Helping 75-year-old hoard safely
March 3, 2024 9:41 AM   Subscribe

My mother is 75 and lives alone in assisted living in a different state. She uses a walker and/or wheelchair. She is a hoarder. She cannot be convinced to stop with the resources and time available to us, so I'd like to focus on making her hoarding less harmful. Primary problems are papers, plastic food containers, and cheap clothing that she orders. I'm here for a 2-week visit; what can I do?

A big complicating factor is the assisted living. I can't build rapport with the staff and ask them for help because there's lots of turnover. I can't tell them to just throw stuff away because my mom stops them and they won't/can't override her. And of course they have all manner of regulations they need/want to enforce; if the piles of papers build back up and become a slipping hazard again they're going to evict her.

We are sending someone from a home care registry over for 4 hours a month. They might be helping with the problem; I'm not sure. I'm surprised there's no expired food in mom's pantry; maybe that's their doing? They supposedly helped organize her desk papers, but they definitely couldn't finish the job. And there are still piles of stuff all over, disgusting unwashed food containers in the kitchen sink, filthy refrigerator, etc. I'll be talking with the registry about specific problems I want their staff to address in the future before letting my mom decide the visit agenda.

Specific, primary problems are:

- Anything paper that comes in gets piled on her desk. Bills are already paperless, all catalogs are for some reason being mailed to my address instead (which is fine). I don't know how to stop any remaining paper sources.
- Plastic food containers. Sandwich boxes, lots and lots of yogurt cups. The facility often serves meals in or accompanied by plastic containers. These are served to everyone so my mom would definitely stand out if they didn't give any to her. (And again, arrangements get forgotten in staff turnover.) She makes grocery delivery orders averaging $70/week; I don't know how to prevent those either.
- Cheap mail-order clothing. Kohl's and Blair are primary problems. The clothes all get stacked on a chair, still in shipping bags, unworn. I don't think she's spending thousands of dollars per year on this but it's got be hundreds of dollars.

And of course, keep in mind that convincing her to donate or discard any of this takes lots of time and effort for me. And staff won't/can't do it because it's her stuff and they could get in trouble. I usually have to wait until she's distracted and then rush some portion of the trash (and most of it IS trash) out to the dumpster. I've been doing this during visits for a couple years now and she never notices anything's gone.

What can I do? What containers or furnishings can I provide (let's say $500 budget) that will at least keep the things she wants to save contained, until I can donate/discard them on a later trip? (Please keep my mom's limited mobility in mind.)

I do have power of attorney for both healthcare and financial matters, if that's relevant.
posted by commander_fancypants to Home & Garden (19 answers total) 5 users marked this as a favorite
 
Best answer: Four hours per month of home care is not a lot of home care. That time could be spent doing anything from hair care, foot care, changing sheets, running errands, going for walks, etc. Also, home health is for light housekeeping and personal care, not deep cleaning. You might also need to arrange for a cleaner to come. You will see much better outcomes with 4 hours a week split between home health and cleaners.

I seriously discourage you from setting the home health meeting agenda because you cannot physically see your mom and her needs at any given time. Home health should be able to fix her hair or take her to the dentist without getting pre-approval from you.
posted by shock muppet at 9:59 AM on March 3 [17 favorites]


Best answer: You might find ideas by looking up harm reduction strategies for hoarders such as those covered in the book Digging Out (I borrowed an ebook from my local library, yours might have a copy as well!)

Two immediate ideas
1) Does your mother think that there is a safety issue (slip or trip hazards from the purchases and the papers) or a visual overwhelm or any other kind of problem? If you can have a conversation that is focused on "how can we make things work better? do these [papers/packages] sometimes cause you annoyance or get in your way etc?" then it is a shared problem solving framework instead of you solving the problem of your mother's behavior.

