Hospital hoarders and pack rats

amoLucia · Feb 20, 2016

To Allie & Talin, I also express my thanks for discussing your difficult family issues. It's like they say "UNLESS you've been there ...". The trials & tribulations that those closest experience are crushing. It's NOT just cleaning out a drawer and tossing stuff! You're dealing with mental illness.

It's taken years for most of the general population to recognize that Alzheimer's and assoc dementias are REAL illnesses, not just 'granpop being ornerey'. Or that ADD and ADHD etc have a real basis and it's NOT just a 'spoiled brat being bad'. The stigma still exists for many other conditions, ones that some wish they could just ignore or just point a finger and offer a simple snap & 'be gone' remedy. Alcoholism & drug addiction come to mind. Also the eating disorders, anorexia, bulimia, and obesity. Abusive personalities, gambling, on & on. A whole string of disorders falling under OCD.

It would just be so convenient if causative research could point to a single definitive cause like a brain tumor. People would be so much more sympathetic if they could just blame the behavior 'on the brain tumor' that makes the pt so maladapted. Like that's why 'granpop is so ornery, spitting and peeing on the radiator'.

We all know about brain cancer, Traumatic Brain Injury, CVA and TIA as responsible for changes in mental status. Tertiary syphyllis, sepsis, encephalopathies, alcoholism, etc also. But it's hard to explain about that little spot somewhere in the brain, some little piece of soft tissue grey/white matter or neuron that is the focus of impulse control and understands to differentiate 'too much' from 'not enough'.

I ask at what point does collecting become hoarding? And when does hoarding become too much? When you throw out 'all that stuff' someone has collected, how much psychic distress are you causing? You would no sooner want to cause physical pain like that, but psychic pain is just as real & damaging.

So how therapeutic can one be when you're purging??

ktwlpn, LPN · Feb 20, 2016

I work in a hospital and we will get patients who like to hoard things. They get upset if thou dare remove their property (usually hospital stuff).
So how do you deal with them and get them agree to clutter a bit.
Finally, what was the worst patient pack rat seen?

Having just been a patient I want to speak to the almost overwhelming lack of control I felt over everything.I tried to keep my area neat and free of clutter with the things I needed within reach but I found I did tend to "hoard" things,most often stuff from my food trays from one meal to the next.Which I never did eat.I also brought home all of those condiment packs.

The only thing I could control even a little was my immediate environment.I,like most of us,am used to getting up and DOING.It's really difficult when you can't.

DoGoodThenGo · Feb 21, 2016

the linen company charges us (the hospital) for that stuff.

Back in the days when places owned their linens and had in house laundries hoarding supplies caused problems, but not along lines of immediate fiscal hits.

Today with many places not only having outsourced their laundry but do not even own the linens (they are rented), shortages can be a big deal.

The linen service knows how many of each item are sent to a facility and thus how many should return. Facility has a contractual agreement to return same counts. When that does not happen the facility often has to pay for the missing items.

Quilterbeth · Feb 21, 2016

I work on a unit where most of our patients suffer from extreme loss of control. The only thing they can control is their food and they hoard everything. One patient would order 2 trays at each meal then endless snacks. She would never let us remove the trays and it became a safety issue. We finally had to limit her to 3 meals and 2 snacks a day, and she could not get a new tray unless she let the previous one go. It was very challenging and stinky

Thunderwolf, MSN, RN · Feb 22, 2016

All behavior is meaningful. In saying that, why does the hoarder hoard? I bet it is very much individualized. So, it is worthy to process the need it serves with the patient and to reach a collaboration with the patient, if possible. Also, how may care and services be structured in a better way that meets that patient need in order to reduce the hoarding? When all else fails, my fall back approach, when things gets to a certain threshold, is that it comes to the issue of safety. The environment needs to be safe for everyone....for the patient, for the staff, and for the room mate if in a semi-private room. "Safety First" trumps everything. This may be related to medication safety. Fire safety. Fall safety. Infection safety. Vermin safety. With food safety, food has an expiration time...which I may set as to the end of my shift. Safety becomes my broken record in this case with most everything. If it is not safe, then why are we doing it? But also, staff need to be uniform and on the same page. Oftentimes, staff sabotage each other in situations like this. So, limit setting may come into play when a patient declines to collaborate and staff needs to be onboard. I tend to see this as a teaching moment whenever possible.

RunBabyRN · Feb 22, 2016

My ex-husband was the worst about snagging anything he could get his hands on, worse than any patient I've seen thus far. One of those things that never occurred to me until I met him. Thankfully I haven't been in a specialty where I'd have to worry too much about those food hoarders!

aeris99 · Feb 22, 2016

I worked home care as an LNA and had two clients who were hoarders.

One bed bound, mostly blind, no family to speak of. Hoarded food, receipts and papers. Twice a week I'd have to "sort" through the meals-on-wheels and toss the trays that were rotten. That one wasn't as bad as the other.

Little lady living alone in a trailer. There was just enough room to walk from the fridge to her bed and out the door.

No hot water. Commode in the hallway.

I was supposed to assist cleaning up once a week. Took me a few times to realize that everything I put in the trash outside, she would take back in as soon as I left and hide it. I had to start taking the trash bags with me when I left.

