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Every time we have tried to help her clean or organize, my MIL has a major panic attack. She's actually ended up in the ER before. Now we need to downsize her from a 2 bedroom condo to a 1 bedroom apartment at an assisted living facility and she is already freaking out about all the things she'll have to leave behind. I keep telling her that we are going to take as much as we can fit into this apt. She is so attached to EVERYTHING, even things I would consider garbage. Last time I went down to help her out, we cleaned her bathroom which was a disaster area and I told her to just sort out the stuff that was obviously garbage. I held up a soiled empty ziploc bag and said, "like this". She got a panicked look on her face and said, "I could put something in that!!" This is going to be a major challenge as you can see.

I've been told that the less involved she is in the moving process, the better it will be. I'm torn, because it's her stuff. I don't want to make decisions for her on what to take and what to leave behind, yet there is the distinct possibility that she will end up hyperventilating on the couch clutching her nitro whether I involve her or not. I don't want that either, of course.

My current thinking is that we will move as much furniture as we can fit in, pack the things she picks out to take (like heirlooms and special items, the few dishes she wants and clothes) take her and her boxes over to her new apt. and put her to work unpacking the boxes while I go back and take care of the stuff that there just won't be room for. Hopefully, the staff at the assisted living can help keep her busy while we do what we need to do.

By the way, my MIL is a hoarder. A few years back we had to clean out her 3 floor house that was packed from top to bottom. It took several huge dumpsters to get the job done. Her current place is nowhere near that and we have cleaned up most of the worst messes, but she still has the hoarder's mentality. She doesn't want to give anything up. Not even garbage. Any suggestions?

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It sounds like the less involved she is, the better for her (and everyone else). Your plan sounds good to me.

I think, though, the one thing I'd change is not to overcrowd her new space. If she is a hoarder she will inevitably start adding to what is there, whether it is a little or a lot.

Can she afford to pay for a small storage unit for her excess stuff? Would that help relieve her panic? I wouldn't pack used plastic bags into the storage unit -- still get rid of the obvious garbage, but if knowing that her precious belonging are safe and somewhere she can visit them helps her mental well-being, that might be an option.
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Actually, she can't even afford to move to this ALF. Family members are making up the difference. We are getting a storage unit, but if she knows about it, she will probably want to visit it and take stuff back with her! I think, if all goes well, her place will look really nice but her walk in closets will have a lot of storage bins in them, at least for the time being. Her dementia has gotten worse and I suspect she might have to downsize again someday. The worst part of it is that she is still aware enough to know that she has to let things go, but she can't handle it emotionally and lashes out or has these intense panic attacks. I think you're right though, not having her around and kept busy will probably prevent her from ending up in the ER or bringing her daughter to tears.
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This is a sad situation and hoarding is a form of a mental disease. The one good thing about dementia is that often "out of sight, out of mind" things they forget they have. When my mother and father moved to elderly housing they did rent a storage unit and this helped tremendously with the transition.

My mother is in a NH and all of her things from her apartment are at my house. I am cramped for storage as it is, but thought it a good idea to ease her mind about her "things" as when she asked for certain items, I told her I had them and if she asked for one in particular, I would bring it to her. But, after a while, when there are things they previously had and don't see anymore, they start to forget. But, my mother was not a hoarder and that is a sad affliction to have.

After a time, I think you will find you will be able to dispose of the things in the storage unit as she will forget. Very sad to deal with, my heart goes out to you and your mother. Take care.
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Would your mother-in-law believe a 'therapeutic lie'? When there's real anxiety about a move (and dementia adding to it), the easiest transitions are made when the last residence is left intact (for the most part). Even if the financial reality is that you have to move everything out of her former home, her mind may be more settled if she believes her 'stuff' is still where she left it. I'd move as little as is needed into the AL apartment (start off spare, even in the AL environment, hoarders find a way to hoard - I've seen it happen) and avoid the storage unit idea. Storage units aren't cheap (and you're already kicking in for her care) and why keep anything that her family doesn't care to inherit at some point?
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Have you ever considered making her see a geriatric psychiatrist? Medications to treat her disorder(s) may make the move easier for all of you. Don't let it be her choice, whatever you do. She will refuse. He/she will have seen these problems many times and know how to handle it. They are very informed as to mental health and the elderly.She has serious mental health issues in addition to the dementia.
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