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Elderly sister always had "collecting" tendencies. Basement and closets were always full of lovely things-but bountiful. Now with a devastating home fire, it appears she is intensifying. She is angry that cleaning crew is not helping, but refusing to let them throw away anything. Therefore, work isn't being done to clean and initiate the rebuilding process. She is accumulating bags and boxes in her temporary apt of things to "use in the future", whether damaged, soiled, smelly (ex; Tried to have them remove fire damaged mattresses from dumpster or continues trying to restore and clean 30 year sheets and bed linens). She appears determined to rebuild. Not receptive to assisted living. Spending limited her resources and having trouble prioritizing.
Her children are not living close. They are obviously concerned. Need advice on which direction to go, where to get affordable counseling advice. Need advice on resource availability. I worry that this tremendous loss and lack of spousal support and proximal family support is enhancing her possible obsessive tendencies or promoting potential depression.

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Poor lady! That's a lot to deal with. Please make sure she gets counseling. Going through a fire is a devastating thing. My brother had one and they lost almost everything. He is a carpenter, so rebuilding the house was his way of working through the loss. His wife and daughter have been having a more difficult time. My niece is doing counseling now - and I'm proud of her for initiating it. Her mother cannot get past it, however, and has turned to alcohol, which is further hurting the family. The right counselor can do wonders.
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Your sister is mentally ill and until she is seen by a psychiatrist, only then can she ATTEMPT to get well. Hoarding is a fire hazard waiting to happen and in this case, it already did. Due time for the kids to take the reins.
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The loss in fire would, yes, make her already profound fear of losing anything all the worse. Why did the fire start? Was it due to the hoarding or was it just worse because of the hoarding. This may be an adult protective case if there is no one in family really living there and able to help on a daily basis. She may need guardian appointed and placement. But I would certainly assess for NEED and DANGER to her first. Good luck. Hope you will keep us all posted.
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When was the home built? Has asbestos and lead testing been done? Does her community require demolition permits? I had a fire. My home had asbestos. My community requires demo permit. Contractor recommended by insurance company did not obtain demo permit which requires asbestos and lead testing. Contractor started taking out walls, horse hair plaster that contains asbestos. I had a major spill as defined by the EPA at my home. Then three phases of asbestos abatement to remove it all.

Asbestos cannot be cleaned from fabrics, small items expensive to clean. I used the fire to downsize. Following a fire homeowners insurance should cover health care, this includes mental health.

If sis will not accept your suggestions and help, you are just going to have to let it go.
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The first thing your sister needs is counseling and/or treatment for all her loss. This hurricane would push any young, healthy person to the brink.

Her kids need to sit in the drivers seat and let you be her sister.
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Cleaning crew is not going to throw away anything unless she authorizes it, but she still has to pay for the home visit. Your options are few--if any. You can encourage her to seek professional help, but if she refuses she has rights too. If a person is mentally competent to make their own decisions you cannot force anybody to do anything. Her children may have a better chance of getting her help. That's up to them.

If her hoarding becomes a public nuisance such as unkempt yard and home, the city can intervene and post violation citations which may end up as fines. If a person cannot control their behaviors..somebody else will called the law.
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Do you know what the cause of the fire was? Presumably the Fire Department will know. I am wondering if cognitive issues of either husband or wife could be at play. What are the chances that they could have another fire in either their temporary place or. if they somehow were actually able to rebuild, in a new house?
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This is a crisis in the making imho.

How much time & energy realistically do you have to spend on this?
& is there anyone who already is DPOA for LewyBody hubs and your sister or are they each other’s dPOA (horrors!)?
if Sissy won’t allow dpoa to be done, then you or 1 of her kids are eventually going to go for guardianship and you actually use all the decisions she’s made on the post fire situation as reasons (with documentation) to show why need for guardian.

I’d suggest as a first step, that you as her sister can do, is for you to speak with whomever is the community affairs outreach person at the fire department to see just where house in it’s current condition is on the laws &/or ordinances involved with safety & permits, habitability and code violations. If you know one or 2 of her adjacent property neighbors, I’d speak with them on this. So you and the neighbor(s) meet fire dept. on site. Bet FD can & will share the damage report with you.

To me the FD report is mucho importante cause IF it’s like 1/3 damaged, in my experience, it’s gonna be hard to get her away from going over and getting burned out or water-damaged debris or wandering on property. Place is not a health & safety issue at 1/3 gone. BUT if its 51% it is & viewed as not approved for habitation then the neighbors can file complaints. You’d help on that as you’d go and take the photos of vermin crawling about, or mosquito larvae water filled containers, or other blight issues. So neighbors get stuff from you so they can report concerns to authorities. The neighbors have “standing” in all this as the house affects their property value and health & safety. Place will start having blight notices and fines placed and it gets torn down with all these placed as liens on the property. Eventually it will make it too costly & impossible $ wise to have $ to clear, rebuild and pay fines and taxes.

If there’s mold happening, try to get video of her in a moldy room or touching stuff with mold.

Do you have any idea of what their homeowners fire policy is like?
Unless they had a high end policy (like Chubb) or a very new policy based on recent appraisal or requires current code rebuild replacement costs % in premium, I’m gonna bet that they are seriously underinsured for a rebuild. They won’t have the $ to rebuild and too old to get a mortgage. Do you have any idea who underwriter is? and what their deductible was? and if the $ paid so far has been for contents? Or for contents and building? Is insurer paying for their temporary apt?

Often policies pay all the contents $ but only pay the rebuilding $ upon a signed agreement with Contractor and pay the $ in stages or if buying another place then $ released upon offer tended on a new home.

Most better homeowners cover temporary accommodations & clean up for a covered event but it’s limited for time & $ unless they have a rider for that or there’s a govt declared disaster. Try to find out from insurance company correspondence (if she’ll let you read it) or from the landlord or property management co if their rent is being paid by insurer as to what the time limit is. Ditto for asking the debris removal co as to who is paying them & the terms. Whatever the story, insurance largess has a $clock is ticking for them. If she’s unable to be cognitive to understand terms on the policy then you or one of her kids use this for additional reasons why they need a court appointed guardian.

We went thru Katrina, knew folks w/ parents in flooded for weeks homes in Lakeview & not able to be competent to understand insurance terms or deal with a rebuild. At some point family had to get emergency guardianships done. If their really stubborn, can be only option for family sadly. Good luck.
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Poor lady, and poor family.

So, where are she and her husband staying at the moment? Is the house still habitable at all?

Is there no possibility of arranging for her and her husband (is he also the children's father, by the way?) to go and stay with them, say for a week each or something like that, to get them away from the "scene of the crime", so to speak? It must be one long continuation of the trauma, for her to be living among the gradual removal and disposal of her ruined possessions.

And how is she coping with her husband's needs in the middle of all this? What support do they have as a couple?

The first step is usually to contact their local Area Agency on Aging, who will "signpost" services. I'd still suggest that, but these are very unusual circumstances. Are the cleaning crews commissioned by their insurers? Might the insurance also cover some kind of counselling service?
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