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My aunt is 73, we just saw her this past weekend, she came for a visit; my family and I believe she is living in a very unhealthy and dangerous home; we don't know the full extent because she doesn't invite us over however she has lost 30 lbs. in the last 6 weeks and we do not believe she is eating right or bathing and does not have proper running water or a working washer and dryer so her clothes always have a terrible odor. About a year and a half ago she got hit by a truck and had severe head damage but she survive although the accident has made her mentally unstable. She will not listen to any of our advice, we asked her to go to the doctor and to get some of the stuff fixed in her house but she just doesn't do anything. We are afraid that she is going to hurt herself or someone else will take advantage and hurt her. She will not accept any help so we are thinking that we have to get an outsider involved; do we contact the state? How do I go about doing that? She lives in a different area than my family, my mother lives the closest to her, and she’s an hour away so it’s been difficult for us.

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There are some options. I'll list my thoughts. I bet others will provide theirs as well.

Does anyone that you know of how Power of Attorney for her?

If not, do you or someone in your family want to be the person appointed to make decisions for her, such as a Guardian? If so, then I would consult with an attorney in her jurisdiction about what type of evidence is required in court, the process, legal fees, do you get reimbursed for legal fees, challenges, time commitment, responsibilities, etc. You can also ask the court to appoint a professional to be her Guardian.

If you don't want to get that involved, you might report her to adult protective services so they can do an investigation. That might work and they might step in and file to be guardian, if no family is interested. However, if they show up and she has a good day, tells them things that they have no way of knowing are false, convinces them she's okay, they might not realize the dire nature of the situation and you might not get the result you were expecting. Unless, there is someone close to give them the background and the details of her deterioration, they may not see what has happened to her.

Can you contact her doctor and provide the doctor with information? He may not be able to talk to you, but you could send him info. Maybe, he could contact the county about it. Still....you have no say so in how that pans out.

Is is possible to just go visit her and check out the home? That might reveal a lot. She could have also lost utilities, homeowner insurance, etc. due to failure to pay, if she's lost track of taking care of her bills.

Is she still driving? Is she properly insured?
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Since you have first hand knowledge, and are certain that the issues will not be solved by family, then the next step is to report the situation to Adult Protective Services. They have expertise in this area, and will soon understand the complete situation and arrive at an optimum resolution. It is very common that the person living with dementia, who needs help, rejects help. Please understand the differences between POA and Guardianship. it is also common that the person living with dementia, in the early stage, can and will convince Medical and Legal authorities that they can, and insist on, living independently, and will legally fight any efforts that someone assume legal guardianship. Family dynamics are usually highly complex. Therefore, I recommend that you ask APS to keep the fact that you made the report anonymous.
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One first step might be to call the police department in her area and ask them to do a welfare check on her. I'm assuming she doesn't have children or they are not involved in her life. APS is also a good idea; I'm just not sure how APS works. Please keep us posted.
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With the accident she obviously had TBI and we now know that TBI can be a precursor to Dementia.
She should be checked by her doctor or at least a neuro evaluation should be done.
As to the living conditions protective services or if there is a Senior Services Agency in your area they would probably be the ones to call.
but if there is immediate family they should be the ones that cold start the process.

If it is found that your Aunt can live on her own there are Handyman services that some Senior Programs have the handyman service is usually a lower cost than getting a contractor or even a local handyman.
I know in my area Habitat for Humanity sometimes does work for Veterans you could call them and ask if they also do work at a reduced cost for seniors. Some church organizations also have programs.
Just know that once this gets going it is possible that her home may be declared unfit and she will have to move until it is either repaired or cleaned so it will pass inspection. She will have to have somewhere to go. Would your Mom be able to take her in for a time? If not or if it would be an indefinite time is there an Assisted Living facility she can go?
good luck not an easy task.
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I was just wondering if this person may actually pay their bills through online bill pay or even had the bank set up her bills to come out automatically without having to go online. Even if you don't have a computer, you can take your bills to a banker and have them set up all of your bills to come out automatically each month. I wonder if the person in question may actually already have their financial matters in order? If so, this particular area may already be covered as long as they're able to take care of their most important bills and get through the month financially.

