There are pathways to the exits, a functioning if dirty bathroom but no place to sit except for my parents. They own their home outright and don’t want to leave but I want to know if in-home nursing visits are even a possibility?
Thank you maryjann for letting us know the website for adult children of hoarders. It was very informative. My mother has so many characteristics of other hoarders and things they have in common. It also explained what we (adult child) had in common with other adult children of hoarders and what those characteristics are.
Thank you Maryjann, yes this is my mother. You are so right. It is a mental illness. We can’t just go in and clean up their mess. My mother didn’t start hoarding until my father died in 1998. She was never a clean freak growing up but there was never anything on the floor like there is now.
In New York State the law is on the elders side if they are competent. All of us called APS. EMTs, me, her primary care doctor,,they said the code enforcer would be called in. Guess what? My mother is still in her hoarded mess. The code enforcer told the fire department to install smoke detectors in her house for free. So they did. They even repaired her back step so she doesn’t fall off it. I got a letter from APS saying there is nothing they can do and they closed her case. I got the letter yesterday.
Check the laws in your state. In California, there is "mandatory reporting" or MR. In your case, this means that any or every nurse, caregiver, EMT, etc who visits your home may lawfully inform authorities that the appearance of hoarding poses a health/safety threat to the homeowner(s), patient, neighbors, etc. Also, MR is likely to occur if multiple pets (especially cats or dogs) live in the home.
What seems like normal clutter to you (and others who regularly visit the home) can easily be deemed by others as unsafe or unhealthy.
With patience and tact, try to gradually organize, launder, throw away, donate, sell, etc excess possessions but with your parents' advice. This could be tedious and take many weeks or even months. But at least you are NOT taking away their dignity or memories attached to the clutter. Also, you are making it healthy and safe for yourself (and other visitors).
They may visit, but not want to stay long so could compromise the care your parents receive. And they may report to APS for "self-harm" if there appear to be issues with sanitation, mold or infestations. Having a 3rd party "lay down the law" can be very helpful since they can be the "bad guy" and you can get more done. But as you've seen from the comments, there isn't a consistent standard or practice. And if it is really bad then you need a full on project approach (dumpster, focused clearing) not the "grab a few items each trip" approach.
People start to lose their friends and visitors because it is such an unpleasant environment. And unhealthy. Very sad. Is hoarding an issue in other countries or is this mainly US dysfunction? It seems it could be a reaction to the insecurity many people USians feel with respect to their finances and healthcare.
Yes, you can get in home services even if it is a hoarded mess.
If it is an unsafe environment the care providers are mandatory reporters and they will have to report it.
My moms is similar and I was told that she can live anyway she wants. Her husband has in home health providers and the situation hasn't changed, so I am assuming that they don't see any danger.
Best of luck, this is such a challenging situation.
One way to stealthily de-clutter is to ask each family member to sneak out a piece of trash or other item upon leaving. Of course, don't allow your mom/dad to see the item being removed! Another viable method is to greatly admire a decorative item and flat out ask if it may be given to the family member if it is not offered after the initial comment of admiration. The item does not necessarily need to be transferred to another home; it can always go to a thrift store or the trash. As for making a good dent in the clutter your parents must go out sometime, if only to doctor visits. Arrange for someone to come in while they are gone to remove much of the hidden items and trash while your parents are absent. Eventually the home will be less cluttered so cleaning may be done. Items may "disappear" while cleaning too. I used to sneak into my MIL's apartment to remove trash while she was at lunch in the community dining room. I was always surprised how many styrofoam containers, plastic flatware, and miscellaneous trash she had managed to accumulate from the dining room and who knows where! My secret forays managed to prevent a mountain of trash and bug infestations.
I would consider my mother (90) a hoarder. Oh, she has nice things, but just so much. And her PAPERS! She's obsessed with PAPERS. She has files and files and files. Before I moved her in with us, she had her own place. It was clean, but cluttered. EMTs came and had to move a bunch of furniture and STUFF just to get to her room - she had a one-bedroom apt in an independent senior living tower. While she was in the hospital for weeks and then rehab, I took it upon myself (with the blessing of her senior friends and my siblings) to clean out the apartment - at least make it wheelchair compatible. I removed select items and cleaned out 1/3 of drawer contents here and there. I even built her a corner closet for linens, material and her sewing. She was mad when she came home, but I had showed her pictures beforehand and she seemed alright with it. All her friends came by on cue and told her what lovely changes we had made and how nice everything looked. I did this thinking she could stay there, but she had to go back in the hospital where they told me she can't live alone anymore. Oh Well.
