Paging Mary Poppins for adults....

January 7, 2010 9:09 PM

How do I help my aunt (who has largely undiagnosed mental illness issues) avoid homelessness? Do they make nannies for adults? (details below)

My aunt is currently living in a hospital halfway house. She's there because she got kicked out of her current housing (living with friends), had been in the hospital with an infection, and really had no other place to go. They have said that she has 30 days (starting Dec. 30) to find new housing. I would like to do what I can to help her avoid homelessness/get the help that she needs, given that I am NOT in the area (though if it would help for me or another sane family member to be there temporarily for a week or two, that could be arranged).

This is unfortunately not the first time that she has been kicked out of shared housing and family do not have the space or ability to take her in at the moment. I think the ideal situation would be somewhere where she could get some supervised treatment for her issues/help learning how to function in the real world, but I don't know if arrangements like that exist or how to help her find one.


(N.B. I've read other hoarding/mental health threads, but didn't find anything apropos so if I missed something good, I apologize)

(This is going to get very long with details to help get the most helpful advice. I think the summary at the top is enough for the basics, but the rest might be helpful.)

Potentially helpful details:

* Aunt lives in Richmond, VA

* She has very limited income, which includes child support for my cousin (16, currently temporarily living with her boyfriend), but it is apparently just high enough (~$1200/month) to disqualify her for most social services. However, part of the job of the halfway house is supposed to be to enroll her in helpful services...I am not sure how well they do at this and if there may be other things we could do/help with that they are not aware of.


* She is recently divorced and has never held a job...until 2 years ago when my grandmother went into a nursing home her primary job was taking care of my grandmother. It is unclear if given her physical and mental health issues (some diagnosed/some not), if she is capable of holding a job.

* She has never balanced a checkbook and has a history of really bad financial mismanagement (until my mother took over the finances for my grandmother so that the nursing home got paid, she was spending all of my grandmother's income (~$5000/month) on incidentals--no savings, no payments to anything, we're still not entirely sure what it's been spent on). Since my mother took over grandma's finances and put her on an allowance, she's incurred overdraft fees almost every month.

* She currently has no working vehicle. When we tried to give her money to fix her vehicle, it was spent on other things.

* She is a hoarder.

* There is both a paid off house and an apartment she pays for available...unfortunately, they're so full of stuff (mostly rotten food and other garbage) and so poorly maintained (no working fridge/heat/air conditioning and in the house plumbing) that they are not currently livable and they are sufficiently deteriorated that is is unlikely they could be made sufficiently livable in the time allotted.

* The hoarding is diagnosed along with severe depression, but she does NOT currently have medical insurance, nor has she had it for at least 5 years. There are pretty clearly other non-diagnosed mental illness issues and the severity of the former 2 has worsened since the last time she saw a doctor.

* I'm happy to work to get her legal advice, but despite my own training, I'm not even sure who would be an appropriate person to talk to or if the law has a solution at this point. While she's lay incompetent, I'm fairly sure she's not legally incompetent (though, you know, different judges/psychiatrists...). And even if she is, I'm not sure who would be willing/able to manage her affairs for her.

Side question: If the halfway house has assigned a caseworker to her, would that person be able to talk with me (not to give me details of what's going on with her, but so I can share hoarding/ways family would be willing to help/what financial help family has been/can give)? If they haven't assigned one, how hard would it be to get someone to evaluate her for services?

posted by anonymous to human relations (4 answers total)

My mom has similar issues...One suggestion I have is to google mental health crisis for her area. The mobile crisis team was able to point me to helpful services.
posted by bananafish at 11:03 PM on January 7, 2010

You're a very kind to want to help your Aunt in this way. Warning: you are not going to get your Aunt housed within 30 days unless you A) pay for a rental yourself, or B) get a work party of family members together and clean out one of the unlivable but currently available properties.

Your first call should be to the social worker/case manager at the halfway house. S/he will not tell you any personal information about your aunt unless she agrees to sign a release of information. Who knows? Your aunt may agree to sign the release. Give it a try. Even if she doesn't sign a release for you, the case worker,(if not too busy and overworked - yeah, right), will still be happy to listen to any information you would like to share regarding your Aunt's history. Although she'll probably tell you that she can't even verify that your Aunt is living there and/or that she's working with her.

The Richmond Behavioral Health Authority is your Aunt's best bet for low cost mental health care, case management services, and housing assistance. Get her referred for an intake appointment. The case worker at the halfway house can probably manage an intake referral if she hasn't already done so. The problem with this is that help is not going to come right away. There's a bunch of red tape and a lot of other people demanding services, too. That's not to say that these contacts shouldn't be made. Your Aunt definitely needs case management and probably medication management, too. The BHA can do both of these things. My favorite housing program for folks in your Aunt's situation is the Housing + Care Grant. If one of these can be arranged, she can get housing and regular care for her mental illness all wrapped up in a neat little package.

Keep in mind that the above scenario will not happen within 30 days. Case Management Services and Housing Grants all run pretty lengthy wait lists in Virginia. They say that the wait lists don't exist but that's baloney. There's only so many services to go around and more people than that who need help.

Another, less pleasant, but quicker option is to pursue an Assisted Living Facility (ALF). ALF's are not nursing homes. They are basically halfway houses. Some are better than others. Some are really nasty roach traps. This search engine will find ALFs in the Richmond area for you.

Of course, all this is dependent upon your aunt wanting and accepting help. She may not agree to medication management, mental health case management, or moving into an ALF. If that's the case, then there's not much you can do. It sounds like your family has been supporting your aunt for a long time. Learned helplessness is a bitch.
posted by dchrssyr at 11:15 PM on January 7, 2010

I didn't intend for my second paragraph about the case worker at the halfway house to sound so snarky. What I mean is that even if the case worker won't verify that your aunt lives there, she will still probably agree to listen to you tell her about the woman who may or may not be her client. It's a weird game to play. You should say to the case worker, "I know you can't give me any information regarding this person, or even if she lives there. I'd like to share some information with you anyway, if you don't mind listening." When I had that job, I would listen and take notes for however long seemed reasonable given the information being shared and then I would politely extract myself from the conversation after getting a phone number from the caller. If the family member I'd just talked to seemed like a reasonable sort of person, I'd approach my client and ask if he or she would like me to be able to share information with the concerned family member. Sometimes it worked.
posted by dchrssyr at 11:23 PM on January 7, 2010

seems like my Aunt needs to be reparented

Um . . . no. Do not fall into this trap. I'd like to tell you that this is not your problem and you don't have to make it your problem. But I don't think you'll let this go anytime soon. Your mom got out and kept you out of the family dynamic for a reason. You can't force unhealthy people to get well, but crazy can infect those around it.
posted by dchrssyr at 12:10 AM on January 8, 2010