Tips for managing dementia rummaging and hoarding
Dementia patients often display rummaging and hoarding behaviours that carers can find hard to understand and respond to without knowing management strategies and appropriate actions.
This behaviour may particularly appear in the early or middle stages of Alzheimer's Disease.
Memory changes, impaired judgment and confusion contribute to behaviours which may in fact be the patient trying to express their feelings and unmet needs.
These behaviours may increase the stress and frustration of carers who struggle to understand the behaviour, why it occurs and what action or inaction is appropriate.
While each individual will differ, the following Alzheimer's Queensland information may assist carers with problem-solving and offer potential actions to trial. Those actions may need to be modified as dementia progresses and skills and behaviours change.
• Distract patient with a meaningful task or valued routine, for example sorting jewellery, sewing buttons onto material/shirts, sorting nuts and bolts.
• Maintain list of activities with positive outcomes.
• Declutter area: for example, in the wardrobe pack away and rotate clothes/shoes, or give away.
• Provide contrasting coloured bags, baskets, bins or cupboards especially for the purpose of rummaging. A contrasting colour may attract a patient's attention.
• Safety: Put away poisons such as cleaning products, medication; keep doorways and walkways uncluttered; check for hidden and expired foods; disconnect microwave/oven if being used to hide/store items.
• Buy two or more of the same items in case one is temporarily mislaid.
• Observe where items are regularly hidden.
• Inform other family where items are to facilitate assisting the person and relieving anxiety.
• Respond positively and non-judgmentally when items are found.
• Logical explanations may not be meaningful to the person and may increase agitation. Avoid arguments. Be empathetic. Listen and have positive facial expressions, body language and words 'It is worrying when you lose something'.
• Seek medical review if distress levels are high.
• Locate regular hiding places and check sites such as under pillow or mattress, in a handbag, among clothes, in the washing machine. Check rubbish bins.
• Choose handbag colours that are easy to find.
• Remove all valuable items from wallets and replace with laminated card and explanation such as, 'John has your credit card - it is safe'.
• Put signage on cupboards like 'pants', 'socks'.
• Have duplicates; spectacles and purse. Choose contrasting colour for frames or glasses case. • Leave items in regular use in sight for ease of access and to avoid anxiety if not hiding items.
• Consistent routine or place of storage may assist.
• Remove items slowly and suggest valued reason such as charity, church or family may need it. Focus on both emotional and environmental safety.
• Observe response for signs of distress and/or change of behaviour.
• Give fresh food in exchange for expired food.
• Take photos of valued items that are given away; value the memory.
• Ask person to assist with sorting small amounts at a time.
• Clear walkways by reorganising rather than throwing out.
• Window-shop, but do not purchase. Refer to pre-prepared shopping list negotiated with the person. Negotiate a limit to spending money.
Each individual will differ so while the above lists may assist problem-solving and offer potential actions that are worth trialling, each action may need to be modified as the dementia progresses, and skills and behaviours change in the patient.
Alzheimer's Queensland also offers the following advice, "Be aware of potential positive outcomes such as maintaining dexterity from movement, the calming effect of rummaging or being surrounded by familiar objects, a decrease in anxiety and agitation, feeling comforted from being occupied, feeling useful and achieving perceived goals".
The complete list of the above tips is available from Alzheimer's Association Queensland's website at www.alzheimersonline.org.