Patient Education: How to Deal With Hoarding in Dementia

Hoarding is a common behavior in people living with dementia. It can be distressing for caregivers and may create safety risks, but it is important to understand that hoarding is caused by changes in the brain and is not intentional.

This guide explains why hoarding happens and provides practical strategies to manage it safely and compassionately.

What Is Hoarding in Dementia?

Hoarding refers to collecting, hiding, or storing items in unusual places. These items may include food, paper, clothing, garbage, personal belongings, or valuables.

People with dementia may hoard because they:

Forget where items belong and try to keep them “safe”

Feel anxious or insecure and gain comfort from possessions

Fear losing items or believe others may take them

Experience memory loss and confusion

Seek a sense of control as independence declines

This behavior is a symptom of dementia, not a deliberate choice.

Why Hoarding Can Be Dangerous

Hoarding can create serious safety and health risks, including:

Increased risk of falls due to clutter

Fire hazards, especially near stoves or heaters

Spoiled food, mold, or unsanitary conditions

Lost medications or important items

Reduced ability to move safely within the home

Addressing hoarding helps maintain a safe environment.

How Caregivers Can Help

1. Focus on safety first

Safety is the highest priority. Immediately remove dangerous items such as:

Rotten or expired food

Sharp or hazardous objects

Garbage or unsanitary materials

Items near heat sources

2. Stay calm and avoid arguing

Do not confront, criticize, or argue with the person about hoarding. Logical reasoning is often not effective due to memory and brain changes.

Instead:

Remain calm and patient

Offer reassurance

Respond with empathy and understanding

Arguing may increase anxiety and worsen the behavior.

3. Reduce clutter gradually

Avoid removing everything at once, which can cause distress.

Better approaches include:

Removing small amounts over time

Involving the person when possible

Prioritizing removal of unsafe items first

Offering to trade for items rather than forcibly removing them can sometimes work better.

4. Provide a safe place for stored items

Instead of trying to eliminate hoarding completely, provide a designated safe space to hoard (on a smaller scale), such as:

A drawer

A box (“memory box”)

A basket

This helps the person feel secure while maintaining safety.

5. Protect important items

People with dementia may accidentally hide or throw away valuable or essential items.

Helpful steps include:

Locking away medications, money, and jewelry

Keeping backup copies of important documents. Keeping extra sets of keys.

Checking trash containers before disposal

6. Keep the home organized and simple

A calm and organized environment reduces confusion and anxiety.

Helpful strategies:

Keep frequently used items in visible, consistent locations

Label drawers and cabinets if helpful

Reduce clutter throughout the home

Locking unused cabinets, storage areas, or even whole rooms if they are unnecessary, thereby limiting possible places to hoard

Consistency improves comfort and function.

7. Check common hiding places

Items are often hidden in predictable locations, such as:

Drawers

Closets

Under furniture

Trash cans

Clothing pockets

Regularly checking these areas can help locate missing items.

8. Provide emotional reassurance

Hoarding is often related to anxiety or fear.

Caregivers can help by:

Providing reassurance

Maintaining predictable routines

Offering emotional support

Avoiding sudden changes

Keeping the person active and engaged during the day in other activities

Emotional security can reduce hoarding behaviors.

9. Accept harmless hoarding when possible

If hoarding does not create safety risks, it may be best to tolerate it. It's important to pick your battles.

The goal is safety and quality of life, not complete elimination of the behavior.

What Not to Do

Avoid these approaches:

Do not argue or try to use logic to stop the behavior

Do not suddenly throw away large amounts of possessions

Do not shame or criticize the person

Do not assume the behavior is intentional

These actions can worsen symptoms and increase distress for the person living with dementia and/or the caregiver.

References

VA Caregiver Support: Wandering and Hoarding
https://www.dementia.cindrr.research.va.gov/caregiver_topics/problem_behaviors/wandering_hoarding.asp

Alzheimer’s Foundation of America: Hoarding and Dementia
https://alzfdn.org/alzheimers-today-volume-17-number-3/hoarding-and-dementia/

Alzheimer’s Association: Home Safety and Dementia
https://www.alz.org/help-support/caregiving/safety/home-safety

Alzheimer’s Society: Hiding, Hoarding, and Losing Things
https://www.alzheimers.org.uk/about-dementia/symptoms-and-diagnosis/symptoms/hiding-hoarding-losing

AgingCare: How to Handle Hoarding Behaviors in Dementia
https://www.agingcare.com/articles/how-to-handle-hoarding-behaviors-in-dementia-patients-133679.htm