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Hoarding is fabulous because it's a person's way to control their environment. For instance, you and I, right now, if we go in our refrigerator, we have things in there that we're not going to eat for a while. It's just in there. That's hoarding. We're just hoarding stuff in there. We're not going to eat it right away. We have a whole lot of clothes in our closet too, that we're probably not going to wear all the time, every single day. That's hoarding. A lot of people have collections. They have collections of snow globes or little forks. They buy different cities or thimbles, or whatever. That's hoarding. You don't need them, you're not going to use them, but you like them because they give you control over something that you can have for yourself, that's personal to you. It's no different for people with dementia. They try to get as much of something that means something to them as they possibly can, whether it's appropriate or inappropriate.

We see hoarding as a very healthy way to manage their environment, and we most commonly see hoarding in things like food. They'll hoard all kinds of food that's perishable, that will draw bugs, or rats, or whatever. And they'll hide it in places that it's hard to find. You can smell it, but it's hard to find.

Let's take that example, in particular, to try to eliminate some of that hoarding, is let them go ahead and take it back to their room. They're going to try to do it anyway, and if you try to talk them into not doing that, it's going to escalate into a conflict, so let them go ahead and take it. But keep some canned goods with pretty pictures on the cans; different pie fillings are pretty, other kinds of food that they can see an actual picture. Take it to them and say, "Look what I found at the grocery store. Doesn't this look great?" And they say, "Yes." "Would you like to have some?" "I sure would." "Well, you just had lunch, so let's not do that right now. I'm going to leave this with you, and I'm going to go ahead and take this out so that you can look at this pretty picture." And you just substitute. If they're hoarding sugar packs or other people's clothing in their room, just take them another piece of clothing and say, "Ooh, look what I found. You might want to keep this, but I'm going to go ahead and take these, so you can keep this." And you just try to manage it with substitution kind of a thing with the hoarded items, so that you don't knock their props right under them.

One of the worst things that you can do with someone who's hoarding, is to take all the hoarded items away. That's like a punishment and that's like knocking their props out from under them. And they get very agitated, and very upset, and rightfully so. If I took somebody's snow globe collection and told them they couldn't have any more, they might get a little bit upset, so view hoarding as a positive thing. That's something that they're controlling their environment with and celebrate it. The only time you have to worry about hoarding is if they become a danger to themselves or others. And usually, that doesn't really happen. Sometimes families get upset when they're hoarding newspapers and things like that, but be realistic. If it's not hurting anyone, then let it go and keep it manageable with the substitution task.