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He keeps the spaces he doesn’t use fairly clean... BUT, boats, cars, trucks, food (COSTCO)... He lives alone. If he can’t FIND something he HAS, he just buys another... How do I approach this issue when he “Feels” the items are “worth” something even if he doesn’t use them or they go BAD, (food)...

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Ah, I feel for you.

My mother is also a little hoarder, but luckily(?) she can no longer drive, so she is hampered a little by not being able to leave the house alone, to shop. She 'online orders' crap from every catalog that comes. She gets 4-5 packages per week. Her little apartment is stuffed to the gills and she has a basement full of more stuff, which she only let me put in bins, to store, when my one and only attempt to "organize" her went south.

My advice? Don't do a thing. Just like any other mental disorder, unless the person WANTS to change, they won't.

To a true hoarder--a can of soup has the same "emotional value" as a Ming Vase. They can't differentiate between what is "nice and needful" and what is, well, "crap".

You can ASK him if he wants help sorting, and of he does, good for you. I would not hold my breath. All you can do is make sure he has a safe exit from his home. And that heaters and such are not blocked. Just basic safety.

BTW, Mother owns over 100 shite blouses/shirts. She is basically housebound now. Still buying more.

Mother has some dementia, but this hoarding is as old as I am. Her home of 5,000 sf was emptied over the course of 3 years and she has effectively hoarded herself in her 800 sf apartment, over the years.

What's "claustrophobic" to you or I, is "hugging" to a hoarder. We've cleaned and cleaned and she just blows up at us. Not worth it.
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My Dad is a hoarder too, poor Mum putting up with it for years. He can't do anything now but he still won't get rid of all the wood stored in their hall for DIY jobs he'll never complete. Boxes of tools, shirts, shoes, expired medication, papers, books you name it he keeps it. 5 unusable vaccum cleaners. Dining table covered in "stuff" can't see any wood. Kept all his bank statements/payslips since year dot! The house will be a nightmare to sort through eventually. I feel for you !
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HEY!!!!! I'm a hoarder and I don't have dementia. ;)

There's hoarding and then there's hoarding though. I've noticed it's quite common for the elderly to hoard paper. There's paper squirreled away everywhere. If he's holding on to a used napkin that he got a restaurant 10 years ago that's one thing. If he's holding on to a pristine Apple I computer, that's investing.

I often buy something I know I already have. Why? Because it would take me longer to find the one I already have then it would be to buy another one.
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I believe a lot of people don't understand the difference between hoarders and junk collectors. Hoarders have emotional attachments to stuff and would not sell that pristine Apple I for a billion $! A junk collector will sell things for a reasonable, un-ego filled price. Compare the stars of Hoarders vs the guys who star & sell in  Pickers.
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One of my brothers is a hoarder, has been for years, certainly no dementia at work. It’s one of the strangest psychological phenomenons I’ve witnessed. He actually mourns anything that is thrown away, even when it’s worthless. And our family has certainly learned there is nothing we can do to change the behavior. Make sure he’s safe, but otherwise leave it alone, it’s not fixable
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My Dad is a hoarder too. It got worse after his mother died and he had acreage to store stuff. I have to use clear garbage bags and he has to see everything that goes into them. If I can find a 'safety' reason to toss something, he is more likely to let me toss it. The shredded curtains at the French doors were a tripping hazard, so I could toss them.

I estimate there is 3-4 dump trucks worth of junk to get rid of on the property.

I admit that I have hoarding tendencies, but I do not have the emotional attachment to stuff. I have a fellow helping me clear out stuff and it is great to see my home looking like a home again. Regular garbage and recycling is not a problem, it is the stuff that has to go to a special location for disposal. I used to have an agency that would pick up stuff for the thrift shop, but they did not show up three times in a row, then blamed me for not leaving the items for pick up. Yeah right, I am not supporting that charity again.

