What strategy might you use to help someone with dementia who has the challenging behavior of rummaging and hoarding objects?

Rummaging and hoarding are common behaviors in individuals with dementia, often arising from anxiety, boredom, or a need for security. Understanding the root cause is the first step in determining what strategy might you use to help someone with dementia who has the challenging behavior of rummaging and hoarding objects. Instead of punishing the behavior, caregivers can use compassionate and proactive methods to manage these actions safely and respectfully.

Quick Summary

This article outlines compassionate and practical strategies for managing rummaging and hoarding behaviors in dementia patients, focusing on environmental safety, providing alternative activities, and responding with empathy.

Key Points

• Create Safe Rummage Areas: Dedicate specific, safe containers like drawers or bins for rummaging to contain the behavior and provide sensory stimulation.

• Engage in Purposeful Activities: Redirect the urge to be busy by offering simple, meaningful tasks such as folding laundry, sorting silverware, or working with safe tools.

• Prioritize Home Safety: Secure all valuable, toxic, and dangerous items in locked cabinets or safes to prevent accidental harm or loss.

• Understand and Address Triggers: Observe patterns to identify underlying causes like boredom, anxiety, or confusion, and proactively address them with calming techniques or activities.

• Approach with Empathy: Respond calmly and patiently, validating their feelings rather than getting frustrated or arguing, as this increases agitation.

• Check Designated Hiding Spots: Regularly check common hiding places like trash cans and under furniture to locate items misplaced by the person with dementia.

• Start Gradual Decluttering: When necessary, tackle clutter slowly and respectfully, removing small amounts at a time and involving the individual in decisions to maintain their sense of control.

Understanding the 'Why' Behind the Behavior

Rummaging and hoarding in dementia are not deliberate attempts to be difficult; they are symptoms of the disease and are often driven by underlying emotional needs. By understanding these triggers, caregivers can move from reacting with frustration to responding with compassion.

Common Triggers for Rummaging and Hoarding

There are several reasons why a person with dementia might start to rummage or hoard. A deep-seated need for security and control can emerge as their world becomes more confusing. Similarly, boredom or restlessness can drive a person to seek stimulation by going through drawers or collecting objects. The behavior might also be a way to connect with the past, as familiar objects can offer comfort and a sense of identity. Sometimes, they may be searching for a specific item they believe is missing, even if it has been gone for years.

Proactive Strategies for Prevention and Management

Focusing on redirection and environmental modification can be highly effective in managing these behaviors without causing distress. These strategies prioritize safety and respect for the individual's dignity.

Create Designated "Rummage" Spaces

One of the most effective strategies is to provide a safe, designated area for rummaging. This gives the person a controlled outlet for their behavior without causing disruption or risk.

• Rummage Bins: Assemble bins or baskets with familiar, safe items. Examples include old clothes, towels, safe tools, or paperwork. Rotate the contents to keep them interesting.
• Personal Chest or Drawer: Dedicate a specific drawer or chest that belongs entirely to the person. They can fill it with their special items, giving them a sense of ownership and control.
• Memory Box: Create a memory box filled with keepsakes that evoke happy memories. This provides a positive and contained way for them to engage with objects from their past.

Redirect with Purposeful Activities

Engaging the person with meaningful, simple tasks can help redirect their restless energy. Look for activities that mimic the motions of rummaging but have a productive outcome.

• Sorting Tasks: Offer items to sort, such as organizing a pile of mismatched socks, sorting silverware, or rearranging coins.
• Folding Laundry: Provide a basket of towels or napkins to fold and stack. This can be a soothing, repetitive task.
• Simple Puzzles: Puzzles, coloring, or other simple crafts can provide mental stimulation and reduce boredom.

Immediate Safety Measures for the Home

Caregivers must prioritize safety, especially when rummaging and hoarding pose risks to the individual's health and well-being.

Secure Valuable and Dangerous Items

• Lock up Hazardous Materials: Store medications, cleaning products, sharp objects, and toxic chemicals in locked cabinets.
• Protect Valuables and Documents: Keep important papers, credit cards, wallets, and jewelry in a safe deposit box or a securely locked safe at home.
• Address Mail: Consider getting a lockable mailbox or a Post Office box if the person frequently misplaces or destroys mail.

