Clutter Management: Improving Participation of Clients with MS

Background: Although there is substantial anecdotal evidence that clutter is common among multiple sclerosis (MS) clients, there are no published MS studies on actual prevalence or impact of clutter on functional performance in activities of daily living (ADL). Clutter promotes confusion and places clients in potentially harmful situations by increasing risks of falling, losing medications or misplacing important documents, affecting ADL. Clutter also adds to a client’s feeling of losing control leading towards a sense of helplessness. Many prevalent MS symptoms such as decreased mobility, visual or cognitive changes, fatigue, and depression, can aggravate clutter accumulation which can have a pervasive effect on daily functioning from a physical, financial, emotional, cognitive, and social perspective. For clinicians to improve holistic functional independence and participation in life roles, clutter management is critical to address.

Objectives: To incorporate successful clutter management interventions to enhance quality of life and functional independence.

Methods: Utilizing successful published theories of change, a clutter reduction protocol has been developed and implemented to eight cohorts of ten MS clients for a period of six weekly two-hour sessions. Since eliminating clutter too rapidly can create anxiety and prevent long-term progress, a critical component of the intervention was to introduce changes incrementally. For example, by slowly removing the ties to “beloved” inanimate objects, such as a coffee mug collection, clients were ultimately able to “let go” of unnecessary items. The protocol addresses psychosocial issues preventing organization and offers practical strategies for clutter removal and management to improve performance in ADL.

Results: Preliminary evidence based on clients’ reports suggest that the intervention helped to reduce clutter, promote a more realistic attitude towards "possessions," and establishing a sense of accomplishment in controlling their environment. Clients also reported less falls, feeling less isolated, increased ease in finding medications, and a general sense of cognitive clarity in accomplishing ADL. We are currently developing outcome assessments to objectively measure these effects as well as the prevalence of clutter within the MS population.

Conclusions: Clutter management is an important area for clinicians in MS to address because it can significantly impact function, safety, ADL, and quality of life.