I was constantly finding rotten food, used tp and uncapped insulin pens all over the place.

I finally called APS after her furnace broke down and I found her without heat in the winter.

Her kids wouldn't help and her trailer ended up being condemned. It really made me terribly sad for her.

Both of these cases were assigned to me from the same company. It really made me angry that the office did everything they could to sweep the problems under the rug. It was too much trouble to address the situation and possibly jeopardize the check coming in.

I ended up leaving shortly after these cases because I couldn't stand to work for a company that cared more about getting paid than doing their job.

NanaPoo · Feb 22, 2016

I tend to be a food hoarder. I grew up in pretty significant poverty where food was not always first choice by my mother. Collectibles, drugs, and alcohol came first.
I don't keep spoiled food, but I keep my fridge, freezer, and pantry over stocked. My husband grew up in a house where this wasn't an issue and he hates clutter so we are always in an endless battle.
I understand why people hoard however, when it comes to the point food is sitting out rotting, it's gotta go. I'll try to reason so they throw it away. If that doesn't work I'll pitch it.
I don't stress about ketchup packets, salt, pepper, etc. I stick with the dangerous stuff, because I understand.

My hubby & I live in a similar battle. He was born to teen parents who were super frugal and, even after things got much better, they continued to live as though they were in poverty and hubby continues to live in that mindset.

Together we have a fantastic income and have for years but he would have a serious hoarding issue if I didn't have a serious minimalistic mindset. I basically follow him around quietly and throw things away when he's not looking. He's not able to keep up mentally with all he tries to keep, thank goodness. If only I had a nickel for every time he's said in the past 22 years "you never know when we might need this." Of course, I'd have turned those nickels into the bank so that I wouldn't have a bunch of nickels laying around the house. He, on the other hand, would have the world's largest pile of nickels on our bedroom dresser, the bar in the kitchen, the coffee table, a jar in the garage, you get my drift...

His grandmother, who lived through the Depression, used to come visit us and she would've stopped by a fast food joint on the way and swiped a handful of napkins and straws on her way through. She would offer these napkins and straws as a visiting gift for us as she came through the door. Her son (my father-in-law) was in the hospital once and, upon discharge, took all the boxes of gloves from the wall units and packed them to take home saying, "I paid for these. They're mine."

I really should've known what I was getting into...

Taiin · Mar 3, 2016

To Allie & Talin, I also express my thanks for discussing your difficult family issues. It's like they say "UNLESS you've been there ...". The trials & tribulations that those closest experience are crushing. It's NOT just cleaning out a drawer and tossing stuff! You're dealing with mental illness.

Despite it having mental illness as a cause, it is very frustrating at times. I honestly don't think I could relate at all to why she does it, because my brain doesn't work in the same way. And because I deal with her so regularly, I do experience some compassion fatigue with her (she isn't a pleasant woman to be around in general, she has always been am immensely negative person and leaves people feeling drained), but my family takes turns to share the stress.

My family's goal is safety first. We can do that in the nursing home, it wasn't so easy when she was in the house or apartment. The staff keep us informed and we intervene when we need to. She truly does create fire hazards in her room, so it isn't just an excuse to remove accumulated belongings (because it is literally like pulling teeth, it leaves us all hurt in the end). My family also wants her anger and frustration during those times to be directed as us, not staff.

whisperingsage · Mar 30, 2016

My experience is SNF's and tat wasn't specified in te question, but they are the worst. One lady had a two bedroom all to herself (low population small town, 3000 people in town) and she loaded up the edges of the room and windows with teddy bears, and the fire marshall declared it cleared- which never happened in the year I was there. This lady seemed alert, but refuse her twice weekly shower- she would only take the whirlpool bath with one certain CNA, the only one she trusted- we had to run in and pull her urine SOAKED sheets off her bed, sanitize it, and put new sheets on while she was in her bath or she would fight and refuse to allow us to remove tem in her presence- then she would be mad when she came back to a clean bed. Nope, I never figured that opne out.

One other one was 104 yrs old, ambulatory, half deaf, would save food from every meal yes, in her nightstand- again, we had to wait for the times she was taken to the shower to descend on her corner and clean out the old food and ants, and she too would be mad to come back to a clean room.

nutella, MSN, RN · Mar 30, 2016

I work in a hospital and we will get patients who like to hoard things. They get upset if thou dare remove their property (usually hospital stuff).
So how do you deal with them and get them agree to clutter a bit.
Finally, what was the worst patient pack rat seen?

The worst case ever in a facility was a young pat around 400 lb or perhaps it was closer to 450lb - bed bound, who was able to move a little bit. The patient would hoard food under the blanket and in his folds where we found all kind of food (no kidding). In addition, the parents brought in condiments in small packets which also disappeared in those folds because the pat was "addicted" to ketchup but a dialysis patient with a high potassium and ketchup was of course on the "no" list ...

Potassium was always around 7 no matter what as the patient was eating ketchup and chocolate pudding.

Home care - hoarding in a trailer.

Mrsister · May 17, 2016

... for the greater good dispose of it in the appropriate manner you wouldn't leave opened wound packs, dressings, instruments, IV fluids laying around same with patient food and rubbish ... I would seek professional help for the poor soul who would consider hoarding and then eating leftover hospital food the shite is terrible when fresh ...