By Lacy Doremus, LMSW
 
IT’S TIME TO MOVE.

It may be you, or an elderly parent, but it's your responsibility.

Mention the word “moving” to almost anyone and the look on his or her face becomes one of sheer horror.  It’s the same look one has when visiting the dentist or being audited by the IRS. In the Holmes-Rahe Life Stress Inventory, moving ranks 32nd out of 43 traumatic life events.  The physical logistics of planning, packing, and paying for a move are significant.  Add the emotional component and it leads to a condition known as Relocation Stress Syndrome or RSS ( Mallick and Whipple, 2000).  RSS can affect anyone regardless of age or situation.  However, the older adult is most vulnerable due to their physical health, cognitive, emotional status, and often lack of coping skills.

THE BOOMER

For the “young” elder or baby boomer, moving can be a freeing experience.  The move is often by choice.  Hopefully, they have had the opportunity to plan a roadmap of their future. They feel a sense of control over their own destiny. Although the accommodations may be smaller, such as living on a boat or in an RV, it is the “right size at the right time”. They are not residing in an empty nest but, rather, residing in the right nest to fit their physical, emotional and/or cognitive needs.  They remain in the driver’s seat as relates to health, work, leisure, finances, housing and relationships.  Moving presents a new adventure and chapter in life. 

THE FRAIL ELDERLY

Then there is the case of the frail elder (perhaps your elderly parent) who must downsize. Aging in place is not an option for a number of reasons.  A frail elder is defined as physically or cognitively impaired or both.  Much has been written about adjusting to the new accommodation, but less about the actual process of moving.  How does one actually downsize a household where one has resided for decades? How does one assist the disorganized clutterer or hoarder? Here the process can be anguish for everyone involved. 

The frail elder may be unable to cope with the process and the adult child is at a double loss – convincing the frail elder that the move is necessary and assisting with the move itself. For the frail elder the move is often to smaller accommodations.  It is usually to an assisted living facility, nursing home, smaller house, or apartment. It can even be into the adult child’s residence.  Often the move is not by choice.  Factors for relocation include the following:  decline in health; loss or impending loss of a spouse or partner; continued medication errors; inability to keep up with interior and exterior house maintenance; the inability to complete IADL’s or ADL’s; the risk of being taken advantage of; frequent hospitalizations; history of falls; self-neglect; lack of finances; and finally, the need to be closer to adult children regardless of the state of the relationship.

The frail elderly may (realistically) consider this their final move before death. Not only is there grieving for what was but also the artifacts of an unused life – what could have been but wasn’t.  Although there may be significant positives in rightsizing such as care, safety, activities, and support there is often the focus on loss.  There is the loss of independence and control. There is the fear of the unknown as one loses the routine and predictability of one’s life. There is the loss of roles, identity, and connectedness.  Finally, it is a reminder of one’s death and dying.

THE BOOMER AS HELPER

For the adult child/boomer who may be assisting with the move, it is less about loss and more about change.  It is a time of increased responsibility as one accepts new roles. There is often a change of family dynamics and realignments. Adult children are forced to confront the ambivalence they might have regarding the relationship they have with their parents.  It is a reminder of one’s own mortality and vulnerability.  All this adds to the stress of the move but it’s got to be done.

THE LAST MOVE

In this case, the frail (or not so frail) elder dies, leaving an entire household for the adult child to deal with. Here, it is about loss. But after the funeral and the paperwork, there is still a move to be made. There may be help (other siblings) or hindrance (other siblings). Often the non-titled property has little or no financial value, but has sentimental, historical and/or emotional value both for the giver and receiver. Personal belongings usually have different meanings to each family member. Frequently, decisions regarding these possessions come at a time of crisis.  This time can be an opportunity for family members to reminisce, share memories and work through the grieving process. Unfortunately, this is the ideal rather than the norm.  In these situations it is important to determine what are the goals in the distribution of property and what is the meaning of “fair” among family members. Fair does not always mean equal. Determine what are family members’ perceptions of these highly charged words to avoid misunderstandings. It is helpful to also determine the players – for instance, no spouses. Two books, which are very helpful to assist in this process, are THE SETTLEMENT GAME, by Angie Morris and WHO GETS GRANDMA’S YELLOW PIE PLATE, by Marlene Strum and Marsha Goetting. Disputes in settling estates are often a major reason for adult siblings to break off relationships with one another for decades or even longer.

