Hoarding >> How To Stop Hoarding Possessions

Pharmacologically, there is little high-quality evidence for benefit of medications. Saxena recently published an open-label study showing positive effects using serotonin reuptake inhibitors (both selective serotonin reuptake inhibitors and serotonin norepinephrine reuptake inhibitors) in OCD and non-OCD hoarding using paroxetine and venlafaxine, How To Stop Hoarding Possessions with the latter agent being particularly effective. 

Treatment of dementia with cholinesterase How To Stop Hoarding Possessions inhibitors or memantine (for moderate to severe Alzheimer disease) can be considered, but patient safety and adherence are obvious concerns. In patients with behaviour variant frontotemporal dementia, selective serotonin reuptake inhibitors and atypical neuroleptics are sometimes used to treat disinhibition, agitation, and aggressive behaviour; there are no published studies to show whether these medications improve hoarding.   

Despite a lack of randomized controlled How To Stop Hoarding Possessions trials, memantine is sometimes used by frontotemporal dementia experts, but there is no evidence of benefit for hoarding behaviour. The use of antipsychotics in OCD-related hoarding is not recommended unless psychosis is present. 

Treatment of psychiatric diseases contributing to hoarding behaviour, such as severe depression and How To Stop Hoarding Possessions schizophrenia or psychosis, might decrease hoarding symptoms, especially if apathy is a factor in clutter or squalor. An antipsychotic medication might be indicated if a thought disorder is driving the behaviour (eg, a patient with schizophrenia collecting rubbish because the voices in his head are telling him to do so.

Or a patient with dementia saving used coffee cups because of a delusion they are valuable), assuming the How To Stop Hoarding Possessions benefits outweigh the recognized risks. Given the increased awareness of the problem of hoarding, multidisciplinary models of care and Web listings of resources are becoming more common. 

An example is the Gatekeepers Program in Hamilton, Ont, which identifies potential clients by training nonhealth care staff such as bank tellers and postal workers (and even the beer delivery man) to How To Stop Hoarding Possessions recognize signs of hoarding and refer individuals of concern to a central intake office. The Gatekeeper approach provides multidisciplinary support and advocacy for the vulnerable elderly hoarder through case management. 

Decreasing social isolation, reducing safety risks (eg, by helping to reduced excess clutter and unsanitary living conditions), and connecting such hoarders to community support programs is thought to improve quality of life How To Stop Hoarding Possessions and reduce the need for unplanned hospitalization. Long-term How To Stop Hoarding Possessions monitoring also takes place for those enrolled in the program. 

Similar programs exist in Vancouver, BC, and Calgary, Alta, and in Toronto, Ottawa, and Kingston in Ontario, but we did not find a central listing of coalitions and treatment programs when we did a Web search. When involved with hoarding situations, How To Stop Hoarding Possessions it is hard to not feel the sentiments described by an American task force: 

Everyone working in Adult Protective Services and Elder Abuse and Neglect Offices knows that referrals of people who hoard will be simultaneously amazing How To Stop Hoarding Possessions and confounding. Can a person possibly be both legally competent and living on top of three feet of a mix of garbage and newly purchased gifts, trinkets, and food? 

Or living in an apartment or home in which all but one small corner of one room is totally filled? Or living amid a few How To Stop Hoarding Possessions dozen pets and their waste? One of the biggest management dilemmas is clarifying patient capacity to decide to remain in a potentially hazardous environment. The ability to make personal care and financial capacity decisions might be affected, depending on the cause of the hoarding. 

Patients with dementia or other mental health diagnoses might lack the ability to understand and appreciate the nature of their situation and the risks. People with nonorganic hoarding commonly lack insight into how far from societal norms their behaviour has strayed, but they often are able to identify the risks and justify their choices. 

Removal of the patient from their home without considering capacity is not only unethical but, as noted earlier, might not How To Stop Hoarding Possessions always be in the patient’s best interest. Case resolution Ms L. was found to be incapable of making financial decisions based on her use of limited resources to buy unnecessary items.

The fact that she donated substantial sums to a number of charities despite the need for home repairs and necessities of life (she donated to animal welfare funds but had the carcasses of several dogs in garbage bags on her porch). She was found to be incapable of deciding on How To Stop Hoarding Possessions long-term care placement owing to her insistence on returning home despite full knowledge that her house was condemned. 

The provincial Public Guardian and Trustee upheld both decisions. She received a full psychometric evaluation that included frontal lobe testing but that did not emphasize medial frontal lobe tasks. There was no evidence of How To Stop Hoarding Possessions depression or dementia (including FTLD). No other psychiatric comorbidities were identified, and she was not treated pharmacologically. 

