Assessment and Treatment of Hoarding Disorder in Rural-Dwelling Older Adults

Current literature on hoarding disorder has been limited to urban areas. This article represents the first depiction of the clinical presentation of hoarding disorder in rural-dwelling older adults. A summary of the quantitative data and qualitative notes from comprehensive assessments with eight older adults living in rural Mississippi is presented and integrated into the existing literature on late-life hoarding assessment and treatment. Participants reported hoarding symptoms of similar severity to previous studies of urban samples, with the main difference being slightly lower clutter levels. Most participants were divorced or had never married. All participants reported having at least one current medical condition, with the most commonly reported diagnosis being high blood pressure. Half of the participants reported that they had experienced at least one intervention from their family; however, only one participant reported ever experiencing an intervention from another source. Several participants declined participation in a sorting/discarding task, suggesting a disconnect between interest in hoarding intervention and willingness to engage in treatment. Future research is needed to determine the efficacy of hoarding interventions in a rural setting and the utility of possible modifications, including greater focus on internal motivating factors or the use of teletherapy as a treatment modality. Public Significance Statement This study suggests that rural-dwelling older adults with hoarding disorder have many similarities to their urban-dwelling counterparts. However, several characteristics unique to a rural setting should be considered when treating rural hoarding, including decreased external motivating factors.