My elderly mom is a hoarder. What should I do?

March 12, 2016 6:09 AM

My elderly mom is a hoarder. What should I do?

This is a long story, but I'll keep it as short as I can. My mom is in her mid-70s, retired, and a hoarder. I lived in a different state from her for many years, and didn't realize how bad the house was until I moved back to my home state recently. The house was full of garbage, insects, rats, and other creatures. The water had been physically disconnected many months earlier, when a flood occurred due to broken pipes. The bathroom was completely destroyed. Ultimately, a friend and I filled a dumpster half the size of the house with garbage, and then I hired workers to replace the bathroom entirely (it was sinking through the floor), as well as the shower, the basement stairs, the kitchen sink, nearly every water pipe, and I don't even know what all else. We cleaned out the bugs and removed the wild fauna. This whole adventure took about five months and cost ten thousand dollars.

Through it all, my mom mostly sat around and watched TV. She sometimes "helped" by showing me what garbage I could pick up. She continued to throw garbage on the floor. Yogurt cartons, empty bottles, her incontinence pads. I made sure there was a garbage can in every room. Sometimes she used them. Sometimes not. Mostly not.

We're at a point now where things are really strained. I got family members to give me money for a lot of this, but they rightly feel they've given enough. Most never gave anything, but have a lot of opinions anyway. My mom, who was largely passive while we did the work to restore her water, seemed to bounce back once she had the basic amentities of early twentieth century life restored. Then she started to be just really openly shitty to me. A lot. Putdowns, irritation at my presence, strewing her used incontinence pads all over the floor when she knows I'm coming over to get the garbage out, and screaming when I suggest the house still needs more work.

Which it does. Her house needs more repair. Desperately. She was to obtain a grant for elderly homeowners, but remains incapable of filling out the paperwork, and will not allow me to do it. And the house itself is still full of junk. Even after we took out a giant dumpster of garbage, there's still mountains of "good" things we were not allowed to throw away. Boxes full of hundreds of pounds of filthy dishes that have been soiled a year or more, and that she insisted had to be kept. Dozens of garbage bags full of "good" dirty clothes that I can tell (holes have been chewed into them) are probably full of rat shit, and may have rats living in them right now. Other stuff. It's foul.

And I am out of energy. I grew up in the house, and wanted to see it restored so that she could have a nice place to live. But I also just grew up in it, and it breaks my heart to see it treated so badly. I don't know what to do. I am certain that, left to her own devices, she will turn the house into the cesspool it was a few months ago. I am equally certain that I cannot spend the rest of my life cleaning up after her. She owns the house. I think that eventually the authorities will remove her from it if it does revert to form; the neighborhood is being "revitalized," and the rich hipsters moving in are unlikely to want to share their trendy home with my mom's trash palace. For me, it feels like every choice is a different kind of lose. I'm very frustrated. Suggestions are welcome.

posted by anonymous to Human Relations (24 answers total)

Has she been evaluated by a doctor? Has dementia or other mental illness been ruled out? That would seem the first thing to do before putting more money into a house she is incapable of taking care of, just as she seems incapable of minimal personal hygiene. You or another relative need to get power of attorney to deal with all this if you can. Call a doctor, call a lawyer, get in touch with an elder care expert or dementia support group to find out how to go about this.
posted by mermayd at 6:16 AM on March 12, 2016 [19 favorites]

Doctor first, perhaps get her into assisted living. It sounds like diminishing capacity and it's cruel to keep her in an environment that she's incapable of maintaining.

You may have to sell the house to get her into an appropriate living situation.

This isn't about how to keep a house clean. It sucks and I'm sorry, but this is an untreated mental illness.
posted by Ruthless Bunny at 6:32 AM on March 12, 2016 [36 favorites]

The problem isn't with the house, it's with your mother. Stop focusing on the house for awhile and put all of your energy on your mom. Give her the choice between getting treatment for her mental illness or being put into a home. You can even bring her around to a few homes, they offer tours. She is only going to get worse and right now, she is pretty bad. A full time care home might be the best for her.
posted by myselfasme at 6:32 AM on March 12, 2016 [11 favorites]

Definitely doctor, and a referral to a neurologist if at all possible. If she's developed these hoarding/disorganized tendencies late in her life, it's likely there is some kind of dementia at work; even if she's always been a bit of a hoarder, dementia can greatly exacerbate this.

