Ramifications of unkept house
July 25, 2019 6:24 AM   Subscribe

If dust and clutter continue to pile up in home, what are the long-term consequences and possible risks?

This situation has been slowly worsening over several years. The primary issue is piles of stuff that make rooms virtually unusable, gather dust and make it very hard to clean. Dementia/executive function may be a factor; I'm not sure it's a true case of hoarding. The person in question *can* get rid of things, but the decision-making seems to take up a lot of emotional energy for them.

So far the primary issues that I can see have been 1) increased isolation out of embarrassment - used to enjoy entertaining but now doesn't want others to see the mess 2) depression and guilt over the state of the house 3) possible contributing factor with a bug infestation that required an exterminator 4) dust seems to make coughing worse for at least one inhabitant.

I have a vague notion that if there's no help with getting the mess sorted out and making it possible to keep the home cleaner, their time of independent living might be shortened. I'm not sure this is correct. I have limited energy and feel responsible for helping, but there are a lot of things I need to help them with and i need to figure out priorities.
posted by bunderful to Health & Fitness (23 answers total) 13 users marked this as a favorite
I just went through this with my mother. I'm sorry you're having to deal with it. My mother died in January just as I was considering having to wrestle her into assisted living. The house was cluttered in the areas that she spent the most time in and the sinks were filled with dishes that had molded over. There was a pile of debris about 10 inches high all the way around her nightstand. She spent a lot of time on the bed and smoked in that room. There were cobwebs hanging in various areas and the whole house needed dusting and vacuuming very very badly. She got very angry anytime I offered to help her clean or try to do some cleaning when she was taking a nap. The priorities for me had been getting rid of the mold in the kitchen sink and doing some dusting. And then getting the debris off the floor. The clutter isn't so much a problem unless it becomes something that can be tripped over but you certainly don't want thick dust and mold hanging around. Again I'm sorry you're having to deal with this.
posted by KleenexMakesaVeryGoodHat at 6:38 AM on July 25, 2019 [2 favorites]

I just helped clean out a friend's mother's hoarding spaces, and the main issues with older folks who hoard seem to be isolation, respiratory issues, and fall risks. The more cluttered and dusty things are, the worse the air gets, and the more piles are in the way, the more chance an elderly person has of tripping over them and falling, with real risk of injury.
posted by xingcat at 6:44 AM on July 25, 2019 [13 favorites]

We deal with this with my dad. I'm lucky that I have several siblings around to work with. This may not be an option but what worked somewhat for us was that if he had to go away for a few days, like to the hospital, we would swarm in and clean the place up, throw out garbage and useless items but keeping anything he may want in a better organized manner, such as on shelving if items seemed more useful and boxes if it seemed likely he wouldn't miss it but satisfied with was accessible if he ever wanted to. Surprisingly, as much as he resisted any help cleaning up when he was home, getting very angry at the thought, he would be quite happy to come home to a cleaner house, He carries a lot of guilt and shame about his clutter but refuses help, which is why we took this route on a chance. My dad is very, very detail-oriented and was always working his ass off his whole life but when it became to overwhelming to deal with his "inbox" (so many projects) he would just ignore the piling up. I realize our solution to this may cause too much trauma in someone so it's definitely a case by case situation. Best of luck.
posted by waving at 6:54 AM on July 25, 2019 [3 favorites]

I’ve had several family members in this situation, and people can manage for a very long time in an environment that is cluttered, dusty, and even filthy and moldy. It’s generally better if there aren’t pet messes and if the plumbing works. Of course, it’s not a great thing, and the issues you identify are real and troubling, but sometimes there’s not much you can do unless it gets to the point where someone calls the department of health. For my family members, the health problems that resulted in death were not related to the mess. All three lived into their 90s, though one spent her last three years in assisted living due to cognitive impairment.

You also don’t mention age, so I’ll add that I grew up in this kind of situation. The shame, social isolation, and worry that I’d be taken from my parents were the worst parts then.
posted by FencingGal at 7:11 AM on July 25, 2019 [3 favorites]

The mobility/fall risk is real and serious - the stuff is a trip risk, and then you fall ON the stuff, and then getting up (if possible) is impeded by the stuff, and if you can't get up it can be an impediment to paramedics etc. The older you are, the more likely you can't come home again after a fall like that.