I have an arrangement with the fellow who is helping me. If there is something he can sell that I do not need, he is welcome to sell it and keep the cash. If I planned to have a garage sale to make some money off the things, it will wind up in the garage for a few more years. Out the door is better for me.
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Have you ever watched any of the shows about interventions with hoarders? It's actually a mental health issue and not readily cured. It seems to be challenging for the hoarder, even when they are highly motivated. Like, they have to clean and get rid of stuff or the city will condemn their house and they'll be out on the street. But, even under those conditions, the hoarder remains steadfast.

In light of this, I'd consult with a professional about it. That way you can get some guidance and tips. Honestly, I'm not sure that I would be up for it. It's a huge deal to get a hoarder to change. I might try to make sure things remain safe and contend with the bulk of the problem, when the hoarder is no longer able to maintain the household.
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If you watch the shows (and I've watched a bunch of them over the years), it seems like most hoarders start hoarding after a loss - like a parent or a child dies or they lose a beloved job. And it's one of the hardest mental disorders to treat. People are very resistant to change. It also seems to run in families, but it would be hard to determine whether it's learned behavior or a genetic predisposition.
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Mthr was a hoarder. She was greatly motivated when I set firm boundaries. I think she was going to "show me" when she hired someone to shovel out 3 rooms ( the furniture was simply tossed onto another layer of furniture upstairs and completely shut off access to that floor). The man who did it said the rooms were up to and over the top of the door frames with just a hole to crawl through. 

8 years later when were rescued her the level was about 4-5' from the floor, in the low spots. She had the worst hoard our hoard cleanup specialist had seen, even though some was cleared 8 years previous.

Hoarding is very much like an addiction and the person is not likely to change even after hitting rock bottom. Wait for a crisis. There is a Children of Hoarders site you might visit.
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A few years ago I picked up a workbook-type "Helping the Hoarder in Your Life" or similar title book at the library out of curiosity. It was sadly eye-opening. The author, who was either a social worker or psychologist, basically recommended a strategy of harm reduction, managing, minimizing, as hoarders lack basic insight into their problem and can't really be helped, unfortunately. It was not a hopeful, uplifting read.
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My Dad was a horder, but I don't think he had dementia. He was becoming forgetful, and he had it seemed like hundreds of cans of soup and every time he went out he would buy more. And he was 85 years old, so it was a losing battle with him.
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Wow--I feel rather grateful that my mom's dementia has her throwing out too many things. I have to put her name in everything new or she won't recognize it and toss it, even new clothes. I bought her new towels at her request, and a month later, she tossed them. She is a complete "neat freak"--an excess of her lifetime neatness, but now a compulsion.
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We have found that if an item can be used by someone else, they are more likely to let it go...sometimes. It establishes more of a meaningful connection..."Suzy now has my teapot and really loves it" As for canned goods, we took a black ink large point Sharpie marker and clearly marked the year on front of label to indicate the 'best used by' date. Next step was to collect all the food cans from their various stash locations, sort by type (corn, beans, soup, etc.) and put them on shelving with oldest to the front. At least they were more visible that way. "Oozing" cans - no brainer - gone!
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My dad hoarded safety equipment - in the NH he had flares, drugs, needles[retired dr], asbestos fire blanket, 8 whistles etc all in case of an emergency - I think this comes from being on a ship that hit an iceberg in 1928 when he was 5 years old - I believe he had a form of PTSD from it - he was probably the last survivor when he died in Aug 2017

Many of our older loved ones were raised in the Depression or just after so they were taught that even a broken item still has use then during WWII there was rationing - if possible find out how his parents thought about keeping things because it could be rooted in his up-bringing as a child & that will be hard to change -