WHERE DID ALL THIS STUFF COME FROM?

THE SAVERS

For the frail elder who lived through the Depression, saving was a key to survival.  One has only to listen to old proverbs such as “saving for a rainy day” or “waste not, want not” to hear this message.  There was no short shelf life of goods and technology as there is today.  For the older person with this mindset, it is almost sacrilegious not to save.  Preventing the accumulation of stuff requires active effort.

THE CONSUMERS

Then came the Boomers. Anyone who has grown up in the second half of the last century did so in a culture of unparalleled affluence.  Goods were available. They were relatively cheap.  Stuff was easy to obtain – and we did. Everyone wanted to keep up with the Jones’.  The Boomers have had a lifetime to accumulate their own stuff.  While they may have moved out of their parents’ home with only what could fit in a station wagon, they’ve started their own households, raised their own families, and moved over the years to what have probably been a series of ever-expanding living spaces where more stuff was gathered. The culture has emotionally rewarded “moving up” to a bigger place, as has the financial market.  McMansions and Super Sizing are what we strive for.  Perhaps there were previous corporate moves where a professional crew packed everything, including the dirt in the flowerpots. Unless one has the discipline of a military trainee, has the wanderlust of Tolkien’s Gandalf, or is a counter- culture minimalist, the stuff tends to accumulate.

THE DYSFUNCTIONALS -DISORGANIZED CLUTTERERS and HOARDERS

Added to this are two personality traits – those of the disorganized clutterer and the hoarder. Although many people interchange these two words, there is a difference between the two. The most significant difference is that, with prodding, a person who clutters can throw items away. They recognize that they have a problem. Hoarders don’t see a problem.
 
Clutter can be best characterized as “disorganization gone wild”.  In the book RESTORING ORDER, by Vicki Norris, she describes four causes of disorganization. They are as follows:

1.  SITUATIONAL DISORGANIZATION. Often a life event or crisis causes disorganization or disruption in one’s life.

2.  HABITUAL DISORGANIZATION. This is when bad habits develop and snowball over time and become chronic. 

3.  HISTORICAL DISORGANIZATION. Often they have grown up with disorder and chaos. They model these behaviors.  There are also some who rebel against the neatness of their early environments.

4.  SOCIAL DISORGANIZATION. This is a cultural phenomenon where our society encourages accumulation and consumerism. Think how after 9/11 people were encouraged to go shopping.  Consumerism enslaves us.

As previously mentioned, the disorganized person who clutters recognize there is a problem and generally wants to do something about it.  They just never seem to find the time to organize or know how and where to begin. Often, when they attempt to organize,  “churning” occurs.  Churning involves moving items from place to place but never tossing enough stuff out to address the problem.  They are usually ashamed to have people visit. Often these clutterers become socially isolated, not because they do not enjoy the company of others, but because of the embarrassment of clutter.
 
On the other side is the hoarder. With hoarding behaviors, there is little or no insight into the fact that there really is a problem.  Items accumulate, but with a purpose no matter how strange the purpose appears.  All reasons seem logical and make sense to the hoarder even if its just trash. Broken, useless objects are coveted as much as items purchased and never used.  They just might need all these items someday. Hoarding is not just a house problem; it’s also a person problem.