Having a medical workup - a neurologist if possible - is important in case you need to get guardianship of your mom.

Another resource for you is your local Department of Aging. They are usually organized by county, sometimes by city. Google "YourArea Department of Aging" and contact them. They have experience handling elderly hoarders, and usually will be able to put you in touch with people who can help. (I say "usually" because this depends on the area - some are overworked and underfunded. But most at least try to be helpful, IME.)

Finally - you might check out Stuff: Compulsive Hoarding and the Meaning of Things by Randy Frost and Gail Steketee. Friends and relatives of hoarders often find it helpful - if nothing else it shows you are not alone.
posted by Rosie M. Banks at 6:57 AM on March 12, 2016 [13 favorites]

I'm so very sorry for your situation. It sound incredibly difficult, and I can't being to imagine how hard this has been for you.

Co-signing with everyone who says that your mother needs to be evaluated by a doctor. If you're in the United States, it may also be worth your time to contact your local Area Agency on Aging, and see if they can help you find a social worker with experience dealing with elderly hoarders.

I also encourage you to visit the r/hoarding portion of Reddit, and check out the Hoarding Resource List that's been built by the community there. They've tried very hard to identify organizations and/or support groups across the country to help hoarders and their families.
posted by magstheaxe at 6:58 AM on March 12, 2016 [6 favorites]

You can call the local Adult Protective Services, because the risks to your mother are extreme, including fire, illness, and accidents. You can also get a consultation with an attorney in your state as soon as possible to learn more about your legal options. Links to searchable directories of elder care and elder law resources are available at the MeFi Wiki Get a Lawyer page in the Elder Law section.
posted by Little Dawn at 7:06 AM on March 12, 2016 [9 favorites]

Nthing contacting her physician, elder care services, social services, and/or psychiatric crisis center. If your mom is incontinent and unable to deal with that in a hygienic way, she is not able to meet her basic needs for health and safety, and this requires supervision or assistance with activities of daily living. In some states, this would be enough to 51-50 her (commit her involuntarily to a 72-hour psychiatric hold and evaluation), as she can't safely toilet.

I am so sorry that you have to go through this. I hope that you are able to get more assistance from your family, as moving these mountins alone can be quite challenging. I hope the best for you and your mom.
posted by stillmoving at 8:06 AM on March 12, 2016 [5 favorites]

Another book you might find helpful is Dirty Secret by Jessie Sholl. When I read it, it was striking how much of the book reflected not my mother's hoarding per se but her mindset.

I echo getting professional help, and being mindful of your own oxygen mask. I really do think at 70, if you can get her into some kind of assisted living that is ideal. I wish I had better answers.
posted by warriorqueen at 8:21 AM on March 12, 2016

You need to contact an elder law attorney about seeking guardianship and conservatorship.
posted by HotToddy at 8:51 AM on March 12, 2016 [1 favorite]

Just from a totally unqualified internet stranger perspective, those behaviors sound more like dementia than mental illness. In either case, though, it's definitely something you'd need to have diagnosed before treating it. Of course, mental illness is still possible, but dementia is not mental illness. They're different things that require different treatment.

So that's what you need to work on now. If you can get her to cooperate, and can visit a doctor or two with her, they can help you sort out your options. Try to talk to her earlier in the day, as sometimes people experience sundowning, where the symptoms are worse in the evenings. There are often treatments available that can help, but you can't access those without a diagnosis.