2) Containers! Perhaps get a plastic filing container or anything else that could hold the paper more neatly (vertically instead of horizontally). If there's junk mail coming in, you might want to sign up for the junk mail remover services (there's been some good advice here). And maybe a big clear tub for the packages that could be placed on the chair or right next to it to corral everything? It doesn't solve the issue of the items actually being there, but maybe then the home care aide could go through the tub with your mom and open the packages when they are there.
posted by spamandkimchi at 10:03 AM on March 3 [4 favorites]


For our hoarder grandparent in assisted living, it has been essential to have an outside housekeeper come in once a week. She knows what’s up with the hoarding and is gentle but firm. She also rats out grandma if other things are going on that we should know about. She comes in *before* the on-site staff cleaning because they are very limited in their time and what they will do. And THEY will rat her out to management if they aren’t able to clean due to hoarding. She got several warnings and could get kicked out for that. This is why it is essential.
posted by amanda at 10:22 AM on March 3 [15 favorites]


A friend was recently dealing with a situation where their mom with dementia was making frequent and compulsive donations to political candidates, and it was becoming a huge and expensive problem. I believe they ended up cancelling the credit card or removing her access to it. The cheap shopping purchases sound particularly bad because it's not even stuff she needs. This strikes me as much as a compulsive shopping problem as a hoarding problem. Can you come up with a substitute behavior? An ipad game (with no in app purchases) or books on tape?
posted by bluedaisy at 10:59 AM on March 3 [9 favorites]


Two of our elderly relatives died within a week of each other this past December, one was a gardener but had a serious progress disease. The other was an awful hoarder to the extent that we suspect it may have contributed to his at home falls which eventually sent him into a spiral that ended 6 months after his last fall. We would go to his house to look at the mail while he was in the hospital, and the accumulated mail filled a full size couch in the living room. The garage and his "office" area of the recreation room was overflowing also.

Because the hoarder was my wife's brother, she asked her doctor if what appeared (???) to be dementia could be hereditary. The answer was that when a person has multiple compound physical problems, injuries, surgeries, accidents, etc. it definitely can impact the brain. The doctor said they would be more concerned if healthy elderly relatives with no such history eventually developed dementia.

This was just to say that your situation is not a rare one, and to some extent not a very manageable one, and might (???) be due to mental deficits they are suffering from.
posted by forthright at 11:05 AM on March 3 [1 favorite]


I'm wondering about her motivation for holding on to those particular items. Is it possible it's a misguided impulse to avoid wastefulness? Does she have and use recycling bins for paper and plastic? Perhaps setting up a bin for each of those things and asking a housekeeper or aid to empty it weekly (whether or not it's actually getting recycled) would encourage her to let go of those things. For the clothes, setting up a donation bin and framing it as an opportunity to help others in need might also appeal to her, as it's going to a good cause.
posted by platinum at 11:08 AM on March 3 [1 favorite]


Honestly, I think you need to take away her ability to keep buying shit. If you're in charge of her finances, that sounds doable. She can't and won't stop spending if she has the ability to do it. And hire someone to come in and clean since 4 hours a week of rotating health care workers is probably not going to do it. I think a $500 budget would be best for housecleaning and not paying for more containers to hold crap JUST until you can show up and sneakily throw them out. She'd probably just keep piling papers on top of all the containers anyway and containers are just going to be more crap in the house.
posted by jenfullmoon at 11:09 AM on March 3 [18 favorites]


Four hours per month of home care is not a lot of home care.

Yes...hoarding is, of course, complicated but more time from hired assistants could make a real dent here, I think. Get a cleaner in every other week, at least.
posted by praemunire at 11:48 AM on March 3 [3 favorites]


Can you have her mailing address changed so the mail goes to you, then you can forward on anything actually important?
posted by tristeza at 12:05 PM on March 3 [11 favorites]


Also make sure she’s on the do not mail list.
posted by bluedaisy at 12:07 PM on March 3 [6 favorites]


This all sounds hard, I'm so sorry that this issue is impacting what should be quality time spent with her.

I wonder if any local professional organizers could come by - some specialize in working with the aging, and with folks having hoarding tendencies. Perhaps they come by while you're in town, and come back on an ongoing basis? If you're in the USA, start with NAPO, perhaps?
posted by enfa at 12:29 PM on March 3 [1 favorite]


I would check to see if your Power of Attorney includes the ability to deal with mail. If so, look into a virtual service or as mentioned above redirect mail. Then you can decide which things your mother gets.