We moved her across the country into our home before her STUFF. I tried my best to donate things and have young relatives take some furniture - just enough to not upset Mom who is attached to her stuff. I moved the majority of it to Texas, but the bulk is in storage. I limited what actually came to the house. I wish I had limited more - but once she's seen it, it's in her mind. She has junked up the master bedroom suite she has now. Yes, it's nice stuff, but there's so much clutter and crap. She keeps asking for at least one of her 4-drawer filing cabinets to be brought out into the bedroom. (WHERE???) I just don't answer, seem not to hear and walk out of the room. So not going to happen. Not adding more. But I STEALTH clean when PT or OT have her out of the room. I take one thing off a shelf and put it in the trash or charity box. She hasn't noticed a thing. At the previous place, she started noticing pieces of furniture missing, but never the junk or small stuff. So, next I'm going to start trashing some of those medical and other files FROM THE 70s AND 80s! Who cares? Bills, old notes, etc. No longer relevant. She really has files. I think she was the secretary for the prophet who wrote the book of Genesis.
Anyhow, I'm an advocate for stealth "cleaning." They don't even notice if you take a bit from each stack or shelf here and there. It keeps the peace.
There are a lot of groups where you can ask about hoarding specifically and its relationship to in-home care. Hoarders are notoriously difficult to get to change and MOST areas will not step in until it is seriously bad (falling in roofs, no water, no sewage, pests/rats invading neighboring properties). Hoarding is a mental illness and a mandatory/unwilled cleanout can cause WORSE hoarding and a loss of contact with the person if they find out who "did this" to them. It is a complex mental illness that is often brought on by some sort of trauma or loss. They have the right to live in squalor. Especially as they age it can be exacerbated by what is called Diogenes Syndrome, which is senior squalor syndrome characterized by extreme self-neglect, social withdrawal, and hoarding (stuff, animals). I am a member of an adult children of hoarders Facebook group as I was raised by a hoarder parent before it was known as hoarding. It was awful. Anyway, here is a general, non-Facebook organization that you can use to research the matter further: http://childrenofhoarders.com/wordpress/?page_id=33
I am very interested in finding help regarding hoarding. In my case, I am the mother of an adult son who lives with me. He has his own private area sectioned off for him in my home. He has a bedroom, living room entertainment center and bathroom. We share the kitchen area. He is respectful of my area. He was a perfectionist for a very long time and then his OCD turned way around and now he is an extreme hoarder. I have had his area cleaned up twice. But he keeps on letting things pile up. I stopped trying to control it as I knew it had to be up to him. He does work hard but falls apart at home. I read your response above and would like more information. I want to help him so much. I know now that he has a mental problem regarding this situation. Can you help me?
I have recently has cause to work with CPS in my state and was 100% disappointed in the end result. APS is no better.
I think it would differ from state to state and from CG to CG. what I would consider a hoarded mess, is deemed "fine" by the state. Low standards seem to be the norm.
Minimally, get the pathways cleared, so tripping hazards are minimized, and if you can bear it, get the bathroom cleaned--for simply sanitary reasons.
My mom is hoarded to the point she cannot have visitors--there is NOWHERE to sit. You have to go to the family's common living room. I wouldn't eat a cookie that came out of a freshly opened bag in her apartment.
And yes, all her 'junk' is like a cocoon to her. Wrapped up in garbage and more and more coming in everyday---She doesn't even KNOW what's in most of her cabinets and drawers.
Sadly, the smell and disarray keep people out. Maybe that's how she wants it. IDK.
I worked for a non-profit Visiting Nurse Assoc as a secretary. My daughter had to do homecare as part of her Nursing rotation and I have a friend who worked for the County Health Dept. And they will all tell you, its very hard to report people you feel are unclean. If competent, they have a right to live the way they want. We reported a couple in an unclean trailer and who we had trouble getting them in out of the bedroom with wheelchairs. Once put to bed at night, it was hard for them to get up and out. APS saw nothing wrong with the set up.