There is also a real chance that someone else is going to force action. If there's already been an exterminator-grade problem, the clock is ticking before a neighbor calls the city about the rats/roaches/whatever, OR a health issue arises that's going to lead a medical professional to blow the whistle. There are a bunch of reasons to take action before any of those things happen, as there can be legal and financial ramifications.

People live better in cleaner environments. Just general quality of life. It sucks to live with that stress and guilt.
posted by Lyn Never at 7:15 AM on July 25, 2019 [5 favorites]

I suggest having the person evaluated first to ascertain or rule out medical causes.

You might want to call Elder Social Services in your area. This is a common problem with elderly people and they probably have experience dealing with such cases. Usually they intervene when the house reaches a state that causes the neighbors to call in to complain and they would have dealt with really serious cases. You could ask them for advice on how to deal with the situation and whether they could recommend any professional cleaning services.
posted by whitelotus at 7:29 AM on July 25, 2019 [1 favorite]

Response by poster: Forgot to include this info as relevant: They live in a rural area and outsider views are obscured by trees and fencing. The nearest neighbors are about a 5 minute walk away - I think reporting from neighbors would be more likely in urban or suburban areas?
posted by bunderful at 7:37 AM on July 25, 2019 [1 favorite]

The situation can also cause them to be reluctant to call a plumber, and plumbing issues can go unresolved for a long time without anyone else knowing about it.
posted by Quonab at 7:52 AM on July 25, 2019 [4 favorites]

It's so much easier to live in a clean home. The mental load required to do any given thing is vastly lower. Want to make a meal? Open the fridge that has a reasonable number of items in it, none of which are potential health hazards, easily spot what you want and take it out without anything spilling or falling, get things from the pantry the same way without even worrying about them being years old or having bugs, put it all on the clear clean counter, get your clean undamaged knives/cutting boards/pots/utensils out of their predictable homes, walk around on a floor that's clear of tripping hazards and not even sticky, discard waste in a bin that's intended for that purpose and contains the sight/smell, cook on a stove that isn't encrusted with grime or a fire hazard from the clutter in/around it, put the food on plates that are stored somewhere clean and dry that you didn't have to just now scrape food off of or decide that eating out of the pot is fine, sit somewhere comfortable without balancing your food on top of piles of stress in the form of unread mail, drink from a clean glass of known contents, ET CETERA. Everything, every little thing, that one does has a chain of actions just like that, and they can be easy and comfy, or they can be burdened with grime and guilt and inconveniences large and small. I don't see how it could possibly not shorten their time of independent living, because who can keep going under all that stress for as long as they could if things were nicer?
posted by teremala at 8:00 AM on July 25, 2019 [16 favorites]

That might make it less likely to happen, but unless no outsiders ever approach the house (mail, deliveries, utilities, etc) it's not a guarantee and it still doesn't make that kind of environment okay. And if the issue that required an extermination has livestock or agricultural impacts, a five-minute walk is not an impediment to a rat or roaches or fleas, and someone calling the county extension office or equivalent to report an uptick in vermin could easily lead to someone walking up to the house just to ring the bell and ask if anyone else has had a problem.

ER doctors, social workers, etc are also pretty good at spotting when patients aren't coming from a clean home environment. Even just the clothing on a person who is struggling with personal hygiene in a fairly clean home looks different from someone coming from a hoarder/high-squalor situation even if they're showering and doing laundry like a champ (which is not that common, usually personal hygiene suffers too).

Repair avoidance is another issue, mentioned above, that can eventually draw authorities. Not only do people end up living in non-functional homes because they can't/won't maintain and repair critical systems because it means letting someone come inside, but eventually something's going to happen that's either visible outside and passers-by who live in the area will call in complaints about code violations, or utility companies will take notice because of usage patterns that suggest a problem (or a crime, which then comes with additional complications when the cops start poking around). But often by the time it reaches that point the home is so damaged that it's unlivable and too expensive to repair.

