Dementia patients hide and hoard objects primarily because of memory loss, fear, and a deep need for security that their changing brain can no longer satisfy through normal means. When someone with Alzheimer’s or another form of dementia tucks a wallet under a mattress or fills a drawer with napkins from the dining room, they are not being difficult or irrational. They are responding to a world that feels increasingly unfamiliar and threatening by trying to hold onto what they can still control. A woman with mid-stage Alzheimer’s might wrap silverware in tissue and store it inside her pillowcase, not because she wants to steal, but because some part of her brain is telling her these items need to be protected.
This behavior, sometimes called “squirreling,” is one of the more common and misunderstood symptoms of dementia. Studies suggest that hoarding and hiding behaviors occur in roughly 20 to 30 percent of people with Alzheimer’s disease, though the number may be higher since many cases go unnoticed until a caregiver stumbles on a stash. The causes range from neurological changes in the frontal and temporal lobes to emotional responses like anxiety and grief over lost independence. This article covers the brain science behind hiding and hoarding, the emotional triggers that drive it, how to tell the difference between harmless collecting and dangerous behavior, and practical strategies caregivers can use to manage it without causing distress.
Table of Contents
- What causes dementia patients to hide and hoard objects?
- The emotional triggers behind hiding behavior in dementia
- Common items dementia patients hide and where they put them
- How caregivers can respond to hoarding and hiding without causing distress
- When hiding and hoarding becomes dangerous
- How past experiences and personality shape hoarding behavior
- Emerging approaches to managing hoarding in dementia care
- Conclusion
- Frequently Asked Questions
What causes dementia patients to hide and hoard objects?
The short answer involves a collision between memory loss and the brain’s survival instincts. The frontal lobe, which governs judgment, planning, and impulse control, deteriorates significantly in most forms of dementia. At the same time, older brain structures tied to fear and self-preservation remain relatively intact longer into the disease. The result is a person who feels compelled to protect resources but lacks the executive function to do it in a way that makes sense to others. They may hide food because they genuinely do not remember eating an hour ago and fear going hungry. They may stash money because they cannot recall where they normally keep it and worry someone will take it. There is also a phenomenon known as perseveration, where the brain gets stuck in a loop.
A person might repeatedly collect certain types of objects, like magazines or rubber bands, not because they want them but because the brain is firing the same behavioral signal over and over without the ability to interrupt it. This is different from deliberate hoarding seen in people without dementia. In hoarding disorder, the person typically feels strong emotional attachment to their items and resists discarding them. In dementia-related hoarding, the person often forgets the items exist shortly after hiding them, which is why caregivers frequently discover stockpiles the person has no memory of creating. A third factor is the loss of the concept of ownership. As dementia progresses, the boundaries between “mine” and “yours” blur. A person living in a care facility may take another resident’s sweater not out of malice but because they genuinely believe it belongs to them or because the act of picking it up and putting it somewhere felt right in the moment. Understanding that these behaviors arise from brain damage rather than personality changes is the first step toward managing them with compassion rather than frustration.
The emotional triggers behind hiding behavior in dementia
Fear and anxiety are the most powerful emotional drivers of hiding behavior, and they are nearly universal in dementia. Imagine waking up every day in a place that looks somewhat familiar but not quite right, surrounded by people who seem to know you but whose names you cannot recall. That baseline of unease makes a person want to secure whatever they can. Hiding objects becomes an attempt to create certainty in an uncertain world. A man who spent his career managing finances might obsessively hide bank statements and checkbooks because his identity is still wrapped up in being responsible with money, even though he can no longer balance a checkbook. However, not all hiding is driven by anxiety. Some of it stems from boredom. Dementia patients, particularly those in care facilities, often have long stretches of unstructured time. Rummaging through drawers, collecting objects, and tucking them into pockets or under furniture can be a form of self-stimulation when there is nothing else to engage with.
If the hiding behavior increases after a change in routine or a reduction in activities, boredom may be the primary trigger rather than fear. This distinction matters because the interventions are different. Anxiety-driven hiding responds better to reassurance and environmental modifications, while boredom-driven collecting responds better to increased engagement and purposeful activities. Grief and loss also play a role that is easy to overlook. A person with dementia is experiencing ongoing, layered losses: loss of independence, loss of roles they once held, loss of relationships as they knew them. Holding onto physical objects can be a way of holding onto identity. A former teacher might collect pens and paper. A retired mechanic might gather tools or anything that resembles a tool. These are not random fixations. They are the brain reaching for something familiar when everything else is slipping away.