The only thing is to insist on safety so that used cans, kleenexes, food waste etc are discarded otherwise you may be beating your head against a wall
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Ok... This is sad, but it is what I have observed with many aging folks. They hoard what they perceive to be 'resources'. I guess it is a reaction to the fact that they have identified there is a limited supply of everything in this world (including days to live) and they don't want to 'run' out before they expire only to find themselves 'needing' when they are physically least able to supply for themselves.
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I think there is a difference between hoarding for a "Hoarder" and one that "forgets" they have something, or it "breaks" because they can not figure out how it works and buys another.
There may be a crossover when a "Hoarder" is diagnosed with Dementia I am sure that makes things far worse.
My Husband was ALWAYS one to save things and repair what broke with parts from another of whatever it was. (Bought an old car with a good engine so he could replace the engine in his car then saved the old car for parts to be used later)
There did come a time when he came home with some stuff that I really questioned but he came up with a great reason and followed through. At the time I wondered if something was going on but since he did what he said and followed through I put it out of my mind.
After his diagnosis going through the house I did wonder what he had been doing. A lot of purchases had been made without my knowledge and I wondered how long it had been going on.

So there is a fine line.
In your case you might want to contact his doctor and explain what is going on. Ask that a mini mental exam be given on his next visit as a "routine" part of the exam. Then take it a step further if you want and ask for him to be referred to a Neurologist for further assessment. (Do not take .."He's fine some memory loss is typical at his age" from his doctor)
Make it a habit once a week to see him and go through the pantry, garage and even some of the cars or boats for food that he has stored. Tell him..ya know Dad, I need some pancake mix do you mind if I take this 20 pound bag of yours? Then do what you want with it. If it is within date donate it to a shelter, food pantry or church. Do that with items that have a shorter shelf life. Toss out what can not be used. (Shelters, food pantry and other places will probably not take out dated items.)

No to another question..how is his driving? Should he be driving? If he is not driving maybe you could cancel his Costco membership. He can go with someone but at least his purchasing might be reduced. (If he has membership for use of the pharmacy I am pretty sure that even non members have the ability to use the pharmacy. I am in Illinois and any non member can enter a warehouse club and purchase from the pharmacy.)
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Hoarding seems to run in my family. My grandfather, my aunt, my sister. In my case it seems to be that I want this thing so that you don't get it. It really is kind of a hopeless situation and I agree with other people who have written The best you can do is make a safe place for them to live in the midst of their hoard. And then when they are no longer here plan to get a dumpster and just toss. Unfortunately it is true that there probably are some things there, some pictures that you might like, and other family momentos that will be lost. It is just a very sad mental illness.
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Keep in mind that children of the depression tend to hold on to everything forever because they feel it wasteful to get rid of it or think they will need it and have to replace it. You can help by suggesting he donate anything he hasn't used to a worthy cause like homes for vets or habitat for humanity, goodwill etc. Suggest sending excess foods that are not quite expired to the local food bank explaining he can't eat that much of it by expiration date. Also tell him expired foods are no longer safe to eat and can cause botcholism (I know that's misspelled) which will raise eyebrows but he will get it--not safe to eat! Do the year test. Clear out spaces and organize all areas. Anything he has duplicates of get donated. Tools excepted if anything is untouched for 12 months he can easily part with it and not miss it. KEY POINT make this a JOINT EFFORT so he is involved and knows what is going on!! This gives you ammunition when he says his things got stolen, NO YOU Donated them to charity not stolen! I did this with my mother's craft and art supplies and it went very well. She kept SOME but not much of the items and when she said someone stole them I said nope, remember you gave them to your grandson for his art projects! She remembered and it was done.
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The children of the Depression or survivors of rationing ideas are noble-sounding rationalizations.

Recycling and hoarding are not at all the same thing.
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I have seen where people throw out a hoarder's treasures and I don't believe in it. I have stuff that is worthless to anyone but me and I treasure them for the memories they bring. There is no way you can know what (if any) memory is attached to each item. And, so many seniors lived through the depression - hoarding isn't hoarding to them - it's preparing "just in case."