It's a known issue that people get overwhelmed by their mess and shame-spiral until it's entirely out of hand, and often there's no way to fix that situation without outside help. If you're reaching this point of alarm, it's definitely time to - as kindly as possible, understanding that this is a fraught subject but can't be ignored anymore - sit down and have a talk about next steps. Honestly generally the first step is assembling a work team (a sensitive issue, since it means letting people inside, but probably unavoidable if the person is to fragile or indecisive to do this with minimal help) and renting a dumpster and possibly also a mobile storage container. You get the recognizable trash out first, the unsalvageable stuff second, the "time to let this go" stuff third, just to make enough space to consider organizing what's left, and to make enough room to do meaningful cleaning of surfaces.
posted by Lyn Never at 8:10 AM on July 25, 2019 [6 favorites]

Other issues:

1) If the house is burgled, how will you know if anything of value was taken?

2) If anyone needs to access important paperwork, such as bank accounts or trust paperwork or health records of note, how long will it take to find it?

3) If the pantry and cabinets and refrigerator are so cluttered that you can't get anything in or out, what does the person who lives there eat?

Answers, from my own personal experience with my mother:

1) Ha! We'll never know exactly what was taken. We know jewelry is missing, but we were unable to provide the police with any kind of inventory.

2) It took us three weeks of twice-weekly cleaning and decluttering to find the info on the trust that needed to be updated but couldn't be updated without the original paperwork.

3) I found out this summer that my mom goes through stretches where she basically lives on oatmeal and cereal and whatever can stay out on the counter.

Are you also looking for general tips on how to convince this person to clean up, or allow clean up to happen? Listing all the health consequences hasn't worked so far for my mom's situation, but some other things have worked, a little. I'd be glad to check back in with a list.
posted by SuperSquirrel at 8:12 AM on July 25, 2019 [7 favorites]

The biggest issue to my mind is that first responders need to be able to reach the person to evacuate them safely in an emergency.
posted by jgirl at 8:44 AM on July 25, 2019 [1 favorite]

Response by poster: They very much want to clean up. I don’t need to convince them of that, but I may need to convince them to accept family help or the help of a professional cleaner, and (ideally) an ongoing cleaning service. Tips welcome.

I’d like to be able to do this in a way that minimizes shame and anxiety as much as possible.
posted by bunderful at 8:45 AM on July 25, 2019 [1 favorite]

One thing that has worked so far for my mom was to suggest specific people or organizations who could use her stuff, rather than just sending it all en masse to Goodwill.

So, the Girl Scout council is getting some giant bags of craft supplies and half-finished craft projects. They may also be getting all her old sewing supplies, but we're still working on that. (My mom was a Girl Scout leader for many years.)

My daughter, who inherited my mother's love of flowers and gardens and doing yard work, is the lucky recipient of whatever gardening supplies, lawn ornaments, flower pots, old bags of potting soil, etc., that we unearth.

The local school district will soon be the beneficiary of several boxes of unopened office supplies, like nice paper, envelopes, and file folders. (When your house is cluttered, and you need something but can't find it, you just go buy more...)

I think it helps her to think of these specific people actually using her stuff - I suspect that it knowing her stuff is useful to someone makes her feel useful by association, and less ashamed of collecting it all. I don't know, but whatever works.

Other things I've tried to do, with varying levels of success:

1. Suggest that a certain category of items be ok for a helper to throw out without asking. So, it's ok for me to throw out any credit card statement or electric bill from before 2005. But woe to me if she sees me sneaking an old Blue Cross benefit statement into the shredder, because that might be useful some day.

2. Kind of corollary to #1, but one reason my mom refused offers of help for so long is she didn't really trust us (her 3 kids) not to just willy-nilly start throwing out all her stuff. So I promised, upon pain of death or disowning, that I would not be so disrespectful as to toss out her old stained plastic leftover container from 2010 without consulting her first. It's hard, but I am sticking to my agreement. And she's getting better at saying "toss it", now that she's become more comfortable knowing I won't accidentally toss something she values, just because we have different ideas of what makes something worth keeping.

3. Look into the local municipality's services (especially if the person in question is a senior citizen). My mom's town has a service that will come to the house and pick up large items like TVs. My own township has regular electronics recycling. So I told my mom that I was going to this event with some of my own stuff, and as long as I was going, maybe we could load up that old TV and those 3 broken VCRs from her basement?

