As an adult child of aging parents, there are several crucial conversations you need to have with them – the car keys conversation, the money management conversation, and the “where to live and what to do with my stuff” conversation. The latter may be the most difficult, and often the most prolonged. For many of the elderly, giving up things they’ve spent a lifetime collecting or that have particular sentimental value is like giving up part of their identity or their history. For some, however, hanging on to things is more than mere sentimentality, it could be hoarding. Here’s how to tell the difference, and some tips for helping your parents downsize.

Hoarding has now been designated by the psychiatric community as a disorder, rather than a subcategory of obsessive-compulsive disorder. However you classify it, hoarding presents significant safety issues for the elderly, who may have limited mobility, or frail health worsened by extremely cluttered and/or unsanitary conditions. How do you tell the difference between a hoarder and a clutterer or a collector? According to Psychology Today, criteria for a diagnosis of hoarding disorder includes the following:

• Ongoing difficult letting go of personal possessions, regardless of their value
• Strong urge to save items, and/or significant distress at the thought of discarding them
• A level of clutter so extreme that a home or office is unusable

In addition to presenting the risk of physical danger for the elderly – falls, respiratory issues, etc. – hoarding may also indicate the presence of dementia, Alzheimer’s disease or mental illness. According to The Alzheimer’s Association, 13% of people over 65 develop dementia. Of these, approximately 20% exhibit hoarding behavior. If your parents’ clutter is such that their living space is hazardous or unusable, the sooner you get the downsizing wheels in motion the better.

Even if your parent isn’t a hoarder, working with them to declutter sooner rather than later makes the process easier on everyone. Having to speed through downsizing in the wake of a medical crisis or home sale and move can be extremely stressful on everyone involved. Before you start the conversation, think about what David Solie, expert in geriatric psychology and author of How to Say It to Seniors, says about how our focus shifts as we age. Instead of being driven to achieve more, older adults are driven to 1) maintain control over their lives, and, 2) discover their legacy, or what will live on after them. Framing your conversation and actions in a way that respects these two drivers will help the conversation to be more productive. Here are some tips.

Start early. Some of the (perceived) clinging to things is sentimentality, and some of it is just being overwhelmed and not knowing what to do with them, or not having the energy to deal with the process. Use some time during visits to clean out a closet together and focus on “repurposing” items through donations to charitable organizations such as Goodwill or Dress for Success.

Listen. Your parent wants to be remembered. Mom or Dad may offer to give you things each time you visit, not necessarily to declutter, but to ensure their legacy. Even if you don’t want the item, listen to the story about it and why it means so much to them. Take a picture of it (with your parent), and document the story. It can be a great bonding moment, and will demonstrate that you also care about their legacy.

Give them choices. Help them maintain some control by deciding which items are “give away”, “sell”, “throw away”, or “keep.” Get rid of the “throw away” items immediately, but allow your parent some time to revisit the other boxes (gently nudging more items out of the “keep” box into the others).

Make a record. Take photos, and/or make a video/audio recording of the stories associated with the most special items. This may help your senior give up the item, because they have a replacement, and will be a nice memento for a family member who receives it.

Have a party. Invite close family members to visit and hear stories and take designated items home with them. Obviously, this wouldn’t work in all families, but if it does, it satisfies for the senior both the need to maintain control and discovering their legacy at the same time!

If you’d like more helpful hints or just an opportunity to pick my brain about downsizing, please feel free to contact me at 408-79-3269 or via email at minda@mindacutcher.com.