Bad food? Dump it. You can point out mold and even ask him to smell something if he still has his sense of smell.

ie:  I have a tiny $1 Nativity I keep on my windowsill and a plastic angel nightlight - both were purchased by my mother who is now long gone but these are daily reminders of my mother.
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My mom is a "saver", as was her father before her. She was born during the Great Depression, and was taught that there was value in saving and reusing everything... glass jars, boxes, scraps of paper, plastic containers, etc. Honestly, growing up, I had lots of fun making crafts out of the things she saved. And, there are times when it saves money because she usually has something on hand. BUT, I entirely relate to how frustrating it can be. My mom is always really nervous when I start to organize her things. She is so afraid I will throw something away. I honestly have learned to just live with it, and try to keep it as clean as possible. She is unable to drive anymore, so that helps. But, it may just be a generational thing. We live in a "throw-away, buy-another" age, so we really don't have to save anything these days (which is actually kind of a shame because we waste a lot). But, I can relate to your frustration.
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I can attest to the hard times reason. My grandma and parents lived through WWII. Not in the US where the hardship was not having sugar for coffee. But in the war where the hardship was trying to stay alive everyday. Grandma especially is kind of a hoarder. Not random things but survival things. Food, water and of course... toilet paper. ;) That's why she only uses one square and folds it into fourths getting poop all over her hands. It's not dementia. She can't stand wasting it. I got her a safe years ago to keep her jewelry and money in. She doesn't keep any of that useless stuff in there. She keeps food and TP. Water she keeps in random bottles, jars and pots scattered around her room.
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Salyer loads of advise above, when I read it I understand that each case is different and we do not know why someone hoards, collects or ? My mom is a true hoarder, i can pull something out of a corner and she will say why she has it, ie thats Bobs favorite sweat shirt, i won that at the fair the 4th year i went and so on, doesn't matter that the sweat shirt can longer be worn, all stretched out, holes, faded, to small, she is keeping it. I spent 6 weeks trying to help her get the 900 square foot house clean so her husband could come home safely from hospital/skilled nursing stay. In all that time I got bedroom, bath and kitchen cleaned to the bare walls, he had major stomach surgery and I was concerned about 25 years of accumulation putting his health at risk. In 2 days she had stuff stacked back around, I knew it was clean and had to say "it's enough" whatever the why behind their actions only God knows, so I just picked my battles, fought hard and hey, someone has to loose the war. I was glad to have those areas clean and she did not have to get rid of one item she did not want to, oh except all of the expired food. I won that battle, it's been 5 years and I still hear about the pickle relish that I threw out, it was still good even though it was 8 years expired. I just say I know and change the subject. Long winded sorry, just beware that if you force him there will likely be some fall out, prepare to be the bad guy.

Good luck
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Throw away rotten food on the sly — and give up on the rest. Hoarders don’t want help. They think everyone else is the problem. If you make the “mistake” of one too many kind gestures or common-sense suggestions, you instantly become the enemy.

Focus on your own mental health, not theirs. Because it is difficult as h*ll to Keep On Caregiving after the person who taught you how to tie your shoes and celebrated your good grades (etc etc) makes it clear that he/she values towers of junk mail & 10-year-old catalogs and rooms full of clothes more than he/she values you. It sucks and it hurts.

