INTRODUCTION:

Hoarding disorder is a progressive, debilitating, compulsive disorder only recently

diagnosed on its own. Hoarding had been a symptom of OCD previously but differs from

OCD in significant ways. Hoarding involves the excessive acquisition of animals or useless

things, cluttered living spaces that become uninhabitable, and significant distress or

impairment for the individual. Hoarding can seriously compromise the person’s quality of life

and even become a health, safety, or public health hazard. The criteria for diagnosis of HD in

DSM-V are persistent difficulty discarding items, the desire to save items to avoid negative

feelings associated with discarding them, significant accumulation of possessions that clutter

active living areas, and significant distress or impairment in areas of functioning. Usually,

these items are perceived to be useful in the future or to be esthetic or cause an emotional

attachment. If clutter is severe, it can cause threats to public health and safety such as fire

hazards and falls (Malloy-Diniz, F, Renteria, M, & Wheaton, M, 2017).

Treatment and interventions can be medication, cognitive–behavioral therapy (CBT),

self-help groups, or the involvement of outside community agencies. Not a great deal is

known about the success of these approaches at this time. The following disorders are

sometimes viewed as related to OCD: repetitive, compulsive behavior that is potentially

harmful to the individual. Others view them as behavioral addictions, characterized by an

inability to resist the urge to engage in potentially harmful actions. (Videbeck, S. 2020)

Diagnosis most commonly occurs between the ages of 20 to 30. The prevalence and

severity of the disorder are 2% to 5% of the population and increase with age. It is more

common in females, with a parent or first-degree relative who hoards as well (Dozier, Porter,

& Ayers, 2016). Currently, researchers believe compulsive hoarding affects 1 in every 50

people, but it may impact as many as 1 in every 20. According to the National Alliance on
Mental Illness (NAMI) Massachusetts, up to 5 percent of the world’s population displays

symptoms of clinically-diagnosable hoarding. (Hull, M. 2020)

Furthermore, mental illness is the third most common disability in the Philippines.

Around 6 million Filipinos are estimated to live with depression and/or anxiety, making the

Philippines the country with the third-highest rate of mental health problems in the Western

Pacific Region. (Martinez, A, Co, M, Lau, J, & Brown, J. 2020)

 REASON FOR CONDUCTING THE STUDY

The reason why our group was assigned hoarding disorder as our case study was for u

s to have a deeper knowledge about this disease. This also helps us understand the disease pro

cess of hoarding disorder, and orient appropriate nursing interventions that could be offered/h

elp to the patient. Through this, we could identify and address the needs and concerns of our

upcoming future patients by providing them with proper individualized or standardized care.

OBJECTIVES:

General

This case study aims to broaden the knowledge and skills of nursing students regardin

g the management of congestive heart failure utilizing the nursing process.

Specific

⮚ To conduct a proper assessment to determine the factors or causes associated

with the development of hoarding disorder

⮚ To develop nursing diagnoses that can serve as a foundation in prioritizing a pl

an of care for the client with hoarding disorder.

⮚ To formulate a specific, measurable, attainable, realistic, and time-bound plan

of care and determine the expected outcomes.

⮚ To perform appropriate nursing interventions in promoting client’s comfort an

d wellness.

⮚ To evaluate the effectiveness of all interventions rendered to the client, and to

know whether the expected outcomes are met.

⮚ To document the patient’s response to the nursing and medical management rendered.
Dozier, M. E., Porter, B., & Ayers, C. R. (2016). Age of onset and progression of hoarding
symptoms in older adults with hoarding disorder. Aging & Mental Health, 20(7), 736–
742.

F.A Davis. (2021). Lorazepam. Davis Drug Guide for Rehabilitation Professionals.
https://fadavispt.mhmedical.com/content.aspx?bookid=1873&sectionid=139016525

Hull, M. (2020). Hoarding Facts and Statistics. The Recovery Village.

https://www.therecoveryvillage.com/mental-health/hoarding/related/hoarding-statistics/

Malloy-Diniz, F, Renteria, M, & Wheaton, M, (2017). Hoarding Disorder: A Case Report.

Front. Psychiatry, 28 June 2017 | https://doi.org/10.3389/fpsyt.2017.00112

Martinez, A, Co, M, Lau, J, & Brown, J. (2020). Filipino help-seeking for mental health
problems and associated barriers and facilitators: a systematic review. Social Psychiatry
and Psychiatric Epidemiology volume 55, pages1397–1413.
https://link.springer.com/article/10.1007/s00127-020-01937-2?
fbclid=IwAR3nO0xE5xOD0i1r0pRIaS9QdgfFnfFxS4jdbWZ9COzDEoceXVcnfIO-
_2w

Videbeck, S. L. (2020). Psychiatric-Mental Health Nursing. Wolters Kluwer

Name: Ms. B
Age: 66 years old
Gender: Female
Diagnosis: Hoarding Disorder DRUG STUDY
Name of the Date Dosage and Mechanism of Indication Contraindication Side effects Nursing
drugs Administered Route Action Responsibility
(Generic and
Brand name)
Generic Name: 11/29/21 Dosage: 1 mg Benzodiazepines Commonly used Contraindicated CNS: dizziness, Prior to
Lorazepam Route: PO mediate the to decrease in patients drowsiness, administration:
Brand Name: actions of the agitation or with an lethargy, -Check and
Ativan amino acid aggression and anaphylactic hangover, verify with
Classification: GABA, the psychotic reaction to headache, ataxia, doctors order
Benzodiazepines major inhibitory symptoms. lorazepam, any slurred speech, -Observe 10
neurotransmitter component of the forgetfulness, rights of drug
in the brain. formulation, other confusion, administration
Because GABA benzodiazepines mental -Check for the
receptor channels (cross-sensitivity depression, expiration date
selectively admit with other rhythmic During
the anion benzodiazepines myoclonic Administration:
chloride into may exist) jerking in -Advise taking
neurons, preterm infants, only as
activation of paradoxical prescribed.
GABA receptors excitation. After
hyperpolarizes EENT: blurred administration:
neurons and thus vision. -Assess blood
is inhibitory. Resp: pressure
Benzodiazepines respiratory periodically and
produce their depression. compare it to
effects by CV: rapid IV use normal values,
binding to a only: APNEA, especially if the
specific site on CARDIA patient
the GABA ARREST, experiences
receptor bradycardia, dizziness or
hypotension. syncope.
GI: constipation, - Monitor vital
diarrhea, nausea, signs and global
vomiting, weight assessments for
gain (unusual). effectiveness.
Derm: rashes. may cause
Misc: physical dizziness or
dependence, drowsiness
psychologic -Advise rising
dependence, slowly from
tolerance. lying or sitting
position.
-Advise avoiding
other CNS
depressants, such
as antihistamines
and alcohol, and
avoid caffeine.
-Educate to use
sugar-free
beverages or
hard candy and
drink adequate
fluids.
-Advise to not
stop taking the
drug abruptly.