Hello Sue. I can understand how clutter can build up since your Parents 90 years now and hold on to magazines etc. To answer your Question I say yes a Public Health Nurse will visit your Parents Home and your World will never be the same again, as no Nurse what ever Nationality will tolerate this untidiness and mass build up of clutter which is a huge danger to your Mom & Dad in the event of fire or a fall. I have found Nurses to be extremely professional in their Job with a no no nonsense approach. I would advise to get a major de cluttering job done asap.
In studying all the material I can get my hands on. Your parents will function better with less around them. Perhaps you can box up some of their "treasurers" and label the boxes and put them elsewhere. I know from my work history that a home where there is so many treasurers - it can become a fire trap or easily cause an accident . Mildew and other problems arise as well. They do have professionals who are trained to size down personal items, rotate them and do it sensibly and with sensitivity. Best to you all.
We are not hoarders but hubby is homebound and has his Nurse Practioner, nurses, and physical therapists come into the home for his care. Laurie, his NP, is a funny gal...she walks through the house like a gangbuster and declares this is not safe; Move it! Get rid of the rug, its a trip hazard...buy one like this instead. I want a grab bar right here! Yesterday!! I love her, laugh with her, and always do what she says. I pray you find someone like her to help you. Sometimes it takes a no nonsense type person to take charge and show you how best to care for those you love...Good Luck
Can you get someone to come in and clean (at least the bathroom and kitchen), maybe every couple of weeks? Some areas have social services that provide for this at a very minimal cost. It would be best to get rid of the extra stuff. It can be a fire hazard, can attract vermin, and also can be a trip and fall hazard. There should be wide enough paths for a wheel chair (if it comes to that) and for emergency service to bring in a gurney. You can't expect aides to visit a dirty place, especially if they have no place to sit. Try to get them to make their home more functional and age-friendly.
Yes, the nurses can visit as long as there is running water and no fire hazard. However, be aware that the nurse may report the situation to the agency on Aging if they feel it needs to be addressed by protective services.
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.
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.
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.
Only to a certain extent. Most PDN's that do home care usually go thru a Senior Services center in their town/county. Their clients usually get assessed every 6 mo during an in-home vistt; even most home caregiver agencies do a bi-annual visit; just to make sure their caregivers are doing their job. The Senior Services agency that my Mom's nurse works thru in my town has had a few nurses stop going to their homes until their LO's or friends clean their houses up. There was 1 incident that the county health dept had to step in to remedy the situation; but within a month that woman was placed in a nursing home.
Sallyb, I just got a letter in the mail from adult protective services saying NOTHING can be done when they are competent. My mother is competent. But is a hoarder. She can barely walk. She sleeps downstairs in the bathroom in a folding chair. The family doctor, the EMTS, and myself have all called adult protective services. She scored a 26 out of 30 on mocca. They told all of us nothing can be done!!! She can live in her hoarded mess. It’s a damn nightmare!!!
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.
Can conservatorship be done for someone who is deemed competent, with full capacity for decision-making? Or as is in my state, it would require a Determination of Incapacity.
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.
Here is what I suggest. Call your County Office of Aging or Adult Protection Services. Explain your delemia. They can send someone to your parents home to see what the situation is and may help with resources. I suggest u be there when they visit in case ur parents turn them away.
You can call parents PCP and ask if he can order In Home nursing to come to your parents home. The PCP may have a Nurse Practitioner who can come in.
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.
The only thing that makes me seriously clench my teeth is when the door locks don't work. Once I literally couldn't open the front door when I wanted to leave: fortunately the client's son was at home, and he climbed through a window and went round to force the lock. Far more often, securing the house behind you is difficult because the lock is dodgy or the key is worn. Even more often, the code we're given for a key safe is wrong, or the key isn't in the key safe...
Ugh, I'm getting twitchy just thinking about it - and it's my day off!
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.
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.
What seems like normal clutter to you (and others who regularly visit the home) can easily be deemed by others as unsafe or unhealthy.
With patience and tact, try to gradually organize, launder, throw away, donate, sell, etc excess possessions but with your parents' advice. This could be tedious and take many weeks or even months. But at least you are NOT taking away their dignity or memories attached to the clutter. Also, you are making it healthy and safe for yourself (and other visitors).