Frost and Hartl (1996) provided the first systematic definition of compulsive hoarding. They identify three characteristics of the hoarder. These characteristics are: the acquisition of, and failure to discard a large number of possessions that appear useless or of limited value; living spaces so cluttered as to preclude activities for which those spaces were designed; and the significant distress or impairment in functioning caused by the hoarding.  It impairs activities of daily living and provides unhealthy and unsafe living conditions. The interference in functioning can make hoarding a dangerous problem, putting people at risk for fire, falling, poor sanitation and health problems (Dameour and Charron, 1998).  In a television show on BBCAmerica called “How Clean is your House” the focus is showcasing the filthiest, most cluttered homes in the United Kingdom and their subsequent clean up. In addition to removing the clutter and trash, the surface areas in the homes are also measured for bacteria and air quality is checked.  In house after house, one is able to identify who is the disorganized clutterer versus the hoarder, based on their perception of the problem.  The hoarder is oblivious to the dangers lurking in their house and within two weeks the hoarding has once again begun in earnest. The disorganized collector displays a new sense of pride in their home and desire to remain clutter-free. Lessons have been learned.

In a presentation and subsequent paper by Elaine Birchall, a social worker with the Ottawa Public Health Department, four types of hoarding behaviors were identified. They are as follows:
 
1.  INSTRUMENTAL HOARDING. Items are saved because they might prove necessary in the future regardless of their usefulness.  Often this hoarder views themselves as thrifty, frugal, and very resourceful.

2.  SENTIMENTAL HOARDING. These items provide comfort and emotional security.  This person relies on the attachment of things versus human contact or relationships. Stuff does not disappoint. They are surrounded by memories of their life.

3.  DIOGENES SYNDROME. This syndrome is characterized by gross self-neglect, domestic squalor and hoarding trash. Often the person is elderly and comes to the hospital due to illness, weight loss, and poor grooming. It is usually a life-long pattern of accumulation (Christensen & Greist, 2001).

4.  ANIMAL HOARDING. Less clinical research has been completed with this type of hoarding. Usually these hoarders are female and unmarried. Typically animals played significant roles in their childhoods, which were often characterized as chaotic, inconsistent, and unstable (Patronek, G.J., 1999). Hoarders of animals emphasized that their animals gave them unquestioning and uncritical love (Worth & Beck, 1981). As with other types of hoarders, they lack insight that their hoarding of animals is a problem. They view themselves as saviors even though the animals reside in squalid conditions and are often sick and malnourished.

Hoarding behaviors affect approximately one to two percent of the U.S. population. This translates into two to four million individuals.  Typically the median age is 50, but onset often occurs in adolescence.  They are usually unmarried and socially isolated.  They are prone to depression, social anxiety, perfectionism, indecisiveness, procrastination, and avoidance (Steketee, 2006). They need to be surrounded by familiar objects to feel safe and secure. Fears of losing important items they might need at some future time, excessive attachment to possessions, and making a wrong decision about what to discard may drive them to save everything. In research by Dr. Randy Frost PhD, emotional deprivation and the level of warmth expressed in the family during adolescence were significant for the development of hoarding behaviors. Hoarding is not linked to income, intelligence, ethniticity, or education. In reviewing the literature, all but one study points to hoarders as females. However, in a study by Samuels, et al., 2002, he reported hoarding as occurring twice as frequently in males than in females.
 
Hoarding behaviors are often linked with the diagnosis of obsessive-compulsive disorder.  Using a positron emission tomography scan or (PET) people diagnosed with OCD with both hoarding and non-hoarding behaviors had their brains scanned. OCD patients with the hoarding component had a very different pattern of cerebral glucose metabolism.  They had a significantly lower metabolism in the dorsal anterior cingulated gyrus than non-hoarders. This is the area of the brain that governs decision-making, organization, attention, motivation, and problem solving skills.  Usually these people have difficulty with visual, spatial orientation (Saxena et.al, 2004). In a recent study sponsored by NIMH, called “ Neural Mechanisms of Compulsive Hoarding” people with and without compulsive hoarding, regardless of a diagnosis of OCD, were put into an MRI scanner to observe brain activity. While in the scanner, participants were asked to think of making decisions to discard personal possessions.  In the brains of people with compulsive hoarding, decisions to discard possessions activated brain regions associated with punishing or unpleasant events.  Decisions to discard may be experienced as punishing or uncomfortable and thus to be avoided.  Further research is needed to determine if hoarding should be defined as a separate disorder versus a symptom or subset of OCD.  Also, people diagnosed with OCD have not responded well to serotonin reuptake inhibitor (SRI) antidepressant medications, whereas compulsive hoarders have had better but limited success. Paroextine (paxil) had the best results, especially if combined with cognitive behavioral therapy. More research is indicated. However, as the hoarder does not recognize he/she have a problem, outcome is guarded even with intervention.

