[Report] Hoarding behaviour and housing insecurity for older adults

Hoarding is a complex mental health disorder that causes people to collect excessive possessions, cluttering living areas and causing problems in their social, work and other aspects of their day-to-day life. People living with this disorder have trouble parting with things due to a perceived need. This research project was the first to explore and improve our understanding of the effect of hoarding on housing insecurity. It provides valuable insights into how community-based organizations, municipalities and housing agencies can effectively work together to address this challenge.

Report in PDF available for download at the bottom of this page.

3 Key Insights

✔ Clear link between hoarding behaviour and housing insecurity: Hoarding behaviour creates unsafe living conditions, financial strain and housing insecurity. It puts individuals at risk of houselessness while affecting families, communities, service providers and landlords.

✔ Early intervention is needed to address symptoms: Effective interventions should empower clients, promote healthier hoarding-related behaviours, prevent the worsening of their situations and symptoms and help manage associated conditions.

✔ The case for a coordinated case management approach: A dedicated case manager takes ownership of hoarding cases, guiding clients through a structured support system.

How to keep seniors with hoarding disorder housed

People living with a hoarding disorder have trouble parting with their possessions due to a perceived need. This leads to excessive accumulation, which causes problems in many areas of day-to-day living. For seniors, hoarding disorder often creates unsafe living conditions, financial stress and housing insecurity. Hoarding disorder is chronic and progressive, with a high relapse rate, highlighting the need for long-term treatment and support.

Understanding the link between hoarding disorder and its impact

This research project explored the relationship between hoarding behaviour and housing insecurity among seniors. The research showed that hoarding behaviour creates unsafe living conditions, financial strain and housing insecurity. It puts many people at risk of houselessness and impacts families, communities, service providers and landlords.

The research also showed that seniors often seek help only when eviction is imminent, driven by the crisis rather than a desire to address their hoarding behaviour. It highlighted that current responses miss the bigger picture by focusing on the housing crisis and preventing eviction.

Without post-crisis treatment or support, most people simply restart the acquiring cycle. Crisis intervention itself can trigger further hoarding behaviours and intensify the desire to acquire and keep items. This approach also limits client control, insight and motivation. This highlights the need for support that addresses the underlying disorder instead of focusing only on the housing crisis.

“Crisis intervention itself can trigger further hoarding behaviors and intensify the desire to acquire and keep items.”

The findings emphasize the need for comprehensive, coordinated support to effectively tackle the physical, mental and financial challenges caused by hoarding disorder.

The study found that successful support strategies include harm reduction, case management, mental health support and systemic changes in service delivery. Long-term success requires 4 key factors:

• Time to address the disorder gradually.
• A sense of control for the individual to foster engagement and trust.
• Motivation to change behaviour, driven by positive reinforcement.
• Insight into the disorder, helping individuals understand its impact on their lives.

How to keep residents in their homes

Researchers recommend 2 key approaches to effectively address hoarding disorder and support seniors in staying housed:

• Coordinated case management Assign a dedicated case manager to oversee hoarding cases, guiding clients through a structured support system.
• The case manager provides long-term support and ensures individuals receive structured support and access to resources, reducing the burden on initial service providers.
• A system-level prevention and harm reduction approachStandardized referral pathways and interdisciplinary collaboration stabilize clients’ living situations.
• Focusing on harm reduction reduces crisis recurrence and the societal and economic impacts.

********************************************************

Program: National Housing Strategy Research and Planning Fund

Activity Stream: Research Project

Title of the Research: Hoarding Behavior and Housing Insecurity for Older Adults

Lead Applicant: Sage Senior Association

Project Collaborators / Partners:

• Greater Edmonton Foundation
• AHS Environmental Public Health
• Terri Bailey Counselling
• Edmonton Social Planning Council