4. Tackle visible or really useful areas first. We started with the aforementioned search for the trust paperwork. The next project was her garage, so that she wouldn't be so embarrassed every time the garage door was open. Those two projects got us on a roll, and she is so pleased with her [almost] empty garage that she mentions it constantly.

5. It's really, really hard, but don't get angry or dismissive. This is really hard for me, and sometimes I go home after a day at my mom's and just vibrate with anger at how she could let things go like this. But I try as hard as possible to be cheerful.
posted by SuperSquirrel at 9:27 AM on July 25, 2019 [12 favorites]

This is a cautionary tale, just to keep in mind, I would not tell it to the people you are worried about, but it is a consideration to keep in mind in hoarding situations, since you asked about possible risks in that type of situation.

A good friend of mine had lost touch with pretty much all his friends over time, in some cases actively pushing us away. Those of us who were his friends had lamented this, but moved on, as time and distance intervened. Then we learned he had died in a house fire. A factor in the firefighters being unable to get to him, as stated in the press coverage of his death, was that he was in a hoarding situation, with piles of stuff, including a lot of paper. This both increased the stuff available to burn in the fire, and made it almost impossible for the firefighters to get through to get to him. I still think about my friend with regret, both that none of us knew his situation, as maybe we could have at least tried to help, and that he died the way he did.
posted by gudrun at 10:36 AM on July 25, 2019 [4 favorites]

A family member is in this situation, and I have encountered similar issues. Is there storage space in the house? If so, get plastic totes or banana boxes, load them up and label them well, then stack them neatly. You do want plastic for the bottom container. Maybe cover with plastic. A co-worker had a boss who hoarded papers and junk, she kept boxing it up and quietly got rid of one box for every new box. If no inside storage, get storage containers like Rubbermaid rough totes that are decently weatherproof. I have some stuff in big ziplock bags in those totes, and it's in good shape.

Let the homeowner provide direction about priorities, getting old is full of loss and indignity, and sometimes your stuff is all you have, and feels like part of you. Many older people feel a loss of control, so try to respect that visibly. Even stuff like using their preferred cleaning supplies. Think of any way to reduce barriers to getting things clean. Agree with supersqwirl, identify key areas like the kitchen, couch/ tv area, bedroom, bathroom. Music is really helpful for getting older people to be able to move, improves mood and energy so put on *her* favorite music. Positive reinforcement - I want you to be able to enjoy your home. You deserve a clean kitchen. Oh, look at these great pictures of you, I love being able to see them. I know this is hard for you, but I think you'll enjoy having this space in order. Now that the counters are clear, can we make your %Family_Recipe? This takes tons of energy, I can see how it got away from you. Lots of hugs, jokes, anything at all to make it sort of fun.

The 1st steps are hardest because you have to invent the organizational scheme, and there's a certain amount on initial chaos. There are professional organizers, more expensive than a cleaner, but possibly a resource.

1) increased isolation- check, 2) depression and guilt - check, 3) infestations (bugs, mice, squirrels), 4) dust, 5) tripping and fire hazards.
Check the smoke alarms. Make sure rugs are as safe as possible. Check for electrical cords that are old and cracking or under a rug. Get rid of ancient food that is in poor shape.

Huge hugs to you and everyone who has helped someone in this sort of trouble, and to your loved ones.
posted by theora55 at 11:18 AM on July 25, 2019 [2 favorites]

They very much want to clean up. I don’t need to convince them of that, but I may need to convince them to accept family help or the help of a professional cleaner, and (ideally) an ongoing cleaning service. Tips welcome.

I’d like to be able to do this in a way that minimizes shame and anxiety as much as possible.

If you can, call around to all the local options yourself and tell them what you're looking for - a cleaner who will approach the process with compassion and patience.

You could also suggest turning family help into a bit of a party - you all show up with food and drinks and then chat and play music while you clean.
posted by showbiz_liz at 12:04 PM on July 25, 2019 [1 favorite]

Clutter and dirt are a serious health hazard. Too much cubic stuff is another serious health hazard. It makes it impossible to fight a fire in a home like that. However...

In my experience for some people too much stuff and a layer of grime in someone else's house is going to hit their anxiety and disgust buttons and make them feel overwhelmed with too much sensory information when they visit, and they will cause more distress than good because they let their disgust show.