Address Environmental Triggers

• Clear Pathways: Remove clutter from walkways and stairways to prevent falls.
• Check Trash Cans: Always check trash cans before emptying them, as important items are often hidden inside.
• Remove Spoiled Food: Periodically remove expired or spoiled food, which a person with dementia may not be able to identify as unsafe.

A Comparison of Reactive vs. Proactive Strategies

Understanding the difference between these two approaches can significantly impact the well-being of both the caregiver and the person with dementia.

Reactive Strategies (Less Effective)	Proactive Strategies (More Effective)
Scolding or Arguing: This increases agitation and causes distress.	Redirection and Distraction: Gently guide attention to a safe, purposeful activity.
Forcing Compliance: Demanding that they stop rummaging or clean up can lead to resistance.	Empathetic Understanding: Acknowledge their need for security and control.
Sudden, Massive Clean-outs: Removing all hoarded items at once can cause severe anxiety and emotional pain.	Gradual Decluttering: Work with them slowly, removing non-essential items over time.
Hiding Triggers Ineffectively: This leads to more frantic searching.	Providing Controlled Access: Create designated rummage boxes and secure hazardous items completely.
Focusing on the Problem: Dwelling on the negative aspects of the behavior.	Focusing on the Person: Attending to underlying needs like boredom or anxiety.

How to Respond with Empathy and Patience

The way a caregiver responds is crucial for de-escalating agitation and maintaining a peaceful environment. These compassionate techniques build trust and reduce conflict.

Validate Their Feelings

Instead of correcting them, acknowledge their feelings. If they are looking for something, try asking, "You seem worried about finding something. Can we look for it in your special box?". This validates their emotion without confirming a false reality.

Use Distraction and Offer Comfort

When you notice rummaging beginning, use distraction. Offer a favorite snack, turn on soothing music, or suggest a walk. Physical contact like a gentle touch on the arm can provide reassurance. Sometimes, simply sitting with them can ease their anxiety.

Involve Professional Help

For persistent or unsafe behaviors, professional guidance can be invaluable. A healthcare professional or occupational therapist can offer personalized strategies and address underlying issues such as medication side effects or anxiety. In more complex cases, specialized hoarding clean-up services can manage the environment safely and with respect.

Conclusion

Managing rummaging and hoarding in dementia requires a shift in perspective, moving away from confrontation and toward compassionate, proactive strategies. Prioritizing safety by securing dangerous and valuable items is paramount. Creating designated rummage spaces, redirecting with purposeful activities, and maintaining a predictable routine can help manage the behavior effectively. Ultimately, responding with patience and empathy, validating the person's feelings, and understanding the root cause behind their actions are the most effective tools for a caregiver. For additional resources and information on dementia care, visit the Alzheimer's Foundation of America.

Frequently Asked Questions

Why do people with dementia start rummaging and hoarding?

These behaviors can stem from anxiety, a need for security or control, boredom, memory loss, or the desire to feel purposeful and busy.

What is a 'rummage box' and how do I create one?

A rummage box is a container filled with safe, interesting items that the person can sort through freely. Fill it with things like old photos, fabrics with different textures, or safe tools, and place it in a common area where they can access it.

How should I react when I find my loved one rummaging through my belongings?

Remain calm and avoid showing frustration. Gently redirect their attention to their designated rummage box or a different activity, such as a walk or a favorite snack.

Is it okay to just throw away hoarded items?

No, you should avoid throwing things away without their knowledge, as this can cause significant distress and agitation. Instead, remove dangerous items, and involve them in a slow, respectful decluttering process.

How can I keep important documents and valuables safe?

Store all valuables, important papers, credit cards, and medications in a locked, secure place that is out of their reach and sight. Consider a safe deposit box for extremely important documents.

What if the rummaging seems endless?

The goal isn't to stop the behavior entirely, but to manage it safely and contain it. Focus on providing redirection and alternative, purposeful activities to satisfy the urge to rummage.

How do I handle unsafe hoarded items like spoiled food?

Prioritize safety by discretely removing dangerous items, such as spoiled food, sharp objects, and toxic cleaners, and securing them out of their reach.