Parents' hoarder home is becoming health issue, how do I respond?
September 11, 2020 6:54 AM   Subscribe

My mother fell and injured herself for the second time this year because her home is too cluttered/messy to safely navigate. Her and my stepfather refuse offers to help them clean. How can I help?

My mother and stepfather are both in their 70s with diagnosed physical and mental health issues (clinical depression being treated, opioid addiction and inability to walk more than a few steps for her, bipolar, diabetes w complications and goes off medication regularly for him). They live by themselves in the NYC suburbs and have had a serious hoarding problem for 20+ years. My sister and I have tried to intervene over the years without much success.

She had her second fall in a year the other day and apparently tripped over a chair. My stepfather found her an hour later, was unable to pick her back up, broke her glasses and knocked over a table in the process and called 911. Police dispatched two officers who helped her back up. She only had minor bruising but was injured in a previous fall at the house last year.

I live on the other side of the country and haven't visited IRL since January, but the last time I visited the house was so cluttered it was difficult to walk from point A to point B. They don't seem to pick up their trash after themselves and the floor/tables/other services are covered in discarded paper plates, cups, and food wrappers. Old clothes and mail all over the place. Carpet has years of built up sofa and food stains. My sister snuck them out of their house in January so I could spend the day cleaning in order for them to safely navigate the house (which they got upset about but we managed) and as far as I know that was the last time it was cleaned. I video chat with them 3x a week and the house has gone back to total mess judging from the backgrounds.

Past attempts to hire cleaners and organizing services haven't worked. They both have difficult personalities and it's hard to get buy-in from them even when it's for something directly benefiting their quality of life/health. They are also in a poor economic situation, don't have much savings and are pretty much limited to my sister and I, Medicare and charity if there's an unexpected crisis. Getting them to move to a smaller house or to a senior community isn't an option at this time.

We also have a strained relationship which makes complicates it; I was estranged from them for a while and kept distance because of drug addiction/erratic behavior on their side. But they have no other relatives or close friends to advocate for them; my sister and I are realistically the only ones who can help.

Anyway, I want to make sure their house gets cleaned up to a point where they can navigate it and that they can live independently as long as it's safely possible. How the hell do I proceed from here?
posted by allthethings to Human Relations (10 answers total) 9 users marked this as a favorite
I hate to say this, but you can’t. I mean, you’ve tried everything already. They’ve refused help from cleaners and organising services. You can’t be there to do it. You can’t move them out yet either. Unless you can think of another person who lives nearby who they’d be comfortable allowing in their house to clean (which I doubt or you’d have mentioned it) you’re out of options. I get that this must make you feel completely helpless but they’re adults and at some point you just have to accept that this is one thing they won’t allow you to fix. You can’t force them to accept help. I’m really sorry.
posted by Jubey at 7:08 AM on September 11 [25 favorites]

Hoarding is a serious mental health issue and not something you can easily fix. There are support groups for children and family of hoarders that can help you figure out what you can do and deal with what you can't.
posted by emjaybee at 7:15 AM on September 11 [8 favorites]

I've been in this situation, and there's not much you can do except for the nuclear options of calling the department of health to report them or trying to have them declared incompetent and gain guardianship if they are unable to make their own decisions. And there's no guarantee those options would even work. I would suggest calling senior services in their area to ask for advice. I'm sorry you're going through this. I know how hard it is.
posted by FencingGal at 7:29 AM on September 11 [5 favorites]

I'm sorry you're in this position. This is really hard. To echo the above, hoarding is a mental illness that won't be resolved by cleaning their house, even though this seems like the most important thing to do. While focusing on cleaning the house up seems pragmatic and urgent right now, I would worry that the inevitably slide back into squalor will be even more demoralizing and distressing for you.