Grit your teeth and turn a blind eye now. Rent a dumpster when Dad moves to residential care or moves on to the afterlife.
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Went through this with my dad. From medications and food to cans of paint that were 40 yrs old! What I found after I would throw these things in the trash is the next time I was at his house... these items miraculously found there way back in! Dad would literally pull them out of the trash receptacles! So I brought big heavy construction bags, filled them and put in my trunk and put in my trash! When we got to his garage and sheds it was much more difficult. So I called in a company that specializes in organizing and disposal. It really helped. Dad was not a hoarder like in the shows you see. One day he cried and said I was throwing away everything he had ever worked for. He had attached memories to everything and he cried and had a few panic attacks. He was 95 when I did this and we were trying to get his house to a state that we could have and estate sale and put his house on the market. So we decided to find an assisted living facility first. Once we got him to choose all the items he wanted to take with him and had him basically assign his mechanical tools and wood working tools to his loved ones, we were able to make some progress. He was living at the assisted living facility when we organized and trashed stuff. So that helped a lot. Then we had a “reputable” estate sale company come in and sell everything and their fee was 10%. The next week we had a cleaning service come in. Then we put his house in the market. His house got a cash offer for 10k less than our ask and within 16 days of listing it it’s was sold and the new owners took possession. God certainly was smiling on us through it all.
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You cannot change this. Their attachment to things seem strange and irrational. With my dad, I started bringing my own heavy duty trash bags with me. I’d collect all food and medications that had expired put them in my bags, put it in the trunk of my car and throw it out from my house. I did this because, even at 94 and 95 years old, he would retrieve this stuff from his trash receptacles after I left! It was an ongoing battle. House keepers didn’t last long because he wouldn’t let them throw things away or clean certain rooms. Dad cried one day and told me I was throwing away his life... everything he had ever worked for. And this was about 30 year old cans of paint!! But it was time for dad to move to an assisted living facility anyway. So once we moved him, we were able to start throwing stuff out and get organized for an estate sale. Dad had already picked out everything that he could take with him. As far as his mechanics tools and wood working equipment, we had him assign these things to family and friends. Once this was done we were able to get a “reputable” estate sale company in to sell everything else. Their fee was 10% of everything sold. After the sale they brought in a very large dumpster (brought by a semi truck) and they disposed everything that did not sell. However, before the stuff went in the dumpster, I found a company that gave us a price for everything that didn’t sell like dinette, lamps, tables, Knick- knacks. Surprisingly enough we filled that massive dumpster! (Its was the largest construction type). I don’t know if any of this helps or not. But I certainly understand what you’re going through. If there is anyway you can get him out of the house for a few days while you dispose of things, it really does help. Just know he’s going to be mad and say mean things. And if he’s going to continue living in the same place, you will be doing this several times a year. It’s takes a professional and many, many years to modify this type of hoarding behavior. So he’s likely not going to change no matter what you say. Best of luck!
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Reminds me of the saying ‘use it up, wear it out, make do or do without’. Those who lived through that era had to do just that. Pick your battles - yes. In the end, what is more important. - the stuff or your relationship? Enjoy them while they are still here; keeping them safe is higher priority....my opinion. The ‘stuff’ can be dealt with later.
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My mom was the exact opposite. She sold off most of our family heirlooms even though she didn’t really need the money. She also threw away photo albums with photos of my great-grands that are irreplaceable. Depression glassware, jewelry, my grandparent’s mantel clock...you name it. It’s gone. I’m not sure what’s worse, hoarding or minimalism!
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I watch Hoarders on television---and according to them, and the therapists on there---hoarding is usually because a person has OCD---don't know if there's a medication for that category!!?? They are usually depressed, and a lot of times some major trauma sets it off. I have OCD and years ago I was addicted to the Home Shopping networks! I take an antidepressant, and I'm not addicted to them anymore. I use to take Celexa---now I take Zoloft. It's genetic(I believe). It isn't the same reasons for everybody. They usually need therapy. Good luck, and GOD be with you and your loved one.
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Don't know if this helps...depends on how bad it is of course...if it's very very bad, like boxes piled in hallways, etc, hoarding can be like an addiction for some people. And many addictions (most actually), relates to an underlying unhappiness or pain or shame or even fear! The unhappy emotion causes the person to want to do something to hide or numb the feeling...in this case, it's getting and holding onto objects. Gosh this world is full of stress & traumas on each of us, it's just how we manage that.

So my thought is, I totally agree with the others in not trying to "change" the behaviour. Rather, if the hoarding is very bad, (like there's no room to move in the house ), keep spending quality time with your father listening, try to see any underlying unhappy memory/thought. (Not saying you have to be there daily, just when you do spend time with him next) it'll take some time of course.

My father grew up in a poor family in a third world country until he was 14yrs old, then he went to China on his own which wasn't first world conditions either. So while he likes to hoard a little (not food fortunately), I see that as his thinking he "might need that later", which relates to the deep lack of things he had when he was younger. So yes, each person is different.

And they do have that right to hold onto their things that brings them good memories ;) or...bring them peace of mind on other case... (even if the house is messy!)

Good luck.
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