Common items dementia patients hide and where they put them
Caregivers report remarkably consistent patterns in what gets hidden and where. The most commonly hoarded items include food, money, jewelry, clothing, tissues or napkins, toiletries, mail, keys, and utensils. Essentially, the items cluster around survival needs and personal identity. Food hoarding is particularly common and carries genuine health risks, as perishable items hidden in drawers or under beds can spoil and cause illness if the person later finds and eats them. One nursing home study found that nearly 15 percent of residents with moderate to severe dementia had hidden food in their rooms at some point during a six-month observation period. The hiding spots tend to follow a pattern as well.
Under mattresses and inside pillowcases are perennial favorites, likely because the bed feels like the safest, most personal space. Drawers, closets, inside shoes, behind furniture, in coat pockets, and inside folded laundry are also common. Some people develop elaborate hiding systems, using the same spot repeatedly, while others scatter items seemingly at random. In more advanced stages of dementia, items may end up in truly unexpected places: a remote control in the refrigerator, dentures wrapped in a sock, or a telephone handset inside a cereal box. For caregivers, learning the person’s preferred hiding spots is more useful than trying to prevent the hiding entirely. Checking these locations regularly becomes part of the daily routine. The goal is not to stop the behavior but to manage its consequences, ensuring that nothing dangerous, perishable, or essential goes missing for too long.
How caregivers can respond to hoarding and hiding without causing distress
The single most important principle is to avoid confrontation. Telling a person with dementia that they are hiding things, accusing them of stealing, or demanding they stop will almost always make the situation worse. They may not remember hiding anything, so the accusation feels unjust and frightening. Even if they do remember, being told to stop threatens the sense of security the behavior provides. The result is usually increased agitation, and the hiding may actually intensify as the person feels more anxious. A better approach involves what clinicians call “therapeutic fibbing” combined with environmental management.
If a person has hidden their own glasses, a caregiver might say, “Let me help you look for those, I think I saw them earlier,” rather than, “You hid them again.” Keeping duplicates of commonly hidden items like glasses, keys, and remote controls reduces the practical impact. Some caregivers create a dedicated “rummaging drawer” or “busy box” filled with safe items the person can sort, organize, and hide to their satisfaction. This redirects the behavior rather than suppressing it. The tradeoff with the rummaging drawer approach is that it works best in the mild to moderate stages. In more advanced dementia, the person may not be redirected so easily, or they may lose interest in the designated items and continue seeking out other things to hide. At that point, caregivers need to shift toward more environmental control: locking away medications, removing access to perishable food outside of mealtimes, and securing important documents. This transition from redirection to restriction is one of the hardest judgment calls in dementia caregiving, because too much restriction too early feels controlling, while too little restriction too late creates safety risks.
When hiding and hoarding becomes dangerous
Most hiding behavior in dementia is harmless, even if it is frustrating. But there are situations where it crosses into genuine danger, and caregivers need to know the warning signs. Food hoarding is the most common risk, particularly when the person hides perishable items like meat, dairy, or prepared food. Spoiled food consumed days later can cause serious foodborne illness, and a person with dementia may not be able to recognize or communicate symptoms of food poisoning. Medication hoarding is another significant concern. A person who hides their pills instead of taking them may appear to be compliant with their medication regimen while actually missing critical doses.
This is especially dangerous with blood thinners, heart medications, seizure drugs, and diabetes medications where missed doses have immediate consequences. Conversely, if a person hoards medication and then takes multiple doses at once, overdose is a real possibility. Caregivers should count pills regularly rather than relying on the person’s report of having taken them. Less commonly but still worth watching for, some people with dementia hide objects in ways that create fire hazards, such as placing paper or fabric over heating vents, or they may hide items that block exits. If hoarding behavior is accompanied by significant agitation, aggression when items are discovered, or a sudden escalation in the volume or frequency of hiding, it is worth discussing with the person’s physician. A sudden change in behavior can sometimes indicate an underlying infection, medication side effect, or progression of the disease that warrants medical attention.
How past experiences and personality shape hoarding behavior
A person’s life history often provides the clearest explanation for their specific hoarding patterns. Individuals who lived through the Great Depression or periods of poverty frequently hoard food and money in ways that echo the scarcity they experienced decades ago. A person who survived wartime rationing might fill every container they can find with bread or crackers. Someone who experienced homelessness earlier in life might compulsively gather blankets and clothing. The dementia has not created these fears from nothing.
