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My mom has been in and out of the hospital the past year. She's had pneumonia 2 times and been discharged. The last time she ended up in the hospital (2 months ago) she had sepsis (she has bladder problems), and flu a&b. This turned into pneumonia (3rd time). She has congenital heart failure, afib, low blood pressure, incontinence and memory problems (which are severe to us, but we are having trouble getting doctors to see what we see.) She has respiratory distress last week and ended up in ICU for her pneumonia that they thought had cleared up. She was severely anemic and they gave her a blood transfusion. She's breathing without oxygen now and responding to the antibiotics (stable vitals/no fever) so they are about to discharge her. I am worried about her at home (alone) since she lives in unsanitary/filthy conditions. Mold around, over 30+ animals and feces all over the floor, tons of dust, etc. She's also very stubborn and does not want to change her way of living and doesn't want any help. I'm worried that her living conditions are contributing to her constantly being hospitalized for pneumonia since the air is not clean in her home. She has trouble remembering conversations from earlier in the day, or even if she visited a doctor or not. She cannot drive and cannot get herself to doctors appointments. We have set up a car service for her, but she's so difficult in even telling us when her appointments are. What can we do? Do we just let her live how she is living? I feel like she's so sick and has recently escaped death with all of the issues that she's been having. I hate to think that we will put her back in this environment and she'll continue to decline.

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Oh Lordy when I read filthy conditions and mold then adding 30 animals it all sounds overwhelming to a healthy person, and a dire condition for elderly person with several serious health issues.
Honestly, I have no advice short of filing a self-neglect case with APS, and have them go by and assess the situation.
Good Luck to you
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SimplePancakes Feb 21, 2020
thank i'm going to look into that.
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Having 30+ animals in one's home which is covered with feces and filthy is not acceptable living conditions, as you know. It's likely not a good situation for the poor animals, either, so you should report the situation to the ASPCA. You can also call Adult Protective Services who will investigate the living situation at your mother's home & make a determination based on what they find.

Best of luck!
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SimplePancakes Feb 21, 2020
can APS go check out the house?
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While mom is still in the hospital, talk to the discharge planners about the conditions they are sending your mother back into. Mention the term "unsafe discharge".

They likely cannot force her into any kind of care immediately, but ask if they will be reporting her self-neglect; they should send someone to the home to check if it is a safe place for her to return to.

Once she is home, call her doctor and ask how to obtain a complete neuropsych workup. This generally consists of a neurologist, a neuropsychologist and a psychiatric nurse. This is a very thorough (6 hour or so) pencil and paper examination that will document her reasoning, insight and thinking skills, as well as memory.

Good luck! And let us know how you make out. We learn from each other.
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SimplePancakes Feb 21, 2020
is the hospital allowed to do that? check in at the house? do i talk about that with the social worker?
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In my state, you call Animal Services on a neglected animal and they are out, Pronto. If you call on humans--you will likely get the runaround and no actual 'help' It's terrible. Animals are more well protected than children or aging people.

The atmosphere of the home MOST DEFINTELY is affecting her health. Full to overflowing litter boxes and poop spread all over the floor--cats are notorious for being on ALL surfaces--I'm gagging a little here.

I just called CPS on a neighbor who is 70 and has had her 3 grandkids dumped on her to raise. Never a 'stellar' housekeeper, she has simply given up and one of the kids' beds is actually a pile of laundry, clean and dirty mixed together. The huge dog runs through the basement apt where they live and spreads the litter box contents all over the place. I can't be in her place for more than like 10 minutes before my eyes are burning from the ammonia and other smells.

Since moving from the upstairs (which was filthy, but had adequate fresh air supply) to the MIL apt in the basement, all 4 of them have had pneumonia, the little girl is covered in eczema so badly she is often bleeding from scratching at herself. I am POSITIVE that the mold, cat feces and such have made all of them sick. It's a 'sick house' that no one should be living in. I have no hope that CPS will really do anything. But I did what I needed to do and stepped back.

Call APS and report her as endangered adult. Give them as many details as you can. They CAN remove her from her home, but most likely they'll do an in home evaluation and try to 'help her'. Really, only in the most dire of situations will they physically remove her.

I am not even going to suggest you try to clean for her. A person who has lived like that cannot and will not change. Her hoard is her hoard and to her, it's probably comforting.