The person experiencing the disgust when they visit is making value judgements and is going to be showing cultural bias. If they visit the home of someone from a different culture and complain because they don't like the small and they don't like the furnishings and they are repulsed by the things that the home owner collects they are making cultural value judgements and we might not agree with them. Dirt is repulsive because we instinctively don't want to be close enough to fleas and infectious materials. However if the grubby person and their house is not infectious or infested we will probably still be disgusted by the dirt. And that is a value judgement that we do not like dust, or elderly shag carpeting or collections of old margarine tubs, if we get upset before it is actually causing health symptoms.

We tend to get very self righteous about these value judgements. Dust could cause respiratory problems. But we are hardly likely to go into a sparkling clean house and disapprove even though we can tell the house is being cleaned with chemical products - and in many cases those can also cause respiratory problems. It's just that it's really easy to think of heaps of household dust as horrible, and much less likely to think of a shiny counter as horrible.

So whoever is going to help your friend or relative with this issue should be someone who has a strong tolerance for dust and clutter. Otherwise they will upset the person they are helping and be miserable while they are doing it, and may fail to get the place clean and end up having only distressed themself and the person they are trying to help.

I think the ideal solution would be to get your relative a home helper who is comfortable with the mess and good at helping clean up in a supportive way.

The mess got that way over weeks or years, trying to fix it over a single week of marathon cleaning is going to be rather like cauterizing a bleeding wound. The trauma to everyone concerned my be as bad as the situation in the first place. You do not want to drive your poor friend or family member into feeling ashamed as that will isolate them further. You don't want to make them feel threatened or assailed or that their feelings don't count. To be successful at helping them you need to support their mental health and well being first. Getting rid of old margarine tubs are NOT as important as supporting the person to gain control. You don't help someone to gain control by taking it away from them.

So what you need is a helpful relaxed and friendly person who can prioritize the hazards - fall hazards - and ignore the non-hazards - 70's avocado green carpeting, for example - and assist the person to make their own changes.

The situation you describe is ready for that. The person wants to make their space more livable and from your description they do not need to be removed from the home for their own safety. But if you make the person feel threatened by trying to make decisions for them, if you rob them of control they will get resistant and much less able to get rid of stuff or tolerate visitors, or tolerate cleaning.

Right now this is what I am doing. I have a friend who asked me to come and help her in her home and we have been slowly, oh so slowly working on the various things that got out of control while she was sick, isolated, away in hospital, and now back home and handicapped. She frequently talks to me about her other friend - someone she was much closer to previously - who staged an intervention and took her out to lunch with her financial manager and told her she had to get rid of her angel ornaments, her piano, her 70's wall to wall carpeting and her dog. She can't get over how hurt she is that this friend didn't empathize with her feelings about these things, and how precious three out of the four are to her. We're keeping the carpeting for now, as we agreed that a hardwood floor would be slippy and the carpet provides some protection and cushioning when she does fall.

E told my friend that since she had peripheral neuropathy in her hands she could no longer play the piano, it was huge and took up space, nobody would ever want it and she had to get rid of it. I told my friend that I had never heard the tune to "I'll Fly Away" and got her to play the melody slowly one note at a time. Now the piano that her parents sacrificed to buy for her when she was only ten is now her opportunity to do rehabilitation exercises that she is much more willing to do than listlessly squeezing a rubber ball.

There are still pantry moths in her kitchen, but I don't have to ask her if I get rid of anything with a best before date earlier than 2017 now. And we recently got her living room, dining room and halls cleaned out enough that she got the carpets shampooed. She was the one who found the coupon - have two rooms cleaned and get a hall cleaned for free - and decided we could do it because she knew that I would move anything she wanted, put it back wherever she wanted, not throw out anything she didn't want me too, would carefully tear her address label and put it in the fireplace to burn if she gave me magazines to get rid of and had no agenda except to help.

It's been nearly six months now, of me coming over two or three times a week, most of which time is actually spent in her hot tub, or me making us lunch and doing laundry, but my friend is feeling more secure, more happy, and the clutter and dust are steadily going down. Rather than asking her to get rid of those heaps of clothing, my suggestion is that it would be so nice to wear some more of them, "You have so many nice clothes!" and so now the piles are getting stirred a bit and instead of her wearing the same four shirts we are starting to decide which ones are just too awkward for her to get into and take off. I think that in another month or two we will start having a pile of clothes that can go to goodwill. When that pile exists it will be because she knows that she isn't going to wear that anymore, and have had a chance to try every item on before she rejects it.

