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If I'm not mistaken, medical POA is the only one who can oversee or help to make decisions when someone becomes incompetent, correct? My mother is living in filth and hazardous conditions. She can't see, only shadows, she doesn't have proper plumbing or electrical (although we tried to fix that). I happen to have a brother who goes home and does nothing but make her life even more miserableshe. She won't let us get him out. I called APS and spoke with them extensively. They were going to check on my mother, you know like personally, instead they sent my brother a warning letter so now I don't feel safe contacting them again. What can I do as her daughter since my family member became a medical POA? Shes got all these thoughts in her head that someone's going to put her away and refuses to leave home. I just want to help. We can't clean her house, when we try it's all for nothing. We've all done it, and we all continue to try, but like a hoarder when we go to take care of things she won't let us throw anything away. She won't take her medications properly. She cuts all dosages in half or 4ths saying she was afraid to take meds because she's out there alone. I'm not going to lie to you her conditions make it impossible for anybody to stay with her for more than a couple hours. No running water, no bathroom facilities, no way to wash hands etc. Her front door won't lock and even if it would she refuses to shut it because she has cats that go in and but. When it's cold she complains about freezing when it's hot she's too hot. Even though she has heat and air accessibility it is not doing her any good. I don't even know if I'm making any sense. She keeps saying "I just can't stand being alone anymore," but refuses assisted living, refuses to live with one of us and just wants to stay at home. She said that's going to be at her hospice. While I get wanting to keep your independence and stay in your own home there's really not much of a home to stay in. I just need to get that off my chest. Is that normal, athough heartbreaking, for elders to live this way? She's 83 this year and if we talk about getting help of any kind she has a fit, starts crying and holds her ears. We can't get her home health care. As a one time home health aide I know that  if I would have went to my mother's home I wouldn't have been able to go back due to the unsafe and unsanitary conditions. She complains about her living conditions and things like that but she won't do anything or let us do anything to make it better. It's hard to hear without getting frustrated, what are you supposed to do in these situations?

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First of all, I have some idea what you are going through. My aunt not only wouldn't allow anything to leave the house, she would pick through dumpsters and bring the trash home.

1. A lot of commenters here have excellent ideas about government entities to contact for help even though APS has been disappointing.
2. There is a difference between a Springing medical POA and a Durable medical POA. A person with a springing medical POA has no powers until something designated in the POA has happened. Most of the time this is when the principal (your mother) has been declared incompetent to make decisions regarding her health care. A person with a Durable medical POA has the powers as soon as your mother, if she was competent, signed the document. In most cases though, the POA must defer to the the principal if competent. Therefore, a springing POA is ineffective until your mother is declared incompetent. However, know that most people choose a Durable POA.
3. If you (and any other friend or family member) think your mother is incompetent and the POA agent is not acting in her best interests, you can petition the court to revoke the POA agent's powers. In revoking the current POA agent, the court will appoint another person as her guardian and perhaps conservator. This is not simple and will cost time and money.
4. Collect as much information as you can to show the court that your mother is incompetent. An elder law attorney willing to go to her house is a good first step. If there are reasons to doubt her competency the court will need her to have a psychological exam by a medical professional. Of course, the struggle will be to get her to the psychologist.
5. Whoever has the powers to see that your mother lives in healthy conditions will then have to deal with her mental illness and go through the nightmare of moving her. Realize that her hoarding behavior will not stop no matter where she ends up living.
6. The big question is whether she is legally competent. Self-neglect is not necessarily evidence of legal incompetence. As others have suggested, look into social services and other community resources to help form a team to address her hoarding. Research how to help your mother come to terms with her behavior.
7. If you truly think that the house is a health hazard or a hazard to the surrounding community, talk with an attorney about the extreme step of having the house condemned. Lack of running water and plumbing are generally not considered illegal.
8. I can't stress this enough. Rules, regulations, and statutes vary from state to state and even county to county.
9. This comment is not legal advice.
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Not sure where Mom is located (Denton, TX???) but I just checked with the Health Dept in NJ. It is still in their bylaws that all requests for assistance and all their reports are confidential and can only be released under a court order. If they can not get in on their first unannounced visit, they will send a letter requesting an appt. Now brother may have guessed it was the you and "woofed" at you when Mom got the letter. If you aren't a good actress ("why, darling brother..... I have no idea what you are referring too".) that was his proof that you contacted them.

Every state operates different but just for general info, here are the limitations on what APS workers in NJ can do:

"An APS worker is not authorized to:
* Remove a vulnerable adult from his or her home without a court order.
* Force an adult with capacity to accept services.
*Move an individual to an alternate living situation without his/her agreement or a legal representative’s agreement."

So it gets back to the fact that she must be declared incompetent by a physician in order for them to forcibly move her.

Next best bet is to call local zoning and health code officers although if she lives in the backwoods that isn't going to get you much either. There are a bunch of people out there without running water and toilets. Hopefully she is in a township with more structure and codes.

So sorry you are going through this. Wishing you luck in this difficult journey
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Isthisrealyreal May 2022
Geddyup, a doctor can NOT declare someone incompetent. It requires a judge to do that. You lose your legal autonomy when that happens and it is not something any of use should want allowed by a doctor, they don't know the law.
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You explained this all to APS and they did not investigate? Yes, call the Health Dept. In my Township/State once the water is turned off in a dwelling you cannot live there. Authorities will come and evict u. We had a woman who they had to remove from her home because of no water and found she was living in horrible conditions. She threw her soiled toilet paper in the tub.

