Mom is 88. Her home is very dirty. She can't clean her home and will not let anyone else clean. What are our options?

I just got back from 8 weeks in CA where my brother and I put my 91 yr. old, legally blind mom in a geripsych hospital for evaluation. Scratchiecat, I would never have thought that this was a possibility. Mental illness was our guess...these are traits we've seen since we were kids. Because mom is so good at hiding the issues, she was to be sent home after being there 5 days. Fortunately, I had a picture of the dirty mess in which she lived, the doctor was shocked and decided to send her to a locked geripsych residential care facility while we continued to clean up and repair her home. Then, we would decide if she could return with a care worker.

Those of you who say you wouldn't give your loved one a choice have no idea what I've gone through with her. How would you get her out of the house? Give me specifics. Or, get back in the house when she refused to let you in because you threw something away on the last visit? People would say, you need to take her for an evaluation? I'd ask, how? when she will not go. We've made appts and couldn't physically get her out of the house. Her reaction was like trying to put a cat in a tub of water! Give me specifics on how to do these things. I bet we've tried it.

We attempted to get an apartment or assisted living for her for a month or so. That way we could come in, triage, clean, and repair the home without her interference. Remember, legally we can not force her to do that (or go to a doctor, or take medication, or clean her house, or....and she knows that).

We tried APS (adult protective services) who came out, saw this situation, and after 3 months closed the case. This happened three times.

How then did we get her to the hospital? It took over three weeks to put together. Find the appropriate geripsych unit, get two of her doctors to write (and have notarized) that she is not competent to take care of herself...that's harder than you think, especially if she only has one doctor, take over her finances via successor trustee listed in her Trust, make a plan to get her to the hospital. That included her internist calling her to come in for an exam, my brother coming in to take her there, the doctor (we couldn't have done it with this man!) telling her he wants some blood workup taken at a specific hospital (the one with the geripsych unit) and talking her into going from his office straight to the hospital. (It took Dr. an hour to get her to agree that these blood tests). As my brother started driving her there, she changed her mind (nothing new). When he refused to stop, she attempted to get out of the car while it was moving, started beating the inside of the car with her fists (and, yes, StandingAlone, with her cane), then started on my brother. Because of the danger of the situation, my brother took her home to use the bathroom, etc. There he incurred verbal abuse that should never happen to anyone! He left to settle down and returned an hour later. He was able to coax her into the car and drove the 20 mins. to the hospital. The hospital had been primed and was waiting for her in order to direct her to the geripsych unit. She didn't have any paperwork to do since we, in conjunction with the dr, did it ahead of time. She still thinks a mistake was made, that she should have just had some blood tests.

Mom has refused to take any medications the drs at the hospital wanted her to try. She comes across as "delightful" to most people...for a while. They don't understand why "her kids don't help her". She'll forget what we (or anyone else) has done???? Not likely! I constantly hear about things missing that she accuses someone (usually me or my brother) of stealing 10 yrs ago.

StandingAlone, I am really offended by all your "I would make sure". I'd love to know how you would make sure. When people would say to me, you just need to do it, I'd ask how and no one could give me concrete plans of action. Or, the other phrase "you need to get her to...". Tell me how.

I hadn't intended to write all this. ScratchieCat, your situation sounds a lot like mine. "She has a long history of mental illness but she is functional and very smart." Yep. I got it! Frustrating, isn't it? Especially when others have pat answers that don't work or help. Just adds condemnation.

Thanks for listening.

scratchie, 1. Notify the local police of who to call in the event of an emergency, because pretty soon they will respond to her house and not know who to call.
2. Notify her doctor by call or in writing of your concerns and meet with the MD if you can, discuss medications and see if she is actually taking them properly.
3. Notify her county senior services that she is at risk and have them check on her. Depending on how bad things are, they may have her taken in for evaluation. 4. When you are there, quietly clean up and ignore the protests. I would tackle the cupboards one at a time, and told mom I was getting rid of bugs and was careful not to criticize her, just the bugs. I arranged the boxes and cans that remained on the front of the shelves, so the cupboard looks full.

