Allow me to introduce you to Diogenes syndrome. It is a particularly unpleasant behavioral disorder whose sufferers are often elderly.
Diogenes syndrome is hoarding on steroids. It is characterized by squalor in the home, hoarding and extreme self-neglect. Think 100 cats kept in a 2-bedroom house, stacks of papers to the ceiling that make hallways impassable, rooms full of garbage, or compulsive buying of unneeded items that accumulate on every horizontal space. People with the syndrome become isolated, unkempt, are often foul-smelling and avoid medical care, leading to a host of untreated medical conditions.
Nonetheless, you may find it difficult to identify a person suffering from Diogenes syndrome. The sufferers tend to be of average or above-average intelligence and will not admit, and may not even recognize, that there is anything wrong. There is no one grouping of symptoms that leads to a clear diagnosis.
Diogenes syndrome is often associated with other mental illnesses, such as schizophrenia, mania, and frontotemporal dementia. It is difficult to treat because the sufferers often deny that a problem exists and refuse help.
Diogenes syndrome can be fatal. People with Diogenes syndrome suffer an increased death rate – over 46% will die within 5 years, usually from physical illnesses resulting from living in squalor and self-neglect.
So how can you help a senior whom you suspect suffers from Diogenes syndrome? The successful approach is not simple, primarily because most sufferers are extremely resistant to any type of help.
If you can establish a good rapport then you may be able to induce the senior to go to a good doctor. A full physical exam, including blood tests, should be completed, and the doctor could administer cognitive testing. Many of the symptoms of Diogenes syndrome could be related to a treatable medical condition.
You could bring a geriatric care manager in to consult, or set up a flexible outpatient treatment that includes counseling and cleaning services. There are some medications that can be prescribed, but the common ones address just one symptom of the disorder – for example, zopidem for sleep, paroxetine for hoarding, and quetiapine for bipolar disorders.
The goal of treatment is to have the senior remain is his or her home. Statistically, Diogenes syndrome sufferers are at a much greater risk of dying if they are placed in an institution.
Nonethless, sometimes the home conditions are so dangerous that you don’t have a real choice. In an extreme case, you might seek an involuntary mental-health commitment or a guardianship.
Adult protective services workers know that these are difficult cases. A senior has the right to make choices, even bad ones like sleeping on top of a pile of garbage in the bedroom. Hoarding and anti-social behavior do not necessarily mean that the senior does not have capacity.
The sufferers who successfully overcome the syndrome do so by making small changes that alleviate their unhealthy living conditions. The process may take months or years, and involve a lot of family and community support.
Hammerle Finley Law Firm. Give us a call. We can help.
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The information contained in this article is general information only and does not constitute legal advice.