She participated in therapy, did not reaccumulate possessions within her room, and was accepting of personal care and assistance with hygiene. She did complain bitterly throughout about the discharge plan and the loss of her How To Stop Hoarding Possessions house. She remained skeptical about her access to her finances, feeling that the "government" had "stolen" her money. 

She was discharged to a nursing home but continually expressed her eventual goal of returning home. The Public Guardian and Trustee remained her substitute decision maker for placement and living situation. The consulting psychiatry service did not provide a diagnostic label but believed Ms L. would meet the How To Stop Hoarding Possessions proposed criteria in DSM-V for hoarding disorder. 

Conclusion Hoarding behaviour is more common than reported, and family physicians should be alert to its presence, particularly in older patients. Hoarding might arise from a primary mental health disorder or be the result of secondary causes such as dementia, stroke, or brain injury. Treatment should be multidisciplinary, with the goal of reducing harm and allowing patients to remain at home except in circumstances of severe risk or decisional How To Stop Hoarding Possessions incapacity. 

Pharmacologic treatment of secondary causes can be helpful. Hoarding behaviour is more common than reported, and family physicians should be alert to its presence, particularly in older patients. Hoarding might arise from a primary mental health disorder or be the result of secondary How To Stop Hoarding Possessions causes such as dementia, stroke, or brain injury. 

Treatment should be multidisciplinary, with the goal of reducing harm and allowing patients to remain at home except in circumstances of severe risk or decisional incapacity. Pharmacologic How To Stop Hoarding Possessions treatment of secondary causes can be helpful. 

The Care of the Elderly series was developed as an initiative of the Continuing Professional Development Committee of the Canadian Geriatrics Society in collaboration with Canadian Family Physician to provide articles on geriatric topics written by How To Stop Hoarding Possessions family physicians for family physicians.

How To Keep Squirrels From Damaging Lead Vent Pipe

 State wildlife regulations clearly prohibit any person from taking game or protected birds or animals alive from the wild. The sale of wild animals, dead or alive, and their parts, is also strictly prohibited, except for the specific provisions outlined in the Code of Iowa. This would include   read more..

Wildfire Caused By High Winds

High wind and tornado events could impact the initiation of other hazards. Wildfires could be ignited by downed or damaged electrical transmission systems. From a human-caused perspective, a high wind or tornado event could produce hazardous material releases, cyber disruptions, or Wind Damage Wildfire Caused By High Winds en  read more..

Wind Damage Insurance Roof Claim

DAMAGING WINDS What are damaging winds? Damaging winds are often called "straight-line” winds to differentiate the damage they cause from tornado damage. Strong thunderstorm winds can come from a number of different processes. Most thunderstorm winds that cause damage at the ground are a result o  read more..

Flood Management Methods

Stand away from, Flood Damage Flood Management Methods not under,the sag. (Under a doorway is safest.) Poke a hole in the ceiling at the edge of the sag so any trapped water can begin to drain. Do not start at the center of the sag because the ceiling may collapse suddenly.

Rescue the Most Valuable Items Find and pro  read more..

Flood Lights

Is there a "grace period" for renewing an NFIP policy after expiration? All policies expire at 12:01 a.m. on the last day of the policy term. However, coverage remains in force for 30 days after the expiration of the policy, Flood Damage Flood Lights and claims for losses that occur during the period will be honore  read more..

Natural Disaster Cleanup

One of the biggest challenges after a natural disaster is the proper and timely management and disposal of disaster debris. Debris Removal Natural Disaster Cleanup could include waste soils and sediment, downed trees, building rubble, and other personal property, and could be a combination of a variety of bio hazardous wastes.  read more..

Water Damage Toilet Leak

Repair Your Leaking Toilets: High water bills are often caused by leaking toilets that waste large amounts of water. The diagram below illustrates the parts of a toilet. Most water waste is caused by a leaking flapper or a faulty fill valve that stays open. An open fill valve can have water flowing   read more..

How To Remove Black Mold On Cement

Mildew and molds are fungi - simple microscopic organisms that thrive anywhere there is a moist environment. Molds are a necessary part of the environment; without them, Mold Remediation How To Remove Black Mold On Cement leaves would not decay and aspects of soil enrichment could not take place. It is their ability to destroy organic   read more..

Sewage Backup During Flooding

Protecting Your Home From Back Flow The sewage/septic system is designed to remove sewage from a house. If flood water enters the system, the sewage can backup and enter your home. To help prevent this, install a backflow valve in the sewer line. The backflow valve is opened by the flow of sewage ex  read more..

Colorado Flood Trash Clean Up

In some cases, tree removal actions were either unnecessarily expensive or later found to be ineligible. In another case, state prisoners were used to help the elderly and disabled to get their debris out to curbside, Flood Damage Colorado Flood Trash Clean Up and the cost of this assistance was disqualified. 

  read more..