Dealing with an Elderly Hoarder

Flipping channels you might have seen bits and pieces of that show, Hoarders. You may have stood, transfixed, trying in some way to process how just no wait but how someone could get that way. The stuff.  Can’t they see the stuff?  Look at all that stuff!  I mean, dern.

If you don’t lose interest, you stick around to see the cleanup efforts of both professional counselors and the de-junking team and if a whole bunch of animals got really unlucky, the ASPCA loading up a bunch of animals who have been direly neglected.

Or you may stand there and flip channels and can’t bear to watch it at all cause it’s too close to home.  You’ve dealt with it personally.  As one person I knew with a hoarding parent said, “They don’t have a television show called ‘cancer’.  It’s an illness–not entertainment.”

I wrote a short how-to article on “How to Deal with an Elderly Hoarder.”  It was by far the most popular of my over 700 online how-to compositions. It generated a good bit of royalties.

Here’s what I wrote:

Step 1

Offer to take out the trash and offer to do some cleaning. You can also offer to pay for someone to come in. Specialists like Dr. Randy Frost, a board-certified OCD/Hoarding specialist, say an elderly hoarder generally will turn you down, but you may be able to make some headway once he realizes you are genuinely there to help.

Step 2

Ask permission before throwing out anything. Hoarders have an overdeveloped since of ownership and can become excessively attached to seemingly worthless things such as junk mail or decades-old catalogs. If you are to make a difference, you must not breach the elderly hoarder’s trust and remove items without permission.

Step 3

Work gently towards the goal of cleaning up. Most hoarders are aware that there is a problem with their lifestyle but are so overwhelmed they do not know where to begin. Work in small doses and ease them into parting with certain items.

Step 4

Call social services if you are far away or cannot get to the hoarder’s home as often as you’d like and report your elderly loved one as a “vulnerable adult.” Many states will not help an individual who can still drive or fix his own meals. However, you can ask for an interview to be held to assess the elderly hoarder’s needs.

Step 5

Find a local charity such as Meals on Wheels that can at least provide one clean meal a day for your elderly relative. A hoarder often will allow a stranger to assist her when she will not let family members do so.

Step 6

Consult a professional who is specifically trained to deal with hoarding if the situation is dangerous or threatening the elderly hoarder’s health. A professional may be able to help your loved one come to terms with his hoarding compulsion and talk him into changing his lifestyle.

The editor cut off step 7, which made me incredibly angry at the time:

Step 7

Realize that sometimes, no matter how much you want to help and no matter how many ways you offer to clean or incapacitated their judgment may seem, choices are being made.  And sometimes you can’t help someone who doesn’t want your help.  Be ready to accept that they are choosing to live this way and that you cannot–despite your best efforts–change their lives for the better.

So let’s talk about these steps.

First and foremost, the only one that wound up mattering in my life was number seven.  I grew up with a father–a mechanic–who kept everything and a mother whom we called “Supervac.”  She was the kind of person who would start cleaning the plate before you were finished with eating.

My mother went back to school at 43 and eventually became a family nurse practitioner.  Her first assignment moved her across the state leaving my dad behind to see on weekends and to sell the house.  It wasn’t working very well between them, and when I went to visit him one day with my three-year-old daughter in tow.

Always a stellar cook, dad kept a plastic grocery bag at the ready and would turn sideways and dump his trash in it as he worked.  Since it was a typical opaque Wal-Mart grocery bag, I couldn’t see in it from across the kitchen.  When I got closer, however, I saw that it was moving.  It was full of maggots.  The same in the trash closet.  The bathroom was full of black mold.  My daughter took one look around and said, “Mommy, do we have to stay here?”  This was my home through high school.  I couldn’t quite get my head around it.  Yes, I was used to junk around his shop, used to junk on his dresser drawer top, but not like what I was seeing here.  It was a tottering, dirty farmhouse, not a home.

When my mother finally split from my dad in ’03, he never recovered.  They were married forty years, three weeks, and eight days.  I was thirty-three when it was finalized. He has become increasingly belligerent over the years as he refused to treat his diabetes with exercise and diet and chose instead the slow way to commit suicide–candy bars and ice cream.  He ate an entire gallon of ice cream every two days–Blue Bell homemade vanilla.