Another thing I'm wondering is if the patient may also have everything already set up on her own behalf? You never know that she might not already have a living will along with other arrangements she may have already previously set up. This may be why she won't let anyone make decisions for her if she becomes incapacitated, she may have already made those decisions and arrangements such as a DNR among other things. You just never know until you actually find out as much as you can. If you have certain things in place regarding your medical care, you may not need a DPOA. If your finances are already fixed a certain way, you may not even need anyone else over your financial matters as long as everything is set up just right and the bills are being paid even if you become incapacitated. I would find out as much as you absolutely can about these areas because you definitely want to look deeper into these areas. Even if she doesn't have automatic bill pay set up, she may be writing checks for all you know. You can always put outgoing mail to be picked up on the mailbox if you have an attached mailbox on the side of your house. You never know who may also be supplying her with stationary or what her arrangement may already be, you just never know until you find out. If she has a hoarding problem, you don't know that she may not already have a ton of stationary stashed in her house. You just never know what kind of arrangements she has to keep her bills paid whether it be by check or automatic bill pay. Definitely lost a little deeper into how her bills are being paid each month and definitely look into any arrangements she may have previously made regarding her medical care should she become incapacitated, she may already have something set up, you just never know until you find out for sure by looking deeper into situations in question.

As for her final expenses though, you may want to try to find out if she may already have a preneed arrangement already set up with a funeral home, and see if she's actually paying on her preneed arrangement. Sometimes people who live alone find certain opportunities that allow them to care for certain areas on their own should they become incapacitated. I already know that if I became incapacitated that my bills will automatically be paid and I'm guaranteed a place to come home to because my bills will keep coming out automatically until I make changes. Though living alone can be lonely after a while, it still has advantages, and when you have a regular steady income, regular automatic bill pay guarantees your bills will be paid as long as the money is there. In this type of case where we've become a mostly cashless society in the digital world, we often turn to online shopping for many things, all within the comfort of home. These days you really don't have to leave home to go shopping and fight for a good parking spot when there's online shopping. There are some situations where you just don't have to leave home anymore.

In your situation, you have an opportunity to learn as much as you can by looking deeper into certain areas where you have questions. I'm sure there's always multiple ways to find out what you want to know. If by some strange chance you have an opportunity to be at this person's house when they're not home, you can get clever enough to snoop through her mail without her knowing because you can always put stuff back where you found it and how you found it. This requires skill and careful handling on your part if you really want to do some snooping and prying.
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Call ur office of Aging and ask them to go see her conditions. If there is no running water she will not be allowed to stay in th home. She needs to be evaluated since her accidebent. POA may not be possible if found she no longer can make decisions.
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One thing I think I should add is be prepared for the person in question not to answer the door or even acknowledge anyone she's not expecting, something people just don't want to be bothered at home. Be prepared for this! Some people can get very nasty if you bother them at home when they just don't want to be bothered. Home is a safe haven for many people, and sometimes when people are at home, this is where they can shut out the outside world and they just don't want to be bothered by anyone. In fact, I'm one of those kinds of people who won't answer the door to anyone I'm not expecting unexpected company really bothers me! I don't know just how clever this person really is and the strategies she may already have to dodge unexpected company, but just be prepared. A wellness check by the police department is OK to ask for, but they can't just kick in her door and force entry if she won't answer, be prepared for this. As long as she hasn't committed a serious crime and she's not a fugitive, the cops just can't force entry if she won't answer the door or even acknowledge them. This happens a lot I'm sure, so they just assume the party just isn't home. There's no guarantee she'll leave an answer the door to the APS either. If she's not even inviting you or anyone else to her home, this should be a sign that she doesn't want to be bothered, take this as a sign. If she won't let you in, she's less likely to let others in either. I'm not saying this is true in every case, but it is in some cases where there are just some of those people who just don't want to be bothered by anyone.

