How can I convince my mother to clean up her home so that it is safer?

Annr asked...

My parents are both in their 80's and still living together in their home. Their health is reasonably good though I suspect my mother has dementia. My mother has always been a pack rat and her home is so cluttered it is not safe. She refuses help to get it cleaned up and says she is afraid we will throw away something she values. I live 900 miles away and let her know I plan to visit soon to help her get her home cleared so it will be safe. She flipped out and now will not speak to me. My dad is concerned about this too but does not want to upset her, so he just tolerates the situation. She blames him for the mess and for "telling" me about it. I have no idea how to handle this situation.

Expert Answer

Beth Spencer is a social worker in Ann Arbor, Michigan, with more than 25 years of experience with families who have a member with dementia. She is coauthor of Understanding Difficult Behaviors and Moving a Relative with Memory Loss: A Family Caregiver's Guide. Previously, she directed Silver Club, early-stage and adult day programs serving individuals with Alzheimer's disease and related illnesses.

What you're describing is called “hoarding” behavior in the mental health field. It's considered a form of obsessive-compulsive behavior and is very difficult to manage. There are medications that can help people control this obsessive collecting, but it can be difficult to get people to take the medications.

You don't elaborate on why you think your mother might have dementia. However, memory loss and cognitive change obviously complicate the way one responds to hoarding behavior. Safety becomes more of an issue when a person has dementia and no longer has the ability or judgment to handle this problem but it also becomes more difficult or impossible to reason with the person.

I think you need to tread softly here. Of course you are concerned about safety, but if you alienate your parents, you won’t be able to help and they will have lost their best advocate. I would suggest visiting, not arguing with your mother, but seeing if you can get her in for a medical evaluation. Use some other medical issue if you can, but alert the doctor to your concerns ahead of time. You also need to align yourself with your father -- be a friend and a sympathetic listener. I know you're worried and concerned, but you're not going to solve this issue quickly. Choose one safety issue and see if you can negotiate that (for example, clearing paper away from the stove, or clearing clutter from the stairs). Don't throw things away; ask if you can move them for safety reasons. You're going to have to move by baby steps here.

One more suggestion is to enlist a geriatric care manager to help; they can be enormously helpful to long-distance caregivers.