Hoarding Case Study

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Obsessive-Compulsive and Related Disorders: Hoarding Disorder within the Geriatric Population
Samuels et al. (as cited in Ayers et al., 2014a, p. 741) suggests that hoarding is present in 5.3% of the population; although, this rate may be greater among the geriatric population. In the long-term care setting, many geriatric clients often hold on to items of sentimental value such as a prized pocket watch or a treasured family photo as a reminder of the past. Keeping these items are often associated with emotional worth; however, when an item such as a spoon from the dining room repeatedly joins the collection of amassed items, this behaviour can manifest into hoarding disorder. Hoarding disorder (HD) is defined in the 5th edition of the Diagnostic
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When teaching a client with HD, it is also pertinent to involve family participation, due to possible unpredictable behaviour (Haber et al, as cited in Bastable, 2014, p. 399). In addition, the family is a resource for the nurse to learn about the client; consequently, adding to the nurse’s resources on how to tailor teaching for the client. Another method the nurse can adopt is the harm reduction (HR) approach. This plan can be taken into action when the client is resistant against teaching. Tompkin (as cited in Fleury, Gaudette, & Moran, 2012) identifies that the goal of HR is “decrease adverse outcomes associated with high-risk behaviors without necessitating individuals stop their behavior” (p. 159). For instance, when teaching the client how to effectively discard certain items that hold no value, such as a stack of old paper plates, the client can be taught that discarding these items may be needed in order to improve their current quality of life. Understanding the impact of HD in geriatric clients coupled with the client’s readiness to learn greatly affects the nurse’s delivery of health education; henceforth, it is essential for the nurse to “allow the [geriatric client] ample time to respond to a task” (Murray, Zentner, Pangman, & Pangman, 2009, p. …show more content…
However, enabling a client with HD to lead a productive and purposeful life can be an outcome when the Recovery Model of care is applied by a trained nurse, while working together with the client. Applying beneficial methods to help the geriatric client with HD and delivering ongoing health teaching are the many ways in which the nurse can integrate care. Although family members may be caregivers for the client with HD, Gilliam & Tolin (as cited in Fleury, Gaudette, & Moran, 2012) note that “approximately 84% of hoarders state that there is a first-degree relative who also hoards items” (p. 157); for this reason, it is important for the nurse to include the family members, whether it be assessing for caregiver burnout or including the family in behavioural family therapy. Additionally, Ayers, Iqbal, and Strickland (2014b) underscore that “treating HD patients in medical or psychiatric settings should rely heavily on a multidisciplinary medical team as the impact of HD is not restricted to the psychiatric status” (p. 151). Caring for the geriatric client with HD involves a multifaceted style of care; it cannot be limited to caring for the client only, or a responsibility of a lone

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