As for the utilities such as the water, is it possible that maybe something in her place needs fixed such as a leak, but she didn't have the money to fix it? If the home was not in need of repairs, is it possible she just didn't have the money for the utilities? Is it possible that it's a combo of both? If she has no running water, maybe the water bill skyrocketed due to a leak she couldn't afford to fix, and she also may not of been able to afford the water bill either? This is just worth a thought. This makes you wonder how she's surviving without water and never leaving home because this is just not possible without some water source coming in from somewhere. You just can't live long without water, you need a certain amount to drink just to survive, so having no water source and not leaving home is just not possible, she would've been dead by now unless she's collecting rainwater and she may have a rain barrel somewhere on the property. Otherwise, she wouldn't otherwise survive because the human body needs water, it's a dire survival need. She has a water source coming in from somewhere if this is been going on for a while. Even if your running water is cut off, there is still rainwater you can collect in a barrel or even bottled water, but her water source is coming from somewhere or she wouldn't even be alive right now. If no one is bringing her bottle water and she's not ordering it from anywhere, she's definitely going out and getting it somewhere if she's not collecting rainwater, so she would have to leave home to go get it if no one is bringing it to her and she's not ordering it. You can definitely bet on that, because you just don't live but a few days without water going into your body.

I would definitely get the APS and the health department as well as the fire chief involved because the fire chief will definitely flip his lid if he sees for himself that she's hoarding stuff and living in a fire hazardous condition. If she happens to be stubborn enough to not answer the door to no one despite these resources, I'm not exactly sure how they would handle it in these particular types of cases. It may turn out that someone needs a court order to force entry into her home if all else fails. Another thing you may want to be prepared for in rare cases is if the person happens to take a few things and vanish if people start showing up at her doorstep and she doesn't want anyone there. I know this wouldn't be true in all cases but there may be a few rare cases out there where this can happen. Sometimes people move to specific areas for the peace and quiet, especially if it's a wide open space with hardly any neighbors or maybe even no neighbors. Something people move to areas expecting not to be bothered, but if someone starts bothering them especially if it's a bit too much, they may pick up and move. My foster dad even threatened to move multiple times when he became aggravated at different times. Sometimes people with dementia tend to act differently and they may even invite you over and forget that they even invited you and throw a fit when you show up. Though he never did act on the threat, he was eventually placed into a nursing home. However, this may not be the outcome in every case. Some people will just pick up and move if they feel they're being bothered too much and don't want to be bothered.

The fire chief woul
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The fire chief would be especially helpful since hoarding poses a fire hazard, which is why I would definitely get the fire chief involved because they can actually pull some strings you may not even know about. I don't know if she has surviving animals, but if she does, someone will be able to remove them from her home. Depending on how bad I have a condition of the home is even after clean out will depend on whether or not it stays standing. Some homes in filth for too long end up being torn down and sometimes rebuilt. I don't know what the situation was with a specific home on my street many years ago, but there was a home that was torn down and rebuilt within a short time. It may be that it was beyond repair and just needed rebuilt. It didn't last long before it was torn back down for reasons unknown to me, and it's still an empty lot today.

As for needing help and rejecting it, there may be multiple reasons for this. For starters, some people just don't like to depend on others. If you catch yourself having to depend on others, things may not get done when you want or need them done or they may not get done right or maybe even not at all. Another possibility is trust issues, especially if you've ever been abused or had anything valuable stolen. Not knowing what all is in her house, she may actually have some valuables she's protecting and she may not want the theft risk, especially for irreplaceable items. Another precaution she may also be trying to take is against the possibility of some stranger coming in her home and attacking her, this is very common and I don't blame her for taking certain precautions. These days there's very much cause to be very leery especially if you're elderly or very vulnerable in some other way. These days I don't blame vulnerable people for being very leery and protecting themselves however they know how, and I don't blame them, I wouldn't want no stranger in my house either! There have been nightmares of elderly being attacked after letting a stranger into their home. There have even been thefts of money and valuables, you just don't let strangers in these days. Sometimes even letting in people you know can be risky because even people you know can turn out to be thieves or even dangerous. These days it's hard to know who to trust because even people you think you know best can turn on you on a dime especially if they find out you're rich or have anything valuable they want
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She wouldn't invite you to her home: would she actually turn you away if you happened to be "passing by" and called in? I just wonder if it might be a good idea to get a sit. rep. if you possibly can, so that you know exactly what to report and who best to approach.
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From your description your Aunt obviously needs help.
Was she a "normal" person before the head injury?
Time to take action. You have received excellent suggestions so don't sit around guessing.
Does the interact at all with your mother?
Contact the authorities ASAP.
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My mthr was a hoarder, and she would not let anyone in for probably 40 years. It's my understanding that this paranoia descends on a lot of people as they fall deeper into dementia.