Standingalone, I admire your fire but please know that I say this respectfully that you don't get it. If you lived it having such a parent you would get it, but again I wouldn't wish this on anyone not even for their greater understanding. If you were to do as you say, the hoarder parent in question would call the police on you and unless their living conditions were extreme their status as a competent adult would allow them to get a restraining order against you and ban you from their home. And they would. Whatchagonnado then? The Hoarders shows only cover the most extreme situations, though most hoarding situations are similar still quite distressing and unhealthy, but do not qualify for the adult to be declared incompetent and legally removed from their home. I cannot tell you how many heartbreaking stories there are on the net of APS being called in by an adult child of a hoarder but they refuse to act because the situation isn't bad enough yet in their eyes. Many hoarders are mentally sound outside of their problems in dealing with physical objects, extremely strong willed, and most definitely will assert their legal rights. Most of the tv shows sensationalize this issue and really skimp on showing what the real family dynamics are behind the situation. The irony is once it gets "bad enough" then the family gets blamed for not doing anything up to that point, but they literally could not. Now I hope for the OP's sake that her situation isn't as extreme as all that and that her mother has enough reasoning capacity to allow some help.

My mother's situation is similar, but I feel worse - inside cats, animal excrement everywhere, maggots in kitchen, etc. Re Social Services - they said as long as she has running water, food (albeit it is spoiled) in fridge, and toilet, there is nothing they can do. Her Dr. says she is just old. After 8 mos of paying a housekeeper, they have quit, Mother will not cooperate in any attempt to keep anything clean. If it has a flat surface, she will feed canned cat food and let the cats defecate/urinate on it. Siblings just don't go to see her. I am at my wits end on what to do.

If the home isn't clean/safe enough for a home health aide, it's not clean/safe enough for your 88 year old mom. Have you watched the Hoarding: Buried Alive shows on TNT? She sounds like so many of the folks they've profiled.

I wonder what Adult Protective Services would think of her living conditions? If you wanted to get the ball rolling, maybe have them check on your mom. You have two choices as I see it, either let your mom live in her dangerous dirty conditions or force the issue to get her to a safer, cleaner place. If she has a history of mental health issues, she may not have the cognitive ability to understand how dire her situation is - if it's as dire as it sounds. In that case, she needs help whether she wants it or not. Senior services in her area should help make that assessment.

scratchiecat, I know how hard it is. It seems like it would be an easy thing to just go in and clean. One has to go through it to realize that it is a war with threats of police and long-term family divorce. Hoarders have thrown away their families in order to keep all the stuff. Dealing with the rage and anxiety of hoarders is more difficult than most could imagine. If you were there long-term, it would be easier. You could take little steps, so the anxiety would not be so high. But you can't be there, so you may want to get third-party intervention, which may involve getting a county order to clean it up or they will do it for her... and charge a lot to do it! There are local codes for acceptable housing.

It may be that if others come in, though, that it will be questioned whether she can live independently at 88 and if she needs a guardian. You might want to prepare yourself for possible fallout from what you do. Personally I would try to talk her into moving into a senior community, then de-hoard her house after she is safely moved.

What are you and your sibs afraid of if you just go and clean up her house? That she'll be angry? Isn't angry better than dead? I know the problem, since my folks have dementia and both have a bit of hoarding going on. Sometimes I wait until they go to bed, then remove things and put them in the trash. Since I take the trash out every week, they have no idea. I've cleaned closets and donated clothes, etc. I dust, clean, mop, vacuum, etc. Since I've been doing it a little at a time, they don't notice. If they ask where something is, I tell them I put it in the basement. Neither of them can navigate stairs.

My sister went to the post office and had them stop sending junk mail to our folks. That helped to significantly reduce the piles of catalogs, as well as stopping both of them from ordering stuff from catalogs that they don't need. When we are taking care of them, we go to the mailbox, and recycle catalogs, shred magazine subscription orders and any personally addressed junkmail. Basically they get the bills and personal mail. They certainly noticed that they're not getting the amount of mail they used to, but we just tell them, "This is the mail today!"

My last point is it sounds like maybe your Mom has ADHD in addition to dementia. Has she been evaluated by a doctor? There are meds that can make a huge difference.

I don't understand this. I've watched the show hoarders before. It was...mind blowing. One question I have is how and why these people were ALLOWED, yes, allowed, to come to these conditions. I'm sorry, I'm not trying to sound judgmental, or to guilt anyone. God knows what the details are. I realize that sometimes adult children that live far away have no idea what's going on, but what I'm not understanding, and I really don't because of the way my mind works, is how adult kids that are close by can see this going down and not do anything.. On the show hoarders, adult children either didn't know it was even happening, they lived out of state, or they would say that 'She wouldn't listen', 'She got aggressive', etc, things like that. I'm still not getting the mindset of the adult kids when they make those kind of comments....