Instead of settling upstate near my family, he decided to move into a property owned by his sister so he could visit with his very elderly mother–she was in her early 90’s at that time. The trailer in which he lived was down the road from my grandmother’s, down a winding side road that I could not see from the road. I would meet him at my granny’s, the once or twice I made the four-hour trek because I knew after how traumatizing it was to see my parent’s house it would be impossible to unsee it again.

My brother was in the vacinity, so he took over daddy’s “care”.  That means that Jack tried, but was limited by my dad’s obsessive psychology.  He would tell me about it.  “Susanne, I’ll clean off the porch so he can move and get in an out, but then as soon as I come back three weeks later it’s full again.”  The inside was just beyond horrible.  He had become so infirmed that he could no longer stand to do dishes and refused to get up to use the bathroom. He would relieve himself in hospital urine bottles.  I found out later from his doctor (who walked right through HEPA and told me what was really happening) is that oftentimes he wouldn’t make it that far and go in his chair.

I remember offering to help.  That was hard to do, seeing how I was broke, in school with two small children, and a job. He didn’t want any.  He refused my cousin’s.  He refused Jack.  He got in trouble for threatening everyone who said they were going to help him no matter what.  The last thing my father said to me was he was going to shoot me if I moved a single thing.

I called the state.  I might as well have been looking for a pastor on Tinder. The state said as long as he could drive or cook, there was nothing they could do.  There were no protections or interventions available. He could qualify for housekeeping, but there was a long waiting list.

When his neighbor found him, he had been dead about six hours.  He was still warm, covered in an electric blanket.  The neighbor tried to clean up a bit–she emptied some of the bottles, but there were at least ten when I got there a few days after the funeral. There were dead rats in the couch.  The dirty dishes were stacked up to the ceiling.

The cleaning services called me about a year after he’d been dead.  They were able to help now–he’d made it onto the list.

So when I say acceptance may be a part of your path when dealing with an elderly hoarder, I mean it. They may die that way.  Here’s what the National Study Group on Compulsive Disorganization wrote in their findings in 1993 to help professional organizers and psychologist understand what they were dealing with and to provide a classification for the disorder.

Level One:

All doors and hallways are accessible. Normal household pet activity with light evidence of rodents or pests. One to three pet accidents evident. Clutter is not excessive. Home has normal, healthy housekeeping and safe and healthy sanitation. No odors.

Level Two:

One exit is blocked and/or one major appliance or heating/cooling/ventilation device has not worked for at least six months. Some pet odor, pet waste puddles, light pet dander, three or more incidents of feces in litter boxes. Limited fish, bird or reptile care and light to medium evidence of common household rodents/insects. Clutter inhabits two or more rooms. Functions are unclear for living room and bedrooms. Slightly narrowing pathways throughout the home. Limited evidence of housekeeping, light unpleasant odors, overflowing garbage cans, light to medium mildew in kitchens and bathrooms, and moderately soiled food preparation surfaces.

Level Three:

Visible clutter outdoors, including items normally stored indoors, such as televisions and sofas. Two or more broken appliances, inappropriate/excessive use of electrical cords and light structural damage in one portion of the house has occurred in the past six months. Pets exceed local limits, excluding well-cared-for new kitten and puppy litters. Stagnant fish tanks, neglected reptile aquarium and/or bird droppings not cleaned. Audible rodent evidence, light flea infestation and a medium amount of spider webs. Indoor clutter leads to narrow hall and stair pathways, one bedroom or bathroom isn’t fully usable and small amount of obviously hazardous substances or spills. Excessive dust, dirty bed linens and no recent vacuuming or sweeping. Heavily soiled food preparation areas and full or odorous garbage cans. Dirty laundry exceeds three full hampers per bedroom. Strong unpleasant odors throughout the house.