I would make sure the Health Dept knows that APS did nothing. I had this happen to people I know. The mother was removed because of gangrene of a toe and Dementia. The 400+, 40 yr old challenged son was left behind. The neighbors in the complex where he lived called everyday to APS because of the smell. Their response was he could live that way. He kept in touch with me thru messenger. I had been there and the smell literally made me sick. He told me a friend was keeping him fed. He kept saying no one called to say when Mom was coming home. I found out she wasn't. The State took over her care and placed her in a NH. I racked my brain on who could I call. I called my nephews SW and found she had worked with the family and knew the dynamics. She called the health dept and they stepped in. He is now in the same NH as his Mom going on 4 yrs. He has told me he will be moving to where a brother is in Fla. He has lost 200#s. He should not be in a NH at this point but it would be traumatic for him not to be near family. Hoping his brother has found him a nice place in Fla.
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So, what happened when APS sent your brother a "warning letter"? What did the letter say?

If the letter provoked a response from him that was threatening or harmful to you and/or your mom, you need to let APS know that.

Have you asked the local police for a wellness check?
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AlvaDeer May 2022
APS in all my experience never tells who reports. It could have been any neighbor. APS does send a letter to say they are visiting often. If not, and they show at door and are not let in they will make an "appointment" when they can be let in; if that doesn't work they involve authorities. But in all my experience they NEVER divulged who complained and they never told the complaintant anything specific. Just whether in their judgement there needed followup, who would follow up. But things might be different now.
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If you can't figure out who else to call, I'd call the local non-emergency number for the Fire Department.
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You should contact the Department of Health and Human Services. Living without water in my state is a no go. The state WILL intervene in this situation. Hopefully, yours is the same.

People can choose to live anyway they want. A filthy horde is totally their choice but, living without basic necessary utilities points to incompetence. You need to get the authorities involved, a MCPOA doesn't give you the power to decide she is incompetent and place her, it gives you the power once she is under medical care to speak with and makes medical care decisions, unless the doctors feel she is able to understand and then she still gets to make her own decisions. That's why you need to get the authorities involved, this no water, no toilet situation needs to be documented by the proper authorities.

You can call the local counsel on aging and they can give you a list of the authorities that should be notified to get the ball rolling.

Best of luck, this is a terrible situation for all of you.
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I would contact any and all of:
Local, County Building and Zoning.
Local, county Health Department
Call your States Elder Abuse hot line number and report the neglect.
Contact local Area Agency on Aging.
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This whole situation reminds me of what happened to a distant neighbor in sf, when I lived there.

The elder developed a fear of running water, and the caregiver just went with it. The water bill was not paid, and thus was shut off.

There was then some medical emergency that sffd went out for. The whole house was stacked with Home Depot buckets full of waste. The fire department had to get counseling for some of the medics.

The lady in her 80s and her caregiver both were taken in. The younger one faced jail. There were at least six agencies involved.

No running water is extreme.
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I'm sorry that you're dealing with this very frustrating and distressing situation with your mom. You say she is "like a hoarder" but in reality she IS a hoarder, based on everything that you described about her.

Hoarding is a mental illness and you are trying to deal with her through logic and reason, which is not what hoarding is about. You may want consider to consulting with a therapist who has experience with hoarding disorder, so that you can identify boundaries and learn better and more productive ways to engage with your mother. You can't make her go to therapy but you can control how you approach this challenge (and if you choose to approach it).

There is a long-running show on cable call "Hoarders". In the show the therapist helps direct the family as they help the hoarding LO try to work themselves toward therapy and healing. You will definitely see yourselves in this show and may learn some wisdom from it. I wish you all the best on this journey.
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BlueEyedGirl94 May 2022
Watching this show is incredibly sad but also a real eye opener. Even though it often feels exploitive it sheds a lot of light on the real plight of the hoarder and their family. The family just wants to go in and clean everything out - just TOSS everything and start fresh ( and who can blame them - in a lot of these situations the city is actually considering condemning the home!!) and the hoarder is distraught over a single item being thrown away and wants to touch and remember every single thing in the house when there are literal floor to ceiling paths to navigate. It is heartbreaking for both sides!

But the takeaway is this - Hoarding is a mental illness. You cannot just go in and throw it all away and say "There - done...now you are all cleaned up and ready to start your life fresh." What I had seen from the show is that they run the risk of literally BREAKING the person. And they come back worse than ever. OR they have a mental breakdown at the loss of their stuff.

For a lot of the people on the show, the hoarding is a symptom of something else - to your point Geaton - she needs therapy but OP can't make her go- she can't MAKE her do anything as long as she is competent - including have heat and running water in her house. The psychologists on the show have called APS and sometimes they are even told that it is up to the individual how they live unless the city intervenes.

I heard one lady on the show say that she was tired of being judged for the way she lived. She got right in one of their faces and told them that she LIKED living the way she lived (in squalor with unmentionables piled up around her) and just because they didn't, it didn't give them the right to judge her. That society has deemed it unacceptable to live the way she does and so she has to live by certain expectations because other people say its socially unacceptable. Honestly, the nasty hoard aside (I won't go into what all they found in her house) the lack of running water, electricity and heat was her point - she said that her grandparents didn't have any of that and they were just fine - and that it was her prerogative to live that way.

BUT, she didn't have the capacity to understand that the problem wasn't really the choice to live without running water, electricity and heat - it was about the danger of living with the other things - and how bad the environment was for her - because every single thing in the room was important to her - including the things that had no value and were literally trash and - ahem....other things.

I wonder based on OPs reference to APS visiting - if their hands were tied based on her capacity or living conditions meeting a certain criteria. I would think if she met certain criteria or the home did, that they could have made some emergency requirements to at least have the house brought up to a certain standard.
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