Dr. Randy Frost of Boston University and, as previously mentioned a leading researcher in hoarding found that hoarding runs in families.  People who hoard usually have a first-generation relative who is described as a “pack rat” (Frost et al., 2000). Often a person with a diagnosis of Alzheimer’s dementia has hoarding behaviors.  However, it is felt that this is due to an inability to differentiate between necessary items and trash.  Also, if a person sustains a brain injury to parts of the frontal lobes of the cortex he/she will often develop hoarding behaviors (Anderson, S.W., 2004). In addition, research at Johns Hopkins Medical Center has indicated chromosome 14 is linked with compulsive hoarding behaviors in families with OCD (Samuels, J., Shugart, Y.Y., Grados, M.S. et al.).

Regardless of biology with both hoarding and cluttering the outcomes are similar – piles of stuff.  Their houses are full of stuff.  Their garages are full of stuff. Their basements are full of stuff.  There are narrow pathways surrounded by stuff.  With all this stuff it is important to determine if it’s due to disorganization or hoarding behaviors. The National Study Group on Chronic Disorganization (NSGCD) has developed a Clutter-Hoarding Scale as a guideline tool to define the level and clutter in a home.  The five levels relate to the health and safety of the individuals living in such an environment.  Knowing the level of the clutter help in developing a treatment plan.  People at Level I and II are likely to just be disorganized.  They are often creative people with numerous interests and projects. People at Level III through Level V need psychological and/or medical intervention.  A Level II house may evoke the eyesore of Oscar from the “Odd Couple” whereas a Level V dwelling is a virtual no-man’s land of structural damage, infestation of animals, unusable water and sewer, rotting food, and often no power. It is truly a health hazard. Often the only recourse is to condemn the property.

While hoarding affects a small percentage of the population, and disorganized cluttering probably a much larger percentage, stuff accumulates because it can. If one remains in their home for decades it accumulates.  If a corporation moves you even the trash goes along to the next accommodation.  If you’re moving yourself you load up the stuff promising to sort it when you have time.

DEALING WITH ALL THAT STUFF
 
After determining the level of the clutter, it is important to address what hoarders and clutterers think as to the reasons they collect and then explore what purpose it serves. Do they feel safer and more secure when surrounded by stuff? Are they afraid that if they throw out items they will lose that memory?  Do they think they’ll need it in the future? Are they fearful of throwing out the wrong item so they just keep it all?   Often a third party can prove to be the most beneficial in dealing with all the stuff that has accumulated. Along with the appropriate psychological intervention, there are companies, which specialize in moving the elder. They are often members of the National Association of Senior Move Managers (NASMM) who are better equipped to handle the trauma of the elder’s move.  Although slightly more costly than conventional movers they can save families a great deal of ill feelings and grief. Also, members of NASMM are excellent resources for obtaining estate sale agents, trash-haulers, recyclers, and charity organizations.  These companies focus on building a trusting relationship with the elder prior to the move.  They may have training necessary to explore why the person collects versus just throwing out the items or boxing them up.  Much of their initial work involves simply listening to the elders talk about their possessions, a ritual that the adult children or grandchildren may not have the patience for.  The elder is going through a life-review and grieving process.  They’re reliving decades of their lives through their stuff. Often this third party can overcome resistance to getting rid of stuff better than an adult child. In the journal Social Work Today, Gail Steketee, PhD, from the Boston University School of Social Work, focuses on the need to approach the hoarder with respect, sensitivity, and a non-judgmental attitude.  Confrontation is not effective. If at all possible stuff should not be touched without permission first. She stresses the need to understand the underlying issues.  Without the why it is only a matter of when the hoarding will begin again.  In an interview with Dottie Albright of Transitional Moving in Atlanta, Georgia, and a member of NASMM reported in an interview with me that she helps the client focus on safety issues when rightsizing (downsizing). Often an individual will listen to a “professional” rather than their own children regarding possessions. Ms. Albright often reframes the clutter to the client as a collection that has acquired a collection so it is time to rein it in.