My way of dealing with this if I was faced with it is harsh and matter of fact. I've watched hoarders and asked myself what I would do if I was dealing that kind of situation....

If I was out of state, came to see my mother, and saw that she was living in filth, she would be out of there that day. There would be no arguments. There would be no discussion. I wouldn't hear a single word my mother had to say. I would call DSS immediately. I would INSIST that my mother wasn't well, while I pointed at the house. I would state the obvious. That she's living with maggots, and rat poop, and piss, cat poop and dog poop, and no working plumbing.... And I would defy anyone to argu with me that I could NOT have her removed. I would have her removed, one way or the other. I would have her dragged out of that hole kicking and screaming. I would make my contempt well, well know if anybody dared tell me I HAD to leave her there because it was HER decision. Yeah, right. Nobody would tell me that I had to leave my mom in an environment that was clearly sickening, reeked of filth, and was a DANGER to her. Tell me somebody wouldn't put my mom somewhere if I felt she was in danger. I don't care who I'd have to go to, or go through, to reach my goal of removing my mother from such a stinking pit and god help them if they tried to stop me. Oh, there are LAWS you say? In my world, laws can bend. I wouldn't give a tinkers d*mn about any law if I walked into my mother's house and saw her like some of those poor people I've seen on hoarders... I wouldn't give a care what my mom wanted, or said. I don't give a d*mn if she came after me with an ax. I'd overpower her, and she'd still be out of there. That day. One way or the other. I would make sure she saw a shrink, got meds, what the h*ll ever. I would strip hoarding away from her like ripping off a band aid. She'd be in a doctor's care, or in mine. But she never, ever would stay in that house one more minute of one more day, and she could d*mn me to h*ll for all eternity for it. I wouldn't have it. I, ME, and what she wants in such a situation be d*mned. My gut would be screaming like a banshee to get her OUT of there, and come h*ll or high water, that's exactly what would happen, too.

Long before that happened though, I think I'd notice if things, trash, whatever, started piling up. It wouldn't be allowed to continue past a certain point. If I noticed hoarding behavior in my mother getting completely out of hand, we'd go to war. I watch these shrinks on TV trying to be so soothing and understanding, walking away when the hoarder shows aggression, telling them all kinds of worthless bull... If it were my mom, and I noticed all this crap piling up all over the house, that's obviously junk....I'd trash it. I'd go through my mom's house like a tornado and get rid of every d*mn bit of it myself. Oh, she's going to object to me getting rid of junk and trash? Sucks for her, doesn't it? I'd do it anyway. Oh, she's going to scream and cry? Ah well, she'll get over it. No, if I see my mother, or any other loved one, engaging in dangerous behavior, living in such a way that's harmful to themselves, well, I'm taking over on the spot. To me, only me, it's the only option. I'm not wasting time discussing it, or worry about my mom's mental state, let the doc handle it...as far as I'm concerned anyone acting like a hoarder and the house is in utter chaos and filth, there's nothing to discuss in my opinion. They're out of there, and clean up begins. Immediately. The end.

That's me. And yes, my mom was prone to bringing home all kinds of crap that people left behind in her rental properties, nothing but endless junk. Even when I wasn't living with her I tossed it. The minute she wasn't looking. The end. If she asked for it...well, d*mned if I know what happened to that mess... *snickers* Problem solved.

I think, and it's just an opinion, that sometimes drastic measures are called for, and people should learn to be more assertive and yeah, aggressive, if need be to help loved ones. Better that than the alternative.

First order of business scratiecat is to get your mother evaluated and if necessary treated for ADHD. It is not much fun being mentally ill. People flit from one thing to the next and never get anything done. if they are not treated they turn to drinking gallons of caffeinated beverages, alcohol and illegal drugs. anything that gives them a high calms them down. Are you relying on the friend's assessment of your mothers living conditions? You need to go there yourself and evaluate. friends and other outsiders often exaggerate what they have seen because something appears to them more horrendous than the standards they maintain. Standing Alone you certainly have the fire in your belly thins morning and in principle I absolutely agree but the other side of the coin is that most of the caregivers of the elderly are elderly themselves with health problems of their own and just can not take on the task or even face involving authorities, so it is easier to take in food do the dishes and take Mom's clothes home to wash but a battle over hoarding, that's not true, she has always been like that. Growing up she found stuff and fixed it up, otherwise we'd be sleeping on the floor. She just does not have the energy to fix things now so they sit in the garage. It is a very sad situation and something needs to be done. But we are dealing with a living breathing person who may be mentally ill but still has feelings, not rescuing an abused animal.