Adult Protective Services in NC was absolutely her lifesaver. They befriended her and convinced her to go to the doctor with them by promising to take her for ice cream afterwards. This took 3 or 4 drop ins by the house when they saw her sitting on the porch. They are incredibly big hearted people. They did not know where I lived, but mthr was able to remember my husband's uncommon name, his line of work, and the big city we are near. They tracked me down, and worked with us as an interested party supporting us getting guardianship.

Call APS. The fire chief never helps with hoarding.
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Actually, yes the fire chief absolutely will help if the place is a fire hazard! If it's a severe hoarding problem and chances are slim the fire department would ever be able to get the person out if they're trapped inside in the event of a fire, it's definitely a fire hazard, especially if there's a bunch of stuff plugged in that could spark a fire, and especially more so if it would affect other nearby neighbors. There are a few different resources and each community that can help with such a problem. However, there's also a group that does the TV show called hoarders. Last I knew they could be contacted to clean up the property in question but they would need the resident temporarily removed from the property. I've seen many success stories on hoarders where they've taken the worst properties and transform them. They don't always have to throw stuff out if it's good, some of this stuff can be donated or even sold as long as it's salvageable. Hoarders don't always lose everything, many times things are saved but just removed from our house that's way too small for all of the stuff. See if you can call the hoarders show to see how they may help in your situation. I recall seeing one particular show where the fire chief was involved because the place was a fire hazard but I don't recall what all happened in that particular show. If I recall right, I think one home had to be demolished and rebuilt whereas others are sometimes just renovated. When the homes are finished, they're beautiful! When everything is sorted out, the owner is given a chance to sort through everything that was saved and decide what to do with it, most of the stuff was not brought back home
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susan219: Below is the informatiion that you need for Adult Protective Services for Parlin, NJ, which is in Middlesex County. Yours is a multi-facted problem. Losing 30# in 6 weeks is of huge concern. Also a head injury that was never seen to nor diagnosed by an ER doctor is a major health issue. Do you believe that the reason why she is not letting you into her home is that she is a hoarder? Does she live in the sticks or something, e.g, no running water, nor washer or dryer? At 73, she's far too young to have this many problems. See below ---

Middlesex
Middlesex County Board of Social Services
P.O. Box 509
New Brunswick, NJ 08903
Phone: 732-745-3635
After Hrs: 911 or local police
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susan219: One more item I thought of is that she may be receiving phone calls from scam artists. We receive them daily, but I know what to do with them as I am of sound mind. These people/companies will threaten the person, e.g. "the IRS calls and says you will put in jail if you do not send off $$$$ amounts of money to them," "the FBI calls and says you have a serious felony charge that will cause you to go to prison." Neither, of course, is the truth, but your loved one may or will fall for it! That's what these scam artists are hoping for is that that one time they call and a get a person who is not in their right mind to send off their life savings! It is no joke! I currently have a list of the allowed amount by my telephone service of 25 blocked calls-all of them scams!
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1RareFind

Are you referring to 1-800 GOT Junk? There is also College Hunks Hauling Junk.
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zytrhr

I'm referring to the TV program called hoarders, I'm not aware of any other hoarder cleanup program other than that. The hoarders show actually comes out to the problem house and they go from there. tlc
they've had very high success rates in helping hoarders clean up. I've noticed all of the cases are very similar but most endings are about the same from what I've noticed
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1RareFind

