Will skilled nurses visit a dementia patient in home if they are a serious hoarder?

A functioning bathroom is quite the luxury compared to some homes I have seen. Dirty? Ha!

Two or three weeks ago a gentleman declined my suggestion that I ask his GP to visit because he was too ashamed to let a doctor see his house; to be sure, it did need a bit of a spring clean. But I was able to assure him truthfully that no one visiting from a health or care service would think anything of it. You very quickly get used, for example, to a bedroom so soaked in old and fresh urine that the ammonia literally makes your eyes water and your throat burn - and the person is *sleeping* in that room. Or the kitchen where there's nowhere to butter toast because every surface is covered in engine parts and oily rags and chicken feed, with a single breadboard the only clear spot in the room and you're none too certain how clean that is.

So I doubt if you will be introducing skilled nurses to anything they haven't coped with before. Ask for an assessment. If the assessor is, truly, alarmed by the safety implications then a) the agency will soon let you know; and b) it may start the ball rolling for your parents to be helped to make improvements - they won't be able to tell themselves that it's just you being a fuss-pot.

I am an elder law attorney in California, so please understand the laws where you live may be different. I have seen here in CA the situation you describe. Sooner or later someone, likely a visiting nurse or caregiver, observes the hoarding situation, which more often than not is dangerous, and calls Adult Protective Services. The Public Guardian then steps in and when they see that the individual owns a home, they try to establish a conservatorship. They then move the incapacitated person from their home and then sell the home to pay the cost of assisted living. It's best to consult with an elder law attorney in advance to prevent this. Conservatorships are very expensive and should be avoided.

To get a yes or no answer, you would have to ask the agencies in your area. We can tell you that yes it’s possible but we can’t know for sure. Not everyone is willing to work in those conditions especially if there is a safety hazard.

You need to seek psych services not nursing services. What Sally talks about happens in all 50 states...it's a real gig. Be careful who you send over there as it could cause a lot of problems. If they took over the house which happens all the time, they would commit them and spend them down. Family is key here, not strangers. Are they hurting anyone? Is either life in danger? Are they happy? Is it worth it to have them live as you want them too? It sounds like the situation has been going on for a long time: it is about comfort...if they want to live and die in their own filth; who are you to stop them.

SueBK, sadly when it comes to hoarding and tiny pathways, even EMT's will have a difficult time coming into that home but they will tackle the challenge. Thus, you may find other medical personnel being hesitant or not wanting to enter the house if it is for a routine visit.

Hoarding is a cocoon safety net for some people. They tend to feel safe with so many things around them. My Dad wasn't a hoarder but he had a lot of books and wanted each and every book to follow him to senior living when he moved. The books gave him comfort.

With your father's mobility problems, cluttered pathways are going to be a problem. My hallway to the family bedrooms is 42 inches wide and one PT attendant characterized it as a little narrow and it is narrow to easily turn a wheelchair. I doubt people are going to want to provide bathing services in a dirty bathroom either. Skilled nurses are going to want somewhere to at least set their bag/box down without contaminating it too much to take to the next location.

I suggest getting at least the entry/living room and the bath clear and clean.

SueBK, I feel for you, I really do. My 95 1/2 year old mother is a gambling addict and a hoarder. I tried everything to get her out of that house and into assisted living. She will not let anyone in her house except the EMTs. I called APS. Since she is competent there is nothing I can do!! She can live and die in her own filth. She can’t go upstairs because of shortness of breath so she sleeps in the downstairs bathroom in a folding chair. Your situation is a little different because your mother is sharp but your fathers mind is declining. I would call APS for help. Your mother could stay there if she has a sharp mind but your father needs to be in a facility because of the dementia. I am sure if you had skilled nurses come in, they would be mandated to call APS. It’s a horrible situation.I am going through it with my mother. I had to back off seeing my mother. I see her once a week to bring in mail and take out trash.

I can't speak for all home care agencies, but that wouldn't stop our clinicians from seeing a patient. They would, however, get our social workers involved and would make a vulnerable adult report. But they would provide care as best they could. The only way they wouldn't is if they thought their safety was at risk.

It's very possible that the nurse will feel obligated to contact Adult Protective Services, who would send someone to your parents' home so assess how safe it is for them to live on their own.

Workers here have a right to refuse so even if an agency agrees to provide care it might depend on whether you can find anyone willing to return after their first visit.