I would speak to an elder care lawyer to find out if your Power of Attorney would allow you to have more control over your mother's spending. Cancelling credit cards and giving her a limited allowance might be helpful if possible.
posted by brookeb at 1:01 PM on March 3 [4 favorites]


Can you have her mailing address changed so the mail goes to you, then you can forward on anything actually important?

And then you can return all the purchases too. (Maybe hire a helper to do this for you?)
posted by unknowncommand at 1:10 PM on March 3 [3 favorites]


I usually have to wait until she's distracted and then rush some portion of the trash (and most of it IS trash) out to the dumpster. I've been doing this during visits for a couple years now and she never notices anything's gone.

Does she ever go on outings, or at least out of her apartment to a common area for a couple of hours? You could take these opportunities to do a more substantial purge...
posted by staggernation at 1:22 PM on March 3 [2 favorites]


Power of attorney is not guardianship and can be revoked by the granter at any time if there is not guardianship.
posted by bq at 5:33 PM on March 3 [3 favorites]


YMMV, but I'm running into some of the same problems (providing elder support and troubleshooting hoarding horror shows while living in a different state, though my relatives are trying to age in place), and my mother's... preconceptions, I guess, are part of the struggle?

1. Stacks of mail and papers -- there are concerns over personal/sensitive information (like, recipient name and mailing address) being stolen from curbside garbage collection.
Partial solution: paper shredder. And if you can, get ALL of her mail at your home and ship a weekly or monthly care package with actual cards or correspondence and select monthly magazines.

2. Used yogurt cup and food container accumulation -- strong conviction items are all recyclable, and need to be washed thoroughly before once-a-week recycling collection. When the residential recycling program in their area started, decades ago, they paid a fine, once. (This fine may have been levied because different types of recycling were mixed together, not over cleanliness).
Partial solution: LIES. Not recyclable! Not recyclable here, per the bottom of the container and the .gov website. (Please put containers in the black Hefty bags for regular trash pickup; no need to delay.) A few food containers were set aside for re-use in various organization schemes, despite warped lids & permanent stains; we purchased storage-container assortments and pretty, coordinated desk-organizer sets.

3. Try to figure out how much of the hoarding and messiness ties to your mom's physical limitations?
a. If she's using her wheelchair in the kitchen, can she thoroughly clean the food containers in the sink from that position? (How deep is the sink? Would a dishpan, a long sprayer attachment, and a lower-height work area help?)
b. If she's using her walker in her apartment, she won't necessarily have both hands free to work at the sink. Maybe she isn't familiar with other techniques?
c. Meals in assisted living are often in those containers as take-away from a main dining area, or as delivery-to-resident door. The dirtiness of the living space is an issue, and the papers are a fall hazard, but it's not clear if she's supposed to be eating most meals on most days in the facility's dining hall? (Is she keeping these used containers thinking they'll need to be returned, or to show she's finishing her meals?) Yogurt cups are piling up; yogurt is a convenient snack to have on hand, as it's an easy-open single-serving container, easy to swallow, and doesn't involve trekking to the main floor.
d. Are the new clothes languishing in part because she'd like to hang them up, and coordinating that is difficult? Is getting dressed difficult in general, and she's resistant to working new garments into the routine? (She wouldn't be the first person making "aspirational" clothing buys in the heat of the moment, then leaving purchases in their shipping bags.)
e. Could she use accessibility tools and devices to keep her place tidy and organized? If your mom's not currently capable of keeping the place up, or flatly disinterested in doing so, then four hours per month with a dedicated HHA is not enough time. If she's not currently capable of limited housework but would like to be, that's a different starting point.

You have financial control; while you're there, find out what's on the usual weekly grocery list, automate that delivery, and make arrangements for hired assistance to be there on delivery days. They can clear perishables from the previous week's order and leftovers from the assisted-living meal program, tidy the fridge, put away the new groceries, and throw away excess packaging. Maybe you can curb the clothing purchases: if your mom's using credit cards for orders, you can set limits for single purchases without reducing overall credit line, or get a catalogue-use-only second card with a low ceiling. (If she has branded credit cards, like the Kohl's card, check interest rates and fees.) Go through her existing wardrobe with her, remove stained/damaged clothes (for dry cleaning, for tailor repair, for donation, for trash, whatever is least upsetting) so she'll have space to put new purchases and reason to wear them. Or, clear a space in the closet, and put *the chair* used to stack packages in there (or use a folding chair).