It has stripped away the coping mechanisms that kept old fears in check. Understanding this history helps caregivers respond with empathy rather than exasperation. When a former refugee hides canned goods under her bed, the appropriate response is not to remove them and explain that there is plenty of food. It is to acknowledge the need, perhaps by keeping a small basket of non-perishable snacks in her room that she can access freely. This honors the emotional reality the person is living in while keeping the environment safe.
Emerging approaches to managing hoarding in dementia care
The dementia care field is slowly moving away from a purely behavioral model, where hiding and hoarding are treated as problems to be eliminated, toward a person-centered model that views these behaviors as communication. The question is shifting from “how do we stop this” to “what is this person trying to tell us they need.” This reframing has practical consequences. Facilities that have adopted rummaging stations, sensory activity rooms, and personalized comfort items report lower rates of agitation and less need for pharmacological interventions. Technology is also beginning to play a role.
GPS trackers small enough to fit inside a wallet or attach to a keychain can help caregivers locate items that have been hidden. Some smart home systems can monitor when certain drawers or cabinets are opened, alerting caregivers to hiding activity without the need for constant surveillance. These tools do not address the underlying need driving the behavior, but they reduce the practical burden on caregivers and allow for a lighter touch in managing it. The broader trajectory in dementia care points toward environments designed to accommodate these behaviors safely rather than environments designed to prevent them.
Conclusion
Hiding and hoarding in dementia is not a behavioral problem to be corrected. It is a symptom of a brain struggling with memory loss, fear, and the deep human need for security and control. The behavior is driven by neurological changes in judgment and impulse control, amplified by emotional factors like anxiety, boredom, grief, and echoes of past experiences.
Understanding these root causes transforms a caregiver’s response from frustration to problem-solving. The practical toolkit for managing hiding and hoarding includes learning the person’s preferred hiding spots, keeping duplicates of important items, creating safe outlets for rummaging, securing genuinely dangerous items, and above all, never confronting or shaming the person for the behavior. When the behavior escalates suddenly or involves food, medication, or fire hazards, it warrants a conversation with a healthcare provider. The goal is never to stop dementia patients from seeking comfort, but to make sure they can do so safely.
Frequently Asked Questions
Is hiding objects a sign that dementia is getting worse?
Not necessarily. Hiding and hoarding can appear relatively early in the disease and may remain stable for long periods. A sudden increase in the behavior or a shift to hiding unusual items can signal progression, but the presence of hiding alone does not indicate a specific stage. Track changes over time and report significant shifts to the person’s doctor.
Should I remove hidden items when the person is not looking?
Generally, yes, especially if the items are perishable, dangerous, or belong to someone else. Remove them discreetly and do not mention it. If the person asks about the items, redirect rather than explain that you took them. However, if the person has hidden harmless items like tissues or magazines, it may be better to leave them and simply monitor, as removing everything can increase anxiety.
My parent accuses family members of stealing when they cannot find hidden items. How should I respond?
Accusations of theft are extremely common in dementia and are almost always tied to the person hiding items and then forgetting they did so. Do not argue, defend, or try to prove innocence. Instead, say something like, “That sounds upsetting. Let me help you look.” Often, helping them find the item or offering a replacement resolves the situation. If the accusations become persistent and distressing, discuss it with their physician, as medication adjustments sometimes help.
Does hoarding behavior in dementia respond to medication?
There is no medication specifically approved for hoarding behavior in dementia. However, if the behavior is driven primarily by anxiety or agitation, medications used to manage those symptoms, such as SSRIs or low-dose antipsychotics, may reduce it indirectly. Medication should be considered only when non-pharmacological strategies are insufficient and the behavior poses safety risks. The potential side effects of psychotropic medications in elderly patients are significant.
How is dementia-related hoarding different from hoarding disorder?
In hoarding disorder, a person is typically aware of their collection, feels strong emotional attachment to the items, and resists any attempt to discard them. In dementia-related hoarding, the person usually forgets they have hidden items, does not show consistent attachment to specific objects, and the behavior is driven by confusion and anxiety rather than intentional collecting. The distinction matters because treatment approaches are completely different.
Is it okay to set up a locked area to prevent hoarding?
Locking away dangerous items like medications, cleaning products, and sharp objects is a reasonable safety measure. Locking away all potential hoarding items is generally counterproductive because the person will simply find other things to hide, and excessive restriction increases agitation. The goal is targeted safety measures rather than blanket restrictions.
