over time, there's some belief that there's overlap or layering when it comes to some of the compulsive disorders and schizophrenic and bipolar disorders.  

As with autism, as an example, I see this is something where everyone is on a continuum somewhere.  I started developing my own thoughts about this when in occupational therapy school in the mid 1990s.  The CSU program at that time was strong on sensory integration dysfunction and treatment and it teased out in a lab class that I had quite a significant case! My father about that time told me he'd thought he might be somewhat autistic when he was a young man and had thought about not marrying and having children.  I'd moved in with the new love of my life just as I was starting OT school and we'd taken a fast trip to meet his parents far away in another country, and his father pulled me aside and told me his son had lined his toys up and sat and rocked when he was a child.  I said 'that's autistic!' and he said 'yes, I know, I thought you should know'. Yet here we were, highly recognized in our work (it had been fairly recognized in my twenties and early 30s that I was extremely capable at program facilitation at the University on a research project, having filled the shoes of someone leaving the job to become one of the VPs of the Univeristy when I was mid 20s and without a college degree). Neither of us were good at sports entailing balls but were very athletic and hiked or rode bicycles extensively.  I'd always topped out at anything I learned in the high intermediate level; I never could get REALLY masterful at anything.  Suddenly MY world was starting to make more sense! Not to apply it as an occupational therapist and educator to others!  

There are those with pristine and perfect neurologic systems and then there are those that are disabled when something is awry at the other end of the spectrum, and we are all on that line somewhere.  As for hoarding, I remember the first and only house I ever did a home assessment on that was to the extend of anything that I see on TV on these shows now, and my PT teammate and I had discussed it ahead of time as we'd heard from someone who had been to the house that it was quite cluttered.  And it was a patient who I never would have guessed this from related to how her room at the facility was kept -- everything was organized and put away, but she'd brought EVERYTHING with her she might possibly need! However, she didn't have family or friends who could have brought her things and she'd been an administrator in the medical field at the end of her career and I just felt she had a background that made her know what all she might need for a month!  

I have to admit I've really wanted ALL DAY, to vacuum and instead have talked to people about business all day and didn't  prioritize that.  But tomorrow is the first day of spring so I hope to get my house re-vitalized. Or am I sounding a little like Scarlett O'Hara in Gone with the Wind? Uh oh! 

Moving from the offices to having the studio and office stuff at my house has for the past two seasons had me kind of mired and just like anyone, I have 24 hours in a day and a certain amount of energy and money (would love to pay someone to help with things!).  These things all provide teaching to us about ourselves for our growth.  This is something that has run in my family, but I was always into organization and when my health got bad in years past I learned that the world spun if everything wasn't done all the time.  But I really liked my life the way it was. 

One of the guests today who has compulsive hoarding mentioned that she has fibromyalgia.  I'd noticed with my live education group for people with fibromyalgia in years past when I was still trying to float the boat in insurance-based medicine, that we all generally reported dissatisfaction with our current abilities with house keeping/ cleaning with the weakness and lack of energy and stamina we experience as part of the fibromyalgia/ chronic fatigue 'picture'.    

Some of that discussion had to do with vacuuming and doing floors and the harder physical things such as scrubbing tubs and showers, but then the organizational and cognitive processing that gets wiggy with fibromyalgia was causing some of the other tasks to be more difficult.  I admittedly put off doing paperwork until I have a chunk of time when my brain's at it's clearest because I have such learning disabilities that if I'm also a little 'foggy headed' then I make mistakes and it ends up having to be straightened out. We joked that we were just so inefficient now becasue of all the things we forgot to do, or fumbled due to our decreased sensation.  Anyway, I thought that was interesting that one of the woman guests tonight mentioned 'fibromyalgia' on the Larry King program.   

If you have opinions/knowledge about this, know of books or links about this topic, please add them, and let this be a good starting point for valid and progressive information!  

Mardy's note, Summer 2011.  I've revised this and removed the link to CNN/Larry King as his show is now off the air.  But seeing the number of reads of this lets me know there's interest and I will work to have more content about this topic in the future.  

Since I originally wrote this piece, I saw an Oprah where Peter Walsh was on and I found his information about hoarding fascinating.  For one thing, his knowledge about people just is astounding, and I've always LOVED LOVED LOVED his product line available at Office Max.  He integrates see though with sticky notes and binder clips and when I first saw the products at Office Max, I thought 'wow, it's like he sat in the office and watched the way I used office materials to SIMPLIFY and just marketed it'.  I've now used quite a lot of the stuff and have a couple of things I've found that aren't well thought through (like things fit when they're empty put not when you use them the way they're designed to be used).  

So since Larry King and CNN might not have information, perhaps Oprah does.  She also is winding down her previous career after 25 years and will have a different Internet presence, I'm sure.  And naturally Peter Walsh, he has a really nice website and potentially they'll have some information from him.  Mostly, I remember him saying that you will NEVER win an argument with a hoarder over anything they find an attachment to, no matter how much it looks like trash or not something they should be holding onto.  NEVER.  That's why it takes so long to clean up the spaces when having their participation sometimes.  

Gosh, my "Motor Control" book is making me wonder if I'm hoarding books! And then I realize, it'll be there when I need to study up on something related to neurology and function in my future days as a consultant and educator.  Someday maybe I'll have time to pick the guitar back up too, and I still love to open a real cookbook and look through and use it in the kitchen, just as much as the ease of the Internet and the printer.  But some of the outdated medications and supplements I hang onto in order to remember what I was taking, when, I can toss those after taking notes.  There's ALWAYS time and energy for change just as much as there's time and energy for staying the course.  

I hope you've enjoyed my take on this topic, and I look forward to MORE from others. ~~ Mardy