I see. It does not hurt for her to try to get the show to help

I recall the episode you mentioned, Fire chief was pleased, but there was still work to do. Not all clean ups have had success stories, a few homes, the hoard caused so much damage (water, mouse, rats, etc) they weren't salvageable.
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Depending on the severity of damage by filthy and wildlife will depend on whether or not the house itself can be saved. If the damage is not stop in time, the house is more likely to be condemned and eventually torn down. However, if it's caught in time, repairs can be made. Not all hoarders live in filth, some of them are actually clean. It really depends on the hoarder themselves. There are clean hoarders that just have a lot of stuff in general but without the filth whereas other hoarders live in filth, it really all depends on the person. I was once a hoarder myself, but I never lived in filth, my mess was actually clean and I never had any pets or anything that left a mess. I was pretty good about keeping trash where it belonged and keeping it going out the door. The only thing in my case was just that I just had a lot of stuff piled to the ceiling. What really caused my particular case is that I was very lonely and have no one. When someone started coming around I started noticing when they started coming more often, and the more often they came around to pay attention to me, I started cleaning up little by little until I was able to get rid of all of the extra stuff I didn't need. Hoarders sometimes hoard to fill a void. Not all hoarders need direct intervention, some of them will clean up on their own when the void is filled with what they most need, it's only a matter of finding out what that void is and filling that void properly. Properly filling a void will encourage the hoarder to clean up. Sometimes all they need is someone who loves them to start coming around and showing love. Such was the case in my particular situation. One thing that keeps me going even if I must go for long periods of time without much contact is that I remind myself through self-discipline when I'm getting a little too much coming in. It's one thing to always want new stuff, but responsibility comes with bringing it in because you must go through your old stuff and figure out what you're not likely to use and be ready to get rid of it. What's convenient is having neighborhood donation bins and even a local thrift shop. What's closer for some people is the donation bins, transportation is another issue when you're out in the world by yourself with limited money and resources. Sometimes you must rely on the convenience of a close to home charity or donation been to get rid of your old stuff. And you find newer and better stuff, you should always be ready to eliminate old stuff. That seed was planted by a friend of mine many years ago when he helped me get all new clothes. There was no where to put them in both closets were full. I sat back one night as he would hold up garments from out of the closet one by one. Wearing those garments is one thing, seeing them from across the room being held up by another person is a whole different story. I ended up letting every old garment go, both of my closets were emptied out to make just enough room for the new clothes. It worked out very well because I had the same amount of old clothes as I did new clothes. This worked out very well for me because each garment ended up being placed into the elimination bag one by one until there were no more garments in the closet. This was perfect timing because each new garment replaced each old one perfectly. You must be ready and in the right set of circumstances with the right people around in order to be willing to part with what you don't need. It's hard when you're not ready to part with staff, but it's so easy when you are ready to part with stuff. It's so much easier when you have something better to replace something you already have. Let's say you have a very old coffee pot among a bunch of other stuff. Let's say you see a newer one you like better. Guess which one I'm keeping and guess which one I'm getting rid of? Of course I'm going to want the newer one, so I'm going to let go of the old one. OK, now let's say you have a shoe collection and you're always buying shoes. This can be advantages to have several pairs of shoes saw you need not always run to the store to buy them all the time if they're always wearing out. It's always nice to have spare shoes similar to the ones you already wear. However, there comes a time when you may have too many and there comes a time to let go of some of them. It's always a good idea to have a few pairs of spare shoes for different seasons as long as you don't get so many they take up your whole house. If you start getting too many, it's always a good idea to get rid of some of them if you plan on getting new ones, this is how you keep from getting too much stuff in your house. Your house is supposed to feel like a home and not a storage unit
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I just happened to remember another show called upscale hoarding. These are the rich people who collect lots of stuff without living in filth. I came from a rich family myself and my type of hoarding since it was clean was upscale hoarding. I saw one such program on this where there were an awful lot of shoes and I also recall an off a lot of handbags. Each case of upscale hoarding depends on the person and what they collect. Each case of upscale hoarding depends on the person and what they collect. Upscale hoarders are very careful often very careful with not letting filth in on the mix of their collections. Upscale hoarders also tend to go for the flashy stuff that would be very expensive to the average person who may be less likely to be able to afford it. Finding expensive items in quality secondhand shops can happen anywhere. When you find those flashy items that are normally expensive in the high-end stores, these are the items that you want to hang onto, but it can still be a problem if you get too much accumulation. Upscale hoarding makes it much harder for you to let go of stuff when you know what you have. Upscale hoarding can be a much harder thing to deal with when you have great things. You can come from rich family, but that doesn't necessarily mean you won't have expensive taste if you land in less fortunate circumstances. Being in less fortunate circumstances doesn't necessarily eliminate expensive taste you were born with, at least from my experience. I can definitely say that good high-quality stuff is the hardest to part with, especially if you originally had plans for those items. Sometimes we may tend to hang onto expensive items because were still waiting for our plans to pan out. When our plans don't pan out for those items, I think we tend to not only hold onto those items even longer, but I think we also tend to hold onto the disappointment that comes with our plans for those items not panning out because we don't really want to part with those items. The better quality the items, the less likely will want to part with them because the harder it will be to detach from them, and the less likely they'll ever transfer to other hands. This has been my experience because I came from a rich family and we had high-quality stuff as well as plenty. When you are deprived despite being in a rich family though, part of some hoarding problems happens to come from childhood deprivation, so some of us tend to make up for what we missed during childhood. Hoarding can sometimes give us a sense of control but I don't know how to explain this, it just is. It's more than just filling a void, it's somehow gives us a sense of control.

