PLEASANT HILL -- A capacity crowd of care providers proved to be a dedicated bunch, as they gathered in a conference room to explore further measures to reduce the risk of seniors taking what is often a debilitating fall.

"Falls are not a statistic we're imprisoned by, they're preventable," Gennifer Mountain, the outgoing program manager of the Fall Prevention Coalition, told the group.

The program currently serves 650, low-income seniors in Contra Costa County, with members from 70 related agencies.

At the recent meeting in Pleasant Hill, participants delved into a realm that can be a key causal factor, but until recently was rarely discussed.

Patrick Arbore of the National Institute on Aging addressed the topic of seniors who are hoarders and whose clutter-filled homes, as well as having animals around, can pose significant obstacles.

A barrier to providing relief, however, is their corresponding shame, defensiveness and deep "psychic clutter." He cited the need for untrained caregivers to seek out expertise from local mental health associations, public health departments and area agencies on aging.

"How to help a senior so they're not stressed by (your presence) and can accept the help, that's the million dollar question," said Elaine Clark, the executive director of the Meals on Wheels and Senior Outreach Services that oversees the program.


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"People tend to address the stuff, not the individual," said Arbore. "What they need is someone to understand them."

Clark can cite significant anecdotal evidence that other measures, including the program's effective home visit exercise programs to increase balance, are working to reduce the number of falls. But, addressing hoarding will require tremendous patience, she and Arbore concurred.

"Surprise cleanouts never work," Arbore admonished, citing the multiple contributing factors, including depression, repressed earlier trauma, isolation, loneliness, addiction and cognitive impairment that crosses all socio-economic lines and "all walks of life."

He noted, for instance, issues with their brain's prefrontal cortex, which regulates executive functioning, including decision-making, being overwhelmed by intense emotions triggered in the amygdala.

He added that these seniors have often ascribed human characteristics to their unwieldy amount of possessions.

He noted that one of his clients went so far as to proclaim herself the "Joan of Arc of broken-down furniture."

"Their stuff is their safety valve ...

"When they're entrenched in their home and surrounded by clutter, they feel safe ... and they're going to great lengths to protect their stuff," he said. "They've created a story around it."

Arbore said his talk was timely as these seniors may realize on some level that they are missing that human connection during this time of year.

"The holidays are often vulnerable times," Arbore said after the meeting, citing intensified feelings of isolation as family members are precluded from visiting.

"There may be an opening (for discussion)."