In the long term, once you've got a better handle on what exactly is going on, you'll have a bunch of hard problems to sort out, but the longer you wait, the more difficult those become. From your description, it's sounding like she may not be safe living on her own anymore, and you'll need to figure out your best approach to that. You should also look into getting control of the decision making. There are several different legal options available for that, but your options are much better and simpler if you can sort them out before she's completely lost control of her faculties, if that's what's happening.
posted by ernielundquist at 9:42 AM on March 12, 2016

I'd start with getting advice from experts who deal with hoarders in your area. Honestly, if she got into an assisted living place, I could see her getting kicked out quickly for the behaviors your describe and then where would she be? Start with getting help for the hoarding mental health issue before you make any other moves. It won't be easy, as you know firsthand. Hoarders get belligerent and nasty when their lifestyle and collections are threatened.
posted by cecic at 10:05 AM on March 12, 2016

Let's honestly label what you're doing: you're trying to help a person with a serious, untreated mental illness who doesn't want to be helped. You have realized that without your mom's cooperation, it doesn't matter how much cleaning you do, because that doesn't address the underlying mental illness. Of course she's lashing out at you. You're taking away her sense of security by taking away her hoard.

While I understand that you want to help your mom, you can't force her to stop hoarding or clean up. And making this your responsibility is having a serious toll on you.

I think you should step back from this situation. Contact Adult Protective Services so that your mom is getting professional help. Contacting a lawyer and a doctor might be helpful, but it isn't your job.
posted by medusa at 10:28 AM on March 12, 2016 [11 favorites]

This is the sort of thing I dread with my parents--how do you, as the perpetual subordinate child, take away a parent's freedoms for their own health and safety? All I'm worried about right now is my dad's access to car keys, and I do not look forward to the day where I have to insist that he stop driving. Dealing with a hoarding parent... my heart goes out to you. I think that people are offering some really good advice about elderly organizations, attorneys, doctors, etc. My advice is more related to your own psychological welfare.

This is awful, but whatever you do that threatens your mother's collections and living arrangements will likely further deteriorate your relationship with her because you are the bad guy taking her things away and judging her lifestyle. You need to steel yourself up for this and possibly develop a short term relationship with a therapist of your own to help you deal with the fallout. The problem you are facing is multi-faceted--your mother is clearly not safe in her current environment, she has either dementia or an untreated mental illness that causes her to collect, and she is in legally in control of her own home. All of these things need to be addressed in order to save the house and help your mother, and she will fight you every step of the way. If you force her hand, even if it's for her own good, your relationship might be permanently broken. You're going to have to decide if it's worth it to you. Either answer is ok, but your choice needs to be made with your eyes open.

If you get the law involved, you will probably end up with unfettered access to the house to repair and sell it before things get even more out of hand, but your mother will be angry. If you just leave her to her own devices you will likely have to deal with a much more intense situation at the house when she passes away. While I'm sure it's sad to see your childhood home in such a state, it's just a house. Unless you had fantasies of moving back in after her death, it's never going to be your problem long-term. And unless you're willing to take the steps to remove your mother from the home, most of the money you spend now will be wasted when she ruins all of your efforts out of spite or just as a result of illness. It might be ok to spend money on structural issues, wiring problems, and plumbing, but I wouldn't spend another dime on cosmetics or trash removal until your mother's presence there and/or her hoarding has been addressed.
posted by xyzzy at 10:47 AM on March 12, 2016

Sounds exactly like my mum. But, it also seems like your mother has crossed the border into dementia, which is a good thing if you can get her a diagnosis.

My mother is not at all demented, and her filthy, smelly apartment is a huge stressor both for us, her family, and for the housing company (it's a rental). But there is nothing we can do but wait.

However, there are aspects in your description that point to the possibility of your mother being on the onset of dementia, and then you can get help. Obviously, you need to get her evaluated. Next thing is to find a nursing home, which can be both difficult and expensive. I hope you find a way.