The key to this is trust. And the key to trust is acceptance. If my friend decides to keep every item of clothing in her house, then I'm going to work on finding her ways to access it and ensure that it is clean and sorted. She doesn't have to wear it to justify keeping it. It's hers. And because I love her, I'm delighted with whatever she decides and whatever makes her happier.
posted by Jane the Brown at 12:41 PM on July 25, 2019 [21 favorites]

Another avenue to explore is the idea of not getting rid of *anything* (except that which is truly garbage), but putting it all in boxes / storage. Maybe storing in the garage as opposed to paying for storage. Or in your garage. Somewhere other than in the house. If part of the problem your loved one is having is trying to decide what to discard, remove that problem by not having them discard anything.

Then, start with something like cleaning the windows, inside and out. Then a back bedroom. Make it a refreshing place, with a clean duvet and some flowers in a vase maybe. That might be enough to create a little enthusiasm in your loved one.

It's pretty easy for anyone to see that a kitchen needs to be cleaned, and pretty easy for anyone to clean a kitchen on a follow up visit. If you start your project with cleaning the kitchen, your loved one may say "that's enough" and not let you address any of the other areas of the house.

If you are able to remove boxes to your house, you have the bonus of being able discard things that won't be missed, without your loved one's presence, and therefore not causing them further stress / embarrassment, etc.

Do your very best to never ever ever say "I can't believe you still have this old thing!" Keep your comments practical - "hm, oh here's [another] tupperware, let's get that into the box with the kitchen stuff so you know exactly where it is if you need it."

As with all other emotional journeys, comfort in, dump out.
posted by vignettist at 12:51 PM on July 25, 2019 [1 favorite]

For some people, it might be easier to have family/friends help. For others, it might be just the opposite--having people who don't know them and who they have no investment in doing the cleaning might be less painful. Something to keep in mind. The key thing is that you should try as hard as possible to sound nonjudgmental in discussing it. It's just a practical thing to make their life more enjoyable, not a condemnation of their lifestyle.
posted by praemunire at 1:53 PM on July 25, 2019

You say executive function may be a factor - I wanted to let you know that much of what you describe could very well have described me, a middle aged adult, before I was diagnosed with and began treatment for my ADHD.

In addition to elder care resources, resources geared to ADHD adults may be a possible source of ideas for you.

I knew the mess wasn't good for me and I didn't want to have it but I was not capable of making meaningful change until I treated my brain disorder.

Good luck in dealing with this difficult situation.
posted by oblique red at 4:03 PM on July 25, 2019 [1 favorite]

> They very much want to clean up. I don’t need to convince them of that, but I may need to convince them to accept family help or the help of a professional cleaner, and (ideally) an ongoing cleaning service. Tips welcome. I’d like to be able to do this in a way that minimizes shame and anxiety as much as possible.

I had almost convinced my mother to hire a cleaner, and she even found someone she knows who does some of that kind of work and was going to ask her, but I just couldn't get my mom to go all the way there.

I am winding up doing it myself. I brought a friend to her house and we scrubbed the kitchen top to bottom, as that was the room that most needed it. I'll similarly do the rest of the rooms one by one.

She's warmed up to the idea of getting rid of clutter by going through things with me and letting me take anything that isn't needed, and I will handle donating them.

Good luck, I feel your pain.
posted by desuetude at 10:05 PM on July 25, 2019 [1 favorite]

> Jane the Brown: Thank you on behalf of geezers with disabilities everywhere. What tremendous kindness and effectiveness.

FYI, I get grain moths occasionally, and rosemary discourages them. I got a bagful from a friend's CSA shipment and I fling it in my cupboards. It seems to help, and it smells nice, so no downside.
posted by theora55 at 1:04 PM on July 26, 2019 [1 favorite]

« Older What is the name for this uncontested economic...   |   how to figure out how much of a raise you want?... Newer »
This thread is closed to new comments.