Hope this helps!
People start to lose their friends and visitors because it is such an unpleasant environment. And unhealthy. Very sad. Is hoarding an issue in other countries or is this mainly US dysfunction? It seems it could be a reaction to the insecurity many people USians feel with respect to their finances and healthcare.
Good luck.
If it is an unsafe environment the care providers are mandatory reporters and they will have to report it.
My moms is similar and I was told that she can live anyway she wants. Her husband has in home health providers and the situation hasn't changed, so I am assuming that they don't see any danger.
Best of luck, this is such a challenging situation.
We moved her across the country into our home before her STUFF. I tried my best to donate things and have young relatives take some furniture - just enough to not upset Mom who is attached to her stuff. I moved the majority of it to Texas, but the bulk is in storage. I limited what actually came to the house. I wish I had limited more - but once she's seen it, it's in her mind. She has junked up the master bedroom suite she has now. Yes, it's nice stuff, but there's so much clutter and crap. She keeps asking for at least one of her 4-drawer filing cabinets to be brought out into the bedroom. (WHERE???) I just don't answer, seem not to hear and walk out of the room. So not going to happen. Not adding more.
But I STEALTH clean when PT or OT have her out of the room. I take one thing off a shelf and put it in the trash or charity box. She hasn't noticed a thing. At the previous place, she started noticing pieces of furniture missing, but never the junk or small stuff. So, next I'm going to start trashing some of those medical and other files FROM THE 70s AND 80s! Who cares? Bills, old notes, etc. No longer relevant. She really has files. I think she was the secretary for the prophet who wrote the book of Genesis.
Anyhow, I'm an advocate for stealth "cleaning." They don't even notice if you take a bit from each stack or shelf here and there. It keeps the peace.
In my case, I am the mother of an adult son who lives with me. He has his own private area sectioned off for him in my home. He has a bedroom, living room entertainment center and bathroom. We share the kitchen area. He is respectful of my area. He was a perfectionist for a very long time and then his OCD turned way around and now he is an extreme hoarder.
I have had his area cleaned up twice. But he keeps on letting things pile up. I stopped trying to control it as I knew it had to be up to him. He does work hard but falls apart at home. I read your response above and would like more information. I want to help him so much. I know now that he has a mental problem regarding this situation. Can you help me?
I think it would differ from state to state and from CG to CG. what I would consider a hoarded mess, is deemed "fine" by the state. Low standards seem to be the norm.
Minimally, get the pathways cleared, so tripping hazards are minimized, and if you can bear it, get the bathroom cleaned--for simply sanitary reasons.
My mom is hoarded to the point she cannot have visitors--there is NOWHERE to sit. You have to go to the family's common living room. I wouldn't eat a cookie that came out of a freshly opened bag in her apartment.
And yes, all her 'junk' is like a cocoon to her. Wrapped up in garbage and more and more coming in everyday---She doesn't even KNOW what's in most of her cabinets and drawers.
Sadly, the smell and disarray keep people out. Maybe that's how she wants it. IDK.
I worked for a non-profit Visiting Nurse Assoc as a secretary. My daughter had to do homecare as part of her Nursing rotation and I have a friend who worked for the County Health Dept. And they will all tell you, its very hard to report people you feel are unclean. If competent, they have a right to live the way they want. We reported a couple in an unclean trailer and who we had trouble getting them in out of the bedroom with wheelchairs. Once put to bed at night, it was hard for them to get up and out. APS saw nothing wrong with the set up.
I would clean the toilet before the Nurse's visit.
You can call parents PCP and ask if he can order In Home nursing to come to your parents home. The PCP may have a Nurse Practitioner who can come in.
The only thing that makes me seriously clench my teeth is when the door locks don't work. Once I literally couldn't open the front door when I wanted to leave: fortunately the client's son was at home, and he climbed through a window and went round to force the lock. Far more often, securing the house behind you is difficult because the lock is dodgy or the key is worn. Even more often, the code we're given for a key safe is wrong, or the key isn't in the key safe...
Ugh, I'm getting twitchy just thinking about it - and it's my day off!
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.
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.
I suggest getting at least the entry/living room and the bath clear and clean.