Focus on the pressing thing; "if the piles of papers build back up and become a slipping hazard again they're going to evict her" is high-stakes. As compulsive habits go, less than a thousand dollars a year on fast fashion is not in the same league as gambling, MLM, or internet Lotharios. A brief heads-up: when I went through accounts, Blair appeared as a monthly $15 auto-debit for a members-only shipping scheme my mom either didn't choose or didn't realize she'd chosen (possibly as the fine print in a free-shipping offer). During this visit, can you arrange for a pro organizer visit, someone with senior-hoarder experience, and then a deep-cleaning? Going forward, if you can safely work out a team situation, with Person A taking your mom out for a few hours while Person B is shoring up her apartment, that might work as a monthly maintenance.

Don't try to fix all of it for your entire 2-week visit? Your mom has mobility issues; she likes to shop for clothing, and she likes to eat -- does she like eating in restaurants? Doing either of those things may be easier while you're there. Plus, it will get you both away from that apartment for a while.

I'm really sorry, btw; this is lousy, and so hard to do.
posted by Iris Gambol at 6:25 PM on March 3 [10 favorites]


Best answer: Power of attorney is not guardianship and can be revoked by the granter at any time if there is not guardianship.

This is an understated comment, especially in light of the comment "Honestly, I think you need to take away her ability to keep buying shit" that has so many favorites and is so deeply and fundamentally misguided.

Power of Attorney does not allow you to fully control the finances or spending of your parent. It allows you to sign legal documents for them or act on their behalf if they are incapacitated. It is not guardianship or conservatorship, where you are actually in control of their lives or spending in the event a court determines that they are incapacitated mentally or physically. As disasteful as one may find it, hundreds of dollars per year of extraneous clothes purchases and the failure to dispose of documents and plastic containers is in no way indicative of incapacitation. (I assure you there are many people, worldwide, who spend hundreds on unnecessary purchases and do not regularly clean up their documents or plastic containers.)

OP, the first comment had it exactly right. So long as finances allow, set up weekly home care, so the home care worker(s) can keep the trash under control, and they can work with her on the incoming purchases. I speak from experience.
posted by I EAT TAPAS at 6:34 PM on March 3 [11 favorites]


I agree that getting more hours of help is the best way to accomplish your stated goal of letting her hoard safely. I'm guessing you have already tried it, but it could be worth coming at it from an angle of "I don't want you to have to move to a nursing home where you would have less freedom, but an assisted living home is not going to accept a resident having items on the floor blocking their way/being a trip hazard."

I would only focus on the items that are making her in danger of being kicked out. Sure, it would be great if she stopped wasting hundreds of dollars on clothes she doesn't wear, but it's going to be hard enough to convince her to accept help for the stuff that's really causing problems.

If she's unwilling or unable to change her behavior, it actually seems like the assisted living place would be acting in her best interest to not let her stay there, as much as that sucks. I have experience with a family member hoarding, you have my sympathy. I hope you're able to find a solution, even if that solution ends up having to be letting her face the repercussions.
posted by Eyelash at 7:34 PM on March 3 [1 favorite]


She's in a care home with very control over her life, so having small things she can control is a Big Deal. She's probably bored - that would explain shopping. And the slight hope that something might happen, she might be able to wear new clothes and do something nice. Is the shopping a serious drain on resources? My Mom was terribly concerned about paperwork when life was dribbling away., but she had no energy to really address anything. She just wanted to feel like she had her old capability and usefulness.

Find someone to visit her who will do something fun with her - dye her hair, play music, do puzzles, paint, birdwatching with a birdfeeder, whatever. Maybe get her interested in Jeopardy every evening, or any activity that might engage her. The containers can be washed and put in a grocery bag for recycling, your Mom can be profusely thanked for her diligence, and they can be taken for 'recycling.' Maybe new clothing can be hung up, and the packages at the bottom could disappear when she's otherwise engaged.

Getting old is a time of steady loss of independence, loss of physical capability, loneliness and boredom. Can you move her nearer to you? Thanks for taking care of her; it's not easy.
posted by theora55 at 9:30 PM on March 3 [9 favorites]


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