Does she have any estate planning documents drawn up? She should have a current Power of Attorney, Advanced Medical Directive, and will. If something happens to her, even if she wants your help you won't be able to do much without these.

DH intellectually agrees but I know won’t push it.

This is -almost- all that matters.
IF he was able to pressure her and make it happen: Move her first. Get her out of that house, first. Sell after. Someplace with care available. Stay in the low cost of living area, rather than here. In the meantime, if there is a medical event that sends her to the hospital, make sure family does not agree that it's safe for her to return home. When it's not agreed-upon "safe", the hospital will arrange for her to be placed somewhere other than home. Which is what you want. Even if she changes facilities.

This is similar to the situation with my mother. I had to wait her out for 15 years until it came to a head, which it finally did when her visiting nurses reported her to the county aging office (with my agreement). This was after multiple falls - even down the stairs - and being unable to remember if she'd taken her medication and manage her diabetes. Ultimately it worked out ok, with her moving to assisted living although she hates it and intermittently hates me for moving her there.

Anonymous wrote:Given everything you have described, the most important thing you can do is give this a lot less mental energy. You cannot make your MIL or your DH do anything — full stop.

There is a good chance your MIL isn’t going to move, she will fall and not contact anyone and she will die. This is how she chooses to live. We all get to make choices. My choice is going to be to go to a country where I have a right to die and off myself when I get a terrible diagnosis. My husband thinks this is terrible and will try to stop me. He won’t be able to stop me if I’m mentally competent and can physically get there.

People make their own choices. You have to come to grips with that.

It has taken me eight painful months of dealing with my declining parents to reach the exact conclusion above. You can't control this. Focus on things in your life (like maybe your kids) where you are needed and can have an impact.

Given everything you have described, the most important thing you can do is give this a lot less mental energy. You cannot make your MIL or your DH do anything — full stop.

There is a good chance your MIL isn’t going to move, she will fall and not contact anyone and she will die. This is how she chooses to live. We all get to make choices. My choice is going to be to go to a country where I have a right to die and off myself when I get a terrible diagnosis. My husband thinks this is terrible and will try to stop me. He won’t be able to stop me if I’m mentally competent and can physically get there.

People make their own choices. You have to come to grips with that.

OP here. Thank you to everyone for the advice.

Adult Protective Services (APS) can potentially conduct a wellness check on an obese and limited mobility elderly person to assess their living situation, including potential hoarding behaviors. However, the specific actions taken by APS would depend on several factors, including:

1. State and Local Policies: APS operates under different regulations and procedures in each state and locality. Some states may have specific guidelines regarding hoarding cases, while others may leave it to the discretion of individual caseworkers.

2. Reason for the Check: If the concern stems only from the individual's weight and limited mobility, APS might focus on ensuring their access to food, medication, and necessary medical care. Assessing hoarding would be secondary, unless it presented a direct threat to their health or safety.

3. Presence of Abuse or Neglect: If the reported concern involves potential abuse, neglect, or exploitation, the focus of the check would shift to assessing these concerns. Investigating hoarding behavior would be part of their overall assessment of the individual's safety and well-being.

4. Individual's Consent: APS typically requires the individual's consent to enter their home and conduct a wellness check. If the individual refuses entry, APS may have limited options unless they can obtain a warrant or demonstrate imminent danger.

5. Individual's Capacity: If the individual is deemed to lack the mental capacity to make informed decisions, APS may involve other parties, such as family members, legal guardians, or mental health professionals. This could influence the scope of the assessment and the actions taken.

Here's a breakdown of potential actions by APS:

Interview the individual and assess their living situation: This includes checking for basic needs, safety hazards, and the presence of excessive clutter that might impede their mobility or access to essential services.

Document observations: APS will take notes and pictures of the living environment to support their assessment and decision-making.

Consult with other professionals: Depending on the findings, APS may consult with medical professionals, mental health specialists, or other agencies to determine the best course of action.

Provide resources and support: If hoarding is identified, APS may connect the individual with services like hoarding clean-up programs, mental health support, or housing assistance.

Involve law enforcement: In extreme cases, where hoarding poses a significant risk to health or safety, APS might involve law enforcement to initiate legal action or involuntary removal from the home.

It's important to note that APS's primary goal is to ensure the safety and well-being of vulnerable adults. Their approach is intended to be collaborative and supportive, aiming to provide the individual with the resources and support they need to live independently and safely.