I was just the other day listening to this interview with a therapist who specializes in working with hoarders. Her approach seemed both compassionate and practical. Her book might have some concrete suggestions for how to get help for both your parents and for yourself.
posted by EllaEm at 8:11 AM on September 11 [3 favorites]

Have your parents been evaluated for dementia or Alzheimer's? A family member had had lifelong issues with clutter and hoarding, but then it got a lot worse (refusing to discard anything, including newspapers). Due to this worsening and resistance to have anybody visiting, the family took them for a through medical checkup and they were diagnosed with Alzheimer's. Family member was in their late 70's.
posted by needled at 8:20 AM on September 11 [1 favorite]

I work in an urban hospital as a social worker, and frequently encounter people who match this profile. I live in Canada, so my legislation is different, and I'm not sure what the equivalent is where you live. We have something called the Adult Guardianship Act which allows us to make crisis plans for people if they meet criteria for self-neglect. The major criteria for self-neglect are that they are putting themselves at risk of harm, that they don't have insight into the fact that they're living at risk (you're allowed to live at significant risk as long as you understand what the risk is and what the contributing factors are), and that they are not capable of asking for help (different than not wanting to ask for help).

When these criteria are met, we basically have two tiers of intervention. One is to make a "crisis plan" which involves things like cleaning up the apartment, getting the carpets cleaned, junk removal, etc. This one is tricky because we don't actually have funds to do this stuff, we're just allowed to do it without their consent if we can come up with the money from community orgs or elsewhere. The next tier of intervention is to put them in a nursing home involuntarily.

It is not my favorite part of my job by any means, and you are in a very tough situation. I would be interested to know if they did have frequent hospital visits? Another commenter asked about Alzheimer's. One thing that we screen for is cognitive decline (regardless of the cause) that limits awareness of risk, insight, or ability to ask for help, and it's probably one of the most important considerations in terms of which path we take. Many, many people do not meet the criteria for involuntary intervention and continue to live at risk. The positive is that they retain their self-determination.
posted by unstrungharp at 9:22 AM on September 11 [9 favorites]

FencingGal has it. I have been in this situation too, but with a parent who lived alone. He fell ill and was hospitalized for 3 weeks and that was the only time I could get the house cleaned up. He was pretty upset about it, too. And then he went right back to hoarding.

I am really sorry you are dealing with this. It is hard dealing with a parent with untreated mental illness.
posted by bedhead at 10:01 AM on September 11

Thank you so much EllaEm!
After I listened to the interview, I found the kindly Canadian social worker's website and immediately fell under her spell. I'm less than ten minutes into the September 2nd episode of her webcast, and it's just great so far. Very gentle and inspiring with already a novel and useful way to think about sorting for people who have trouble with the whole concept of sorting. ftw.
posted by Don Pepino at 11:01 AM on September 11 [1 favorite]

Having dealt with severe hoarders in my own family I will offer this advice/experience.

Hoarding is not really about the stuff, it's about control. What looks like chaos to you and others is a control of the space/environment by the hoarder.

It really doesn't works to sneak people out and clean behind their back. Even if you're just picking up trash, you've taken control of their locus of control and it feels like betrayal, not help.

When I have been successful in getting hoarders to part with things, it's because I was patient and went through things one by one and let them make a choice. I gave them control. You make slow, but steady progress. It's really slow because you can only do this for an hour or two at a time before anxiety about the whole endeavor becomes too much.

Bringing in a eldercare lawyer or social worker to talk about plans for the future and desires can be enormously helpful. Hearing about issues and discussing them with a neutral party can defuse anxiety and emotional baggage that comes with family.
posted by brookeb at 2:05 PM on September 11 [9 favorites]

Nthing that hoarding is a psychological disorder and not the same as just getting overwhelmed/behind on cleaning. My mom is a hoarder and so was my uncle, and this is the book I read about it. My two big takeaways were a) forced cleaning doesn't work, it just makes them upset and they hoard more and b) hoarding is likely a type of OCD. Many serious hoarders were actually obsessively tidy when they were younger, but both behaviors stem from a need for intense control over their environment.
Hoarding is treatable, but it's more of a counseling intervention. Your parents may respond better to an expert than to family.
posted by Nibbly Fang at 7:15 AM on September 12 [1 favorite]

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