READY, SET, GO – MOVE THAT STUFF

MAKING A PLAN

The time has begun to get rid of the stuff whether moving yourself or the   assisting an elderly parent with a move. The first step is to set a date on the calendar.  ALLOW NO EXCUSES.  It may be helpful to take pictures - “before” pictures so when the going gets tough you can see that you are making progress. Also, for sentimental reasons it is helpful to take pictures of items, especially if you’re not taking them to the new environment. These pictures can then be placed in a memory book providing a life review for all family members.  Even if you’re the one moving, keep a non-judgmental attitude towards yourself. Instead of beating yourself up over the amount of stuff you have allowed to accumulate, pat yourself on the back that at last you’re actually doing something about it.  Keep positive and reframe the messages you’re giving yourself.  You’re not downsizing or de-cluttering -you’re rightsizing and creating the right space for the right time. As you may be grieving over the losses of ones life’s possessions, remember the “beach wisdom” of Anne Morrow Lindberg in her book, GIFT FROM THE SEA. Middle age is, or should be a period of shedding shells: the shell of ambition, the shell of material accumulations and possession, and the shell of the ego. Simplification of one’s life can provide inner and outer harmony as well as a sense of liberation.

It is also important to allow yourself enough time to rightsize.  In the book RIGHTSIZING YOUR LIFE by Ciji Ward, she recommends planning approximately seventeen days to sort and purge a two bedroom, two-bathroom house.  Add five additional days if there’s a garage, basement, attic or workshop.  Having moved five times in the last seven years it is my opinion that this is NOT enough time.  I would describe our Household as Level II on the Disorganized Clutterer- Hoarding Scale. Even with professionals doing the packing, boxing, and moving it took approximately thirty full-time days to de-clutter and right size a three bedroom, three-bath house with garage and basement. If a strict timetable is not necessary, set a day or two each week to right size. If working daily for a period of time, it is important to allow yourself a pampering break – even if it’s only for a cup of tea or to close your eyes and listen to a cd. You’ll need to keep your head free of clutter!

Dealing with pets, and animal hoarding, is beyond the scope of this paper.  If you know that pets and animals might be involved, though, give some thought now to how you might deal with them when the time comes. Dumping a no longer wanted pet at the pound is NOT an option.

SETTING PRIORITIES

The first rule to rightsizing is to PRIORITIZE.  Unless you are planning a move in another year or two there will be time constraints.  Prioritize the timing of rooms and areas of space. It is important to tackle only one room or area at a time. It is often helpful to start with a small area until one gets into the routine. Another way is to start with the safe or less used rooms to rightsize. With each room or area it gets easier to rightsize.  Practice does make perfect. Prioritize the other tasks that could get in the way (like closing bank accounts or saying goodbye to neighbors).  These tasks can be used as necessary breaks, or opportunities to visit dumpsters.  They can also be used as excuses, however.  Then prioritize the usefulness of the items themselves.

EXECUTING

The 4 Piles

Place objects into four piles and ask yourself the following:

1. What do I Save?

2. What do I Sell?

3. What do I Discard? 

4. What do I Donate, recycle, or give to a family member?

Try not to go back and forth between piles once a decision is made. There will be “separation anxiety” but remember this is a time of liberation and/or simplification.

Okay, so even with asking these questions you just can’t get into the swing of things. Here are even tougher questions to ask to keep up your rightsizing momentum.
 

Saving

1. If I take an item do I have a plan to use it?

2. What are my space limitations?

3. Do I have more than one of these items?   Remember - if you’re not going to be entertaining more than six people at a time, don’t bring glasses for twelve.