Here are some resources that might be helpful:

National Adult Protective Services Association (NAPSA): https://www.napsa-now.org/help-in-your-area/

National Consumer Voice for Quality Long-Term Care: https://theconsumervoice.org/

National Hoarding Hotline: 1-888-564-6273

Anonymous wrote:I think I was reacting to the posters admonishing OP for not having "done something" yet. I'm not saying that people shouldn't give advice if OP is asking for it. I'm asking the question - beyond offering help and advice to her MIL, is there anything she can really "do"?

This. How do people expect the OP to force the MIL out of her home?

New PP here. Did I wake up in the middle of the night and post this and forget? This is my MIL exactly, down to the age. She refuses to face that she can't manage in her house and I really fear that this is all going to come crashing down soon. Thanks to all for the thoughtful advice.

Anonymous wrote:It sounds like she need 2 knee replacements. I say this as someone who crawled upstairs in my own home after working a responsible job. My knees were shot.
I was in hospital 3 nights and rehab 5 before I was able to go home. I had one knee done and the other wasn't good.
If she has both done in one session or a week apart she will be in care for at least a week. And unable to go home. Cue the one level recovery apartment.
Cue the cleaners. See if the house is ok if garbage is removed and repairs made. If she needs a stairlift due to obesity, an option.
But I had a friend who got 2 replaced weighed 300 and was safe on stairs after PT.
Wherever she ends living getting her knees fixed so she can walk is merciful and will give her dignity.
I didn't like living upstairs when my spouse eas away because it was too hard to get down. I was 56. inam 73 now with 2 great knees and don't dread stairs.

+1. Address the immediate need.

Anonymous wrote:OP here.

I am sure there is some hoarding, probably far worse than we imagine.

DH is not going to force his way in. I think our best bet is to use her mobility issues as an excuse to move her and say that we will clean out her house when she is out (without judgment).


To answer the question about money. Her house is worth about $200-250k and is paid off or very close. She has a modest pension. I don’t have an idea about other savings but I think she’s not destitute but not whatever savings she has will get blown through quickly when she needs increased care.

If there has been hoarding, the house is worth less. You just don’t know it, but there will be neglect and damage.

It sounds like she need 2 knee replacements. I say this as someone who crawled upstairs in my own home after working a responsible job. My knees were shot.
I was in hospital 3 nights and rehab 5 before I was able to go home. I had one knee done and the other wasn't good.
If she has both done in one session or a week apart she will be in care for at least a week. And unable to go home. Cue the one level recovery apartment.
Cue the cleaners. See if the house is ok if garbage is removed and repairs made. If she needs a stairlift due to obesity, an option.
But I had a friend who got 2 replaced weighed 300 and was safe on stairs after PT.
Wherever she ends living getting her knees fixed so she can walk is merciful and will give her dignity.
I didn't like living upstairs when my spouse eas away because it was too hard to get down. I was 56. inam 73 now with 2 great knees and don't dread stairs.

Look for a "compassionate cleaner" service. They are people who specialize in helping people who are in over their heads with housekeeping due to mental illness. There are home organizers who do this too.

https://www.compassioncleaning.com/

OP, I don’t recall you mentioning anything about siblings. Is your DH an only child? If not, you’ll need to consult with the siblings lest MIL pit one against the other.

You also mentioned she is very obese. How is her insurance? Could she get treatment for obesity? That would help w her mobility.

OP, here’s my experience from my neighborhood, so you can understand what happens if your DH isn’t allowed insides and your MIL won’t agree to just leave.

My next door neighbor was in her 70s or 80s and was of fairly sound mind. She was a bit of a collector. But then she had an injury and was hobbling around for a bit. And before anyone asks- she has a grown son who voiodnt or didn’t help but visited often, and she started to become really standoffish with neighbors. So we tried to help but couldn’t.

I think it was hard for her to put stuff away and eventually hard for her to take trash out or walk around the piles of stuff she couldn’t put away. Her collections (mostly seasonal decorations and small collectibles) started to be visibly messy to me as the next door neighbor- instead of storing away things neatly in the shed after each holiday, she piled them next to the shed. And piled things on windowsills and tables.

From what I heard from neighbors, she had another fall and that’s when things just fell apart mentally and physically. She couldn’t manage repairs at home and wild animals started to break into the kitchen and her solution was to put locks on her drawers rather than secure her exterior door.

Finally she fell and got trapped under