Having her move to some kind of assisted living or NH is what's best--but that's a long shot if she is not declared incompetent.

I'm so sorry for you--I know exactly how you feel (hopeless!) and frustrated and angry all at the same time.
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SimplePancakes Feb 21, 2020
Hey, what is APS?
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Before She is discharged from the hospital, request a neurological evaluation. This is a first step towards a diagnosis should you need to prove dementia or incapacity. You should also obtain a copy of her hospital records that has the neurologist’s report. Many financial institutions and others require diagnosis from 2 physicians, so you’ll have to follow up with her primary care or get a referral. Definitely stipulate to the hospital social worker that she had unsafe living conditions and lives alone. It’s a rough time, good luck!
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Can you explain to the hospital social worker that it is unsafe to discharge her to her home?
I would call animal control for the animals. Very possible that if the employees from animal control see the living conditions they may report to the Health Department. They may take steps to force a clean up. If she is non compliant with that they may force eviction (after a few court dates)
Unfortunately unless she is declared incompetent she can not be forced to do what she does not want to do.
You could try to obtain Guardianship but again you would have to have a doctor confirm that she is not competent.
If you requested "Home Health Visits" for a period of time maybe they could report conditions and that might prove to be more helpful.

Unfortunately it often takes a catastrophic event to get things in motion that can help make her safer.
Also keep in mind Hoarding is a completely different mental condition than is dementia it might be easier to have someone declared incompetent than it is to get a Hoarder to accept help cleaning up their living conditions.
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Would it be helpful to take photos of her living conditions to document her living environment?
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Judysai422 Feb 22, 2020
And show them to the doctor who does not see her cognitive issues.
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I have a thought. Can you get some photos of the inside of the house? If you can, show them to APS, County or City Animal Control, hospital social worker, and anyone else you can think of. You can say her living conditions are awful, but that is just your opinion. Show them. I remember when I had small children with Asthma. I had just finished deep cleaning my house, washed windows, curtains, and all the bedding. Every week I moved out all the furniture and wiped behind the walls and backs. I had no carpets, and had just mopped and waxed all the floors. One of our dogs had come in and left a little bit of sand on the floor. My Sister-in-law asked me how could I live in that filth. I wanted to sit down and cry. My point is, they may need a visual image to take you seriously.
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MaryKathleen, your post reminds me of several decades ago when I decided to take on leadership of a Girl Scout troup.   I met with various people, including one female doctor to get background information, details, backup and alternate plans. 

I don't recall if she was the existing or former leader, or played some other role.

When visiting at  her at her house, as she was cleaning up after dinner, she took a pot with something in it, spaghetti if I remember correctly, put it on the floor and let the dog finish off the leftovers. 

I was kind of shocked, but didn't say anything, which would have been very rude.   Her house was "lived in", but not anything I would consider close to being undesirable.   And she was a doctor, so I assumed she had a busy schedule and had better things to do than worry about housecleaning.

Sometimes clutter is how it's viewed, and by whom.
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MaryKathleen Feb 22, 2020
Yep,
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Everyone has given you very good advise, so I won't reiterate that. However, I do need to tell you that as someone who has gone through a similar situation that you need to prepare for battle.
My elderly mom was also very stubborn, a hoarder, and suffering from dementia. Luckily, she only had one pet which sadly ended up dying from neglect. I lived several states away.
It took many thousands of dollars, several lawyers, and years of my life to get guardianship that enabled me to move her out of her house, to my state, into my home, and ultimately into memory care. Somehow, I managed to clean out and sell the house, which is a whole other dismal story. The agencies that were supposed to help (e.g., APS) acknowledged that she was a danger to herself, but fought for her rights to do so. Worst of all, Mom resisted my every effort to help her and our relationship has suffered for it.
I am not telling you this to dissuade you because from what you wrote you will probably need to act similarly to save your mother and those poor animals. I am telling you so that you will prepare by getting your own moral support for what will likely be a very trying experience.
I suggest that you start by circling the wagon of family, friends and faith groups. Next, you should contact the Alzheimer's Association and your local Agency of Aging since they have a wealth of experience and resources. Also in addition to posting here, consider joining a local support group and if money allows seeing a therapist. Finally, find respite when and where you can.
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cherokeegrrl54 Feb 23, 2020
Excellent advice!!
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