Level Four:

Structural damage older than six months, mold and mildew, inappropriate use of appliances, damage to two or more sections of wall board, faulty weather protection, hazardous electrical wiring and odor or evidence of sewer backup. Pets exceed local limits by four animals, more than three instances of aged animal waste, pet dander on all furniture, pet damage in home, excessive webs and spiders, bats and raccoons in attic and flea infestation. Bedroom is unusable, hazardous materials are stored in the home, and flammable, packed materials are in the living area or attached garage. Rotting food on counters, one to 15 cans of aged canned goods with buckled surfaces, no clean dishes or utensils in kitchen. No bed covers, lice on bedding.

Level Five:

Obvious structural damage, broken walls, disconnected electrical service, no water service, no working sewer or septic system. Standing water indoors, fire hazards and hazardous materials exceed local ordinances. Pets are dangerous to occupant and guests. Rodents in sight, mosquito or other insect infestation and regional critters, such as squirrels, inside the home. Kitchen and bathroom unusable due to clutter. Occupant is living or sleeping outside the home. Human feces, rotting food and more than 15 aged canned goods with buckled surfaces inside the home.

 Dad was right up there with five, except he did have services.  He was taking his insulin needles and throwing them around the living room at random when he was done with them.  The place reeked of pet problems, as for years he owned one chihuahua after another without being able to see what they were doing due to diabetic retinopathy. I do not know how you can not count the fact he was keeping his own liquid waste. I have seen cases (on television, transfixed) where the hoarder in question kept their own diapers, refusing to throw them away.
Needless to say, this is a very sad tale.  I was very grateful to find Adult Children of Hoarders online, which helped in numerous ways.  The experts in the field who appear on the show have an extensive presence on ACOH to make their work more readily available.  I couldn’t watch the show Hoarders, for a year and a half.  When I would talk about it–I couldn’t for a long time–some well-meaning individual (usually at the knit shop or the dojo) would interject, “You mean, like that show on t.v.”
No.  I’d want to snap.  Not like the show.  With my father.  With the smells. With the inexplicable amount of Club crackers stacked beside the front door, with the take-out box of Chinese food that would crawl with roaches within seconds if you didn’t watch it. Not like the show.  Not removed, not with monetary intake from commercial breaks.  Now with the bottles of urine, the mystifying piece of tin foil on the inside of the toilet. That one I never did figure out.  With hoarding, you don’t get a break–not even a length of a commercial.  In my case and many others, your break is just not looking and just not taking the chance of seeing something you’re not going to be able to live with.
His death of congestive heart failure lifted a burden off of me like no other. My surrogate father, a Dutchman named Adam, said to me at the time, “I can tell by the sound of your voice that you’re more relieved than anything.”  How could I not be?  He was 350 pounds and scheduled to have his legs taken off because of the constant diabetic sores. How would we have lived with ourselves–and him–in that eventuality?
I remember him saying at the time that he was going to go live in the Veteran’s Home.  I was mortified, having thought nursing home and the piss-poor reputation of the VA.  Years later I toured the immaculate $269,000,000 facility on the beach in Biloxi where they monitored the rooms of the veterans.  It was too bad I didn’t tell him to go.  It is an amazing place, with a bowling alley, barber shop, thrift store, liquor store and bar… I wish I had told him to go.
Either way, there is help, but you have to know where to look for it. First, start with researching the vulnerable adult laws in your area.  If they were like my state’s laws, your relative might fall through the gaps.  There still might be housekeeping services available–ask.  Be persistent.
If you are far away and help is not forthcoming, then sign them up for Meals on Wheels or a community based food bank such as a local church, etc.  Sometimes having folks come in and see can get a few choice phone calls made to someone who can really help through the Department of Human Services.  It will assure you that they are not starving or eating nasty food continuously.
A call to the local fire marshal might help as well.  If you tell them the place is an extraordinary fire hazard, they may be able to help, particularly if they are in a densely packed residential zone.
However, if your relative–like my dad–chooses to live in this particular manner and eschews any help, you might have to look the other way for your own sanity. For myself, I had two small children to take care of and couldn’t take in a man who didn’t want to come and had a propensity for violence. Eventually, his own bad choices took care of all of his problems, and he died peacefully, thank goodness, in his sleep.
In writing, I always help that whatever I put out there proves to be useful to someone.  This subject, however, is riddled with my own helplessness.  There was nothing we could do and in the end, choices, no matter how bad or convoluted, ruled.

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