I'm so sorry that you have to go through this. It's so sad to see loved one change personality that way.
posted by mumimor at 10:50 AM on March 12, 2016 [2 favorites]

I think Elder Protective Services are your best bet, but I would not hold out much hope until it gets a lot worse. I have been through this (including the months without running water), and it is very difficult to get someone's rights taken away. Adults are allowed to make their own decisions, even when the decisions are clearly terrible. It can be very difficult to get guardianship. I don't know what state you live in, but in Illinois, she would have the right to her own lawyer, and you would have a court battle on your hands. It's also very expensive to apply for guardianship, though if you win, you would probably be reimbursed from her assets. If you do talk to a lawyer, it is essential to find someone who specializes in elder law.
The Department of Health might be willing to get involved, but without any cooperation from your mother, it's going to be horrible and stressful. I know you really want to clean the place up, but I fear it is just a waste of your energy as she has no interest in keeping it clean. Sometimes you just have to wait until things are bad enough for the authorities to step in. That is ultimately what we did.
Is there any way you can distance yourself more psychologically, just say "it's her house, and she can turn it into a cesspool and I can't do anything about it right now." If you could just try to accept that, you could at least maybe reduce your own stress. But you can't help people who don't want to be helped.
posted by FencingGal at 11:02 AM on March 12, 2016 [2 favorites]

From afar it sure does chime mental health/dementia bells, but please know the work that you have already done is not for nothing, you have shown great caring and love for her and put so much effort into helping her. That is lots more than lots of people get, you and she should be proud that you have the love and energy to do this.
posted by eggkeeper at 12:05 PM on March 12, 2016 [10 favorites]

I must agree with medusa that you've done all you can, with not much help from siblings or other family members. Your mom probably isn't capable of recognizing mess from non-mess. She needs expert evaluation and care.

...strewing her used incontinence pads all over the floor when she knows I'm coming over to get the garbage out...

This infuriated me when I read it. I'd take a match to the place, but I'm no social worker.
posted by BostonTerrier at 1:12 PM on March 12, 2016 [1 favorite]

My grandmother's Alzheimers looked mostly like irrational anger and abuse toward my grandfather. Mental decline doesn't always look like we expect it to look. Your mom's decline may look like hoarding, anger, and irrational behavior.

As others have said, she needs to see a doctor. If she refuses, then you need to ask for help from elder services. It's a hard decision, but it sounds like her mental acuity has been declining for a long time. The loving/supportive thing is to get her the help she needs.

You also need support. If you are in the US, the searchable list of services at www.eldercare.gov doesn't seem to be working, but there is a page for caregivers that lists some options and does have a working search engine.
posted by 26.2 at 1:14 PM on March 12, 2016 [5 favorites]

Oh, yeah. Don't take throwing the pads on the floor as malice, or at least not conscious malice. I've seen that exact type of thing in more than one person with dementia. I think they just take them out when they get uncomfortable and don't know how to dispose of them, usually at night when they're sundowning.

Anger is also normal, and often fleeting. In the early stages especially, the symptoms tend to come and go, which is why it's important to see if she has lucid moments where you may be able to get her to cooperate with you in making plans, and, if she still has the faculties, to consent to having someone else make decisions on her behalf. If you have to go the legal route, it is much more difficult and expensive to get it sorted out, especially if you are in an area with substandard social services.

And one other thing I just remembered: Please see if you can disable or just get rid of her stove and anything else that could cause a fire if left on, and if she has a vehicle, possibly take her keys. It is apparently very common for people to burn their houses down or cause traffic accidents in the early stages of dementia before they or their families realize how far along it's gotten. Again, a lot of the time when they live alone, they'll be OK during the day, but then they'll decline in the evenings when nobody is there to see it.

I have no idea if it is dementia, but almost everything you describe is something I've seen in people with dementia, so at least until you get a diagnosis, it's probably best to be on the safe side.

Getting a diagnosis is very important, though. There are medications that can treat many conditions, including dementia, and the sooner you find out what's going on, the sooner you can do something about it.
posted by ernielundquist at 1:39 PM on March 12, 2016 [2 favorites]

Came back to add that you can often call the non-emergency police in your mom's area and ask them to do a well-being check. They have the usually have the ability to place someone under a 5150 hold.

