STANDARD OPERATING POLICY & PROCEDURE SUBJECT: HOARDING BEHAVIOR POLICY #: SS-1000.370.00
Reviewed by: Piñon Management P&P Committee
Responsibility: Social Service Director Date approved by P.I.C. Committee: _____________________________ Administrative Signature: ____________________________________
PURPOSE:
To provide a guideline for resolving hoarding behaviors displayed by residents that are detrimental to the resident, other residents, staff or visitors.
PREREQUISITES: Hoarding Behavior (resource packet)
The facility shall provide accurate assessment and care planning for residents who display hoarding behavior. It is the philosophy of this facility that hoarding behavior is a symptom of a more in-depth problem that may serve a function of well-being or perceived well-being for the resident.
PROCEDURE:
a. The collection of numerous non-practical items that the person is unable to discard. b. To be considered detrimental, the items accumulated must cause a safety, infection
control, or mobility problem for the resident, other residents, staff or volunteers.
STANDARD OPERATING POLICY & PROCEDURE SUBJECT: HOARDING BEHAVIOR POLICY #: SS-1000.370.00
The Social Service Director shall assess residents who display hoarding behavior by:
Conducting a chart reviewto discover:
Diagnosis that encompasses hoarding behavior as a symptom
Disorder, Schizophrenia, Anxiety, Depression,
Personality Disorders, or Eating Disorders)
Life history that could cause control issues (look for trauma,
deprivation, family history of hoarding)
Diagnosis indicative of an information-processing deficit (Dementia,
Social interaction level (visitors, family, friends, activities)
Psychotropic medications (Luvox, anti-depressant, Ritalin, anti-
Previous attempts to address the hoarding behavior that were successful
Evidence of avoidance of the experience of loss (life experience of
Why the resident collects what s/he collects (the purpose, attachment,
or belief about the items which may be emotional attachments or
Note: Do not discuss getting rid of items, just listen to get an idea of
the resident’s thought process and mental status, and begin the process
STANDARD OPERATING POLICY & PROCEDURE SUBJECT: HOARDING BEHAVIOR POLICY #: SS-1000.370.00
Documenting a summary of this assessment in the Social Service Progress
The Social Service Director shall facilitate an Interdisciplinary Team Meeting to
identify the strengths of the resident that can help with de-cluttering and what the team
is willing to do to support the resident through this process.
Dependent upon the assessment conclusions, one or more of the following options
may be included in the Resident Plan of Care:
Identified Control Issues: Give opportunities to be in control; discuss with the
resident how collecting puts them in control and now we need an agreement to
let go of some of the belongings. Don’t push (pushing towards letting go too
soon can cause more guilt and feelings of powerlessness).
Identified emotional attachment or erroneous beliefs about the collected items:
Identified history of deprivation or life trauma: Reassure the resident of
provision of needs. Give comfort items (blankets, clothing, stuffed animals,
plants, animals) in exchange for removing dangerous or unhealthy items.
d.
Identified denial of end-of-life process: Conduct a life history review/photo or
scrapbook albums; list non-material items the resident has collected (i.e.
experiences, relationships, memories); facilitate grief and loss work around
accepting terminal illness so a shield or hedge around the resident doesn’t need
The Social Service Director shall educate the Interdisciplinary Team and direct care
staff regarding the Resident Plan of Care and the following interventions that can
Give nurturance, time, and socialization.
Establish a trusting relationship where you can engage in this process.
Allow the resident to agree to one area of the room, one type of item, or
rearrangement of the items to make it a safer environment.
STANDARD OPERATING POLICY & PROCEDURE SUBJECT: HOARDING BEHAVIOR POLICY #: SS-1000.370.00
Educate on the benefits of de-cluttering (safety, health, rights of others).
Ask the resident to point out the most and least valuable item in his/her
Ask the resident to get rid of the least important.
If the resident resists, discuss the use of the item.
If the resident resists, discuss the ease it would be to replace the item.
Ask what happened when the resident got rid of an item in the past (i.e. moved
on, did without it, grieved over it). Praise this past behavior.
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