Scratchiecat, I certainly can feel for you in this dreadful situation. I have been through a very similar problem and it did result in a trainwreck. My sister and I do not live in the same state as my parents. My father, smart and aggressive, at 91 was the caregiver to my 86 yo mother, with alzheimers and incontinence. He was getting weaker and was not giving her much attention but he made sure she she had two good meals a day. He was a wonderful husband but not such a wonderful caregiver in a fragile 91 yo state. The house was dirty, smelled and he refused any assistance of any kind. He would become angry and we knew that if he got angry enough, he would keep us from seeing mother. So we smiled and visited often but did little but sneak clean bathrooms and counters. I did call APS, twice, and they can do nothing unless they see eminent risk, and dirty doesnt mean anything to them (this is in FL). I contacted their insurance social worker and she offered them home health care nursing and was refused. The nurse did come out to check my mother and was so appauled by the house, she called APS as well. Dad was upset everytime APS came out but he showed them the house, and that they had plenty of food and mother looked well fed and not abused, so they left again. He never gave us keys to the house, and never relaxed his position on helping mom. So we passively waited for the trainwreck to happen, and it did as expected when he fell in a weakened state. They both got sent to the hospital, then nursing home, where my father passed away 50 days after the fall. My mother is quite happy at the nursing facility where she gets 24 hour attention and sees her granddaughter every day, bearing fresh fruit, comic strips and games to play. The place is clean and friendly, and dads retirement money is paying for the $278 a day. But if we could have gotten them to chose assistance a couple of years back, this could have been so much easier on the whole family. My father, a strong willed brilliant man, was also tyrannical when it came to protecting his lifestyle and we didnt kick down the door to make them change for the better. We saw the end was coming soon and we let them choose, but kept a close eye (daily contact on the phone and monthly visits.) And the house, well it needed ServicePro to come clean, remove all carpets and treat mildew and mold. We had to update all the plumbing, replace fuse box, replace all the appliances and countertops. We did that with expectations that they would recover enough to return home with a home health care nurse, but that never happened.
My situation was different but similar, and yours is about your mother---which you will have to choose how to handle it. The dirty house isnt the real problem, its a strong indication that her condition is worsening and she is unable to handle basic chores. She may be suffering from depression as well, and denial that she needs help can also be her pushing people away due to that. Or the senior who fears that someone will come in and harm them, so never accept help as it may be a scam or con artist. (My father would tell off neighbors who offered to mow his lawn!)
If I could imagine a scenerio that would work for my parents, it would be to offer them a little getaway---load them in the car and go with them to a place they always loved or wanted to see that wasnt dreadfully far and keep them in a hotel (cost $450) for a couple of days (to see beach, ride train, see grandchild or see a specialist in a city) and then have the Servicepro people come in and do the house in 24 hours (cost about $1500---worth it!) Have a home inspector come out at the same time and make sure the house is safe (cost $100.) Then when they come back, the house would be clean, you would know if the fridge actually keeps food cold or the a/c works, and it would be acceptable for home health care aid to come and see your parent weekly. And you would have the home inspection to know what needs to be done and can prove it to them. Of course, they would be angry but you just tell them it is their birthday or anniversary present and you are sorry they dont like it---so you wont do it again. Well, that is my daydream scenerio and things dont work that way except in a daydream...but you do have multiple siblings that can come up with a sneaky solution like that to make it seem more apt to happen. To me that is better than fighting and dragging someone out the door of their own house, stressing their already fragile body and psyche.
It is still their life. But you want to ease the burden of cleaning and upkeep on a house. Assisted living or a senior community apartment is really the best solution but you have to have money and someone who will agree to that. But it will help your sisters and you not worry so much.
My heart goes out to you. It is a difficult situation and you must make a decision. Make it with love and courage and perhaps you can avoid the trainwreck that ultimately comes with going down this hill.