I agree with others that it sounds a lot like dementia, but it could be other psychiatric or neurological conditions. As ernielundquist notes, it is important to insure your mom's safety, so limit/prohibit access to fire/gas/automobile. If she was able to go a long time without a bathroom and the floor was sinking through, she's not able to ensure the physical safety of her surroundings, which can be hazardous to herself and others.
posted by stillmoving at 1:49 PM on March 12, 2016

You may have to have her taken away involuntarily. If she is in danger from self harm, which she is. She is young for full on dementia, but she has this. The violence is not because of you, it is because she has dementia. She will need to be on a closed unit. The police may have to get involved and paramedics, to take her for a psychiatric evaluation. She is through with living alone, she is not safe. This is considerably more than hoarding, she is incapable of self care. The Allen cognitive index, administered by a speech pathologist can give a numeric value to her ability level. This is ordered by the primary care physician as a part of a home care assessment.
My mom had full blown dementia and Alzheimers, and she was more able to care for herself than your mom, by your description. She is relatively young to be so harmed. This is going to get more difficult until you get her placed.
posted by Oyéah at 7:52 PM on March 12, 2016 [4 favorites]

To get to the "call 911 and have them taken to the hospital by the police" level, you really must believe that she is an imminent danger to herself or others (which usually means hurting or killing herself or others, or having hallucinations/psychosis). If this is the case, I would encourage you to do it - however, it sounds more the case that she is a danger to herself over time, but not imminently. In cases like this it is typically better to go the route of working with a primary care doctor and social services as noted above by several other answerers to ensure that the correct services are lined up through the proper channels.

I'm an ER doctor and so I see not infrequently that old people get brought in because their families just "couldn't handle it anymore" or "suddenly realized how bad things had gotten", which I totally sympathize with on a personal level - but it's a nightmare to deal with in the emergency department, because these patients usually end up with a diagnosis of dementia, which is not considered an emergency or a diagnosis that requires hospitalization, and hence get labeled as a "social admission" (i.e. admission to the hospital for social reasons only, no medical reasons). This means that the admission doesn't get paid for and the patient or their family can get socked with a huge bill, and the patient can end up classified as an "observation" admission because they don't meet inpatient criteria, which means that it can be a challenge to get them placed into an extended care facility, because such facilities have esoteric rules about not admitting patients from a hospital unless they have been inpatient stay. These things are in place to help prevent families from just "dumping" their elderly relatives in hospitals, but at the same time they can be pretty cruel policies. I hate the fact that this is the case, because I understand that there are situations in which you suddenly realize your family member is in a terrible situation and can't stand the thought of them being in it for days to weeks longer while you try to obtain conservatorship and get them social services/placement, but unfortunately our system is just really bad for elder care/mental health care and so I would only advise the 911 option as a last resort.
posted by treehorn+bunny at 11:00 PM on March 12, 2016 [15 favorites]

i think first and most importantly do something for yourself. You tried very hard to make it ok for her and it looks like it is not sustainable. I am very familiar with situations like this from my own dysfunctional family and from this experience I say: go and find a therapist and do something for yourself first. Only after that consider if you should do more for your mother.
Getting someone examined by a doctor who does not want to be examined, or committed to a ward, or becoming their legal guardian, etc etc are draining, absolutely harrowing and drawn out processes (possibly years) with a very uncertain outcome. Ask me how I know. Don't let yourself be pushed into doing it by well meaning people. By all means find out what the state offers where you live, but don't get sucked into becoming her provider and saviour.
posted by 15L06 at 2:09 PM on March 13, 2016 [1 favorite]

When my mom went in she was physically attacking me, and I was injured already. She had an episode so violent, they put her in a padded cell. Then she was admitted to a psychiatric facility, which gave her the three day inpatient stay, medicare requires, before a longer placement. If she is OK with living in her own excrement, without water to wash up with, and all of the rest of the description, it won't be long before she is hospitalized for cholera or infection. Then they can figure out the rest.
posted by Oyéah at 4:24 PM on March 13, 2016