She has frozen shoulder and cellulitis. No children. She could have a home health aid come in but because of the condition she refuses to let anyone come in to help. She does not drive. She is a widow. Her husband was her care-giver and he passed away two years ago. My parents 92 and 94 try to help out. This is taxing on their own health and threatens their independence. I have tried and am trying to set up a support network for these three elderly people that I love but I am at my wits end because they work in concert to deny the reality that things have to change due to aging and health problems.

Any advice on how to handle a hoarder when their health is deteriorating?

Thank you

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I am in the process of obtaining guardianship & conservator status for my mother.
She was very nearly at the point you describe with your neighbor.
This is a $2,000 process if it's uncontested. Guardianship requires that you keep financial records, visit records, and file an annual report with the court. It is a real obligation. I have had to produce copious medical records, physician statements, financial records just to get into the application process!

The state needs to get involved and potentially appoint an agency guardian/conservator who can manage your neighbor's affairs.

What you can do is call in an anonymous report to your county Adult Protection Services office and another one to the Police (not 911, but the office near you). Request that they each come do a welfare check on your neighbor. They are required by law to investigate every single call they get and your anonymity is secure. You can say that you are concerned she may have fallen or that her stuff has fallen on her, and that she lives completely alone with no known family.
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Hate to say it, but yes, you call social services or you spend the money to seek Guardian status. Armed with a court order, you get her to AL or NH, for her own safety. Your parents will then be able to focus on their own needs and extend their own independence. You will be saving three lives in the process.
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A true hoarder needs reported to the health department. Some cities now have a department to combat hoarding. Having a neighbor that harbors trash and attracts rodents, is a fire danger.

Good luck. I think you either need to get into the problem 100% or walk away.
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