Psychiatry & Psychology--General/Hoarding

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Question
Hello Sir, and thank you for volunteering for this service.

My Mother in Law is 76 years old.  Over the past several years she has exhibited symptoms of hoarding.  Her husband just more or less lives with it.  She does not store garbage, but just will not throw useless items away.  Their house is full of piles of who knows what that she will not part with. She also has difficulty making any decisions at all.

They have now been moved to Assisted Living and have conceded that it is time to sell the house as they will not be able to live there on their own any longer.  (It is a challenge to keep her from cluttering up their room at the AL facility!)  Now we face the daunting task of cleaning out the house.  She wants to "go through things", but the reality is she will just move the piles around and won't want to discard anything.

My question is how to approach her.  It is obvious she is mentally unstable, but has never been anyalized or counseled.  I don't want to just forcefully run over her wishes, but left to her own devices, we will literally NEVER get the house ready to sell.  Do you have any suggestions for us?  Is there a way to reason with her?  Are there things to avoid saying?

I know you can't do much over the internet, and every case is somewhat unique, but I feel there are likely some general standards we could follow to get the job done while not doing any damage to her mental state.   Thanks again for your time.
- Mike

Answer
Ask her to make a list of all the items and then number them in the order of importance to her. This becomes a working list for things to eliminate or discard "some time in the future."

The idea is to help her form a mental image or expectation of letting go of some items.

Another approach is to support her resistance. Tell her: "It's understandable you are not ready yet to let go of anything and that's OK."

Psychiatry & Psychology--General

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MSW in psychiatric clinical social work

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