In other cases of hoarding, some people actually survived the depression. Deprivation can definitely lead to hoarding later on. If another depression were to hit, I guess some of us just want to be stocked often prepared so that if there was another depression, it's less likely to affect us. It's always wise to be stocked up in case of emergency, but some of us may tend to go overboard so that if something does happen, I guess you could say will be well stocked up while the rest of the world is struggling during the emergency. I guess it would be a good idea to learn about your family roots and to see what everyone went through back in history, this would actually help you connect the dots in your own life
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Well, it sounds like she had a TBI (traumatic brain injury) and no rehab. Maybe it is not too late, though she has to agree to it unless someone has guardianship, and even then real rehab depends on active participation. Rather than calling it "mentally unstable" we often see it as beign emotionally labile, feeling very vulnerable, having short-term memory deficits that you really have to be taught to compensate for, and tremendous difficulty organizing or initiating. She might intend to do things and just kind of not get started or not know how to start, even though you'd think she should. She might not object to smaller things that others can organize and initiate for her. Sorry this has happened to you all. I vote with the APS (adult protective services) option too.
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Vstenfans: I agree with your post!
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Thoughts on hoarding - it's not rational, its emotional. Fear of being without. Fear of not having what you need when you need it. Being unable to confidently assume you can buy another one if you need to when such is the case and the store is right around the corner. Unrealistic thinking and planning, and giving up the object means giving up a dream. Obsession with not being wasteful - can't throw food away - or if I donate an item no one will want it or use it and it will be thrown away, feeling sorry for the item as if it were an inanimate object. I find I can give things away to good causes but tend to keep too many things I won't use but "might" - thank God for Goodwill and church rummage sales!! I have to make a rule for myself that I have to give away more than I buy at those places, though :-) Then once in a while I find I do use or reread something I've kept, or regret giving something away that I find I really need.

Hoarding gets even worse when you can't remember that you already have half a dozen of whatever is on sale for a bargain price that you "know" you will use...
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For other children of hoarders who need to know how to find ways to set boundaries with their hoarding parents or to realistically help without being on a reality TV show, I have found the online resource "children of hoarders" to be a tremendous value. For those of us who were neglected by our parents because of their hoard, please come where you can find real help with the voices of experience.
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I think the TV show is a good idea because it will give some hoarders out there something to relate to if they happen to be watching. I'm not saying all hoarders out there will want to come clean but some will. Hoarding can get in the way of family life, that's true. I've seen stories on TV shows where hoarders even lost relationships with their children and grandchildren. It's sad when you put stuff before family. I think some people hoard things they know will soon be discontinued or maybe it's something that's rare that can no longer be found. Then again there's stocking up on supplies but this isn't necessarily hoarding. Stocking up on supplies is one thing because you make sure you have what you need so you don't have to visit the store too often. It's one thing to stock up but another to hoard. The TV show was probably designed to show other hoarders out there where they are and it's an encouragement to want to come clean. In some cases it's the family who initiates a cleanup crew especially if the place is a health hazard. if hoarders can see the show, they can see and relate
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Hoarding is a mental health issue with its own diagnosis code. The show is about viewers and advertising, not helping hoarders. TV is about making money.
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