4. Have I used this item in the last year?  If not it goes. No reprieves.

5. If I decide to keep a particular item, what am I willing to put in one of the other piles as an exchange?

6. What is the worst thing that could happen if I don’t have this item?

7. Do I love it?  Does this item have such special meaning or sentimental value that I cannot imagine my life without it?

8. Is it functional?   Is it durable? If you haven’t fixed a broken item before now, chances are you won’t. Let it go.

Selling

1. Has somebody already offered to buy this item in the past?

2. Was it purchased with an eye towards investment (for instance, a painting)?

3. Is there a market for similar items on eBay?   What’s a good asking price?

4. Is there a local consignment shop?

5. Is there enough (and enough time) for a yard sale?

6. Is there enough for an estate sale?

Discarding

1. When does the trash man come and how much will he take?

2. Where are the nearest (and biggest) dumpsters?

3. What may need to be dealt with as “Hazardous Materials”?

4. Is there enough to rent a “skip”?
 

Donating

1. Has a friend mentioned he/she would really like some item?

2. Has a sibling or relative mentioned he/she would really like some item?

3. Is there a substantial tax break involved?

4. Is it in good enough shape that a charity would take it?

5. Where is the local recycling area?

OTHER HINTS

It is important not to take it personally if your children do not want your items or collections.  Even if you have spent years collecting those special possessions and they have given you joy, they do not have the same meaning or sentimental value to others.  Take a few with you and ask family and friends to take a favorite item or two from the collection.  Again in the age of eBay you might find that a certain person one thousand miles away appreciates and wants your collection. Find ways to make the process fun.  Consider a “Housecooling” Party. At housewarming parties, friends generally come over with a “gift for the house”. Reverse the process and throw a party where everyone has to leave with a “gift from the house”. You’d be surprised at how much fun people have and how quickly your “junk” becomes someone’s prized “treasure”.  Clothing items are a big item to rightsize. American closets are oversized and as a result we have too many clothes.  Especially with all the imported goods, clothing has become quite inexpensive.  Remember most homes in Europe do not even have closets and one must purchase wardrobes to keep their clothes in. For starters, pick twelve outfits that can be mixed and matched. Next, put the clothing on. If it doesn’t fit, it goes.  Don’t keep something around because you’re really going to lose that extra twenty pounds. If that happens, reward yourself with something new. Remember you must get rid of the larger outfit. Ask yourself when was the last time you wore an outfit when going through your closet.  If it has been a year, it goes. Chances are that the clothing items you own are not classics and will never really come back into fashion. Few of us have Armani or Dior in our closets. Also, if one is rightsizing, the clothing you wore to the office may not be appropriate in your new life chapter. If you truly can’t let go of particular clothing items ask a friend who is your size if they want the items on loan. In all likelihood once it’s gone you won’t miss it and remember this is not a trading session.

Many boomers and frail elder’s households have also become holding tanks for their children’s stuff. Unless they are in school or the military, you have launched them.  A student at age thirty needs to accept some responsibility for their own stuff. It’s time they learned to address their own cluttering issues. Provide them with a time frame to make plans for their stuff that has been stashed at your home.  If you have more than one child perhaps they can pool their resources and rent a storage container or pod. It is no longer your responsibility or your job.

CONCLUSION

Rightsizing is a way of life. It is not easy.  It is asking ourselves daily what matters. Nothing remains the same.  Every day we’re a day older and we must begin and continue to adapt ourselves, our homes, and their contents to the various stages and needs of our lives. It is always helpful to remember (and remind the “movee”) that when one door closes, another opens. Some doors are better than others, but they’re all opportunities for learning and growth. Often they help teach others. Whether by choice or unforeseen circumstances, you now have to open the door to a new life and hopefully a new rightsized environment. There are no excuses for bring unnecessary baggage from your old life with you. It is a time to remember the Greek philosopher Hericulon’s words that “nothing endures but change”.  

For more information on our products and services, please contact us at:

2112 Eastman Ave., #112
Ventura, CA  93003

Phone:  (805) 650-1178
Email:  This e-mail address is being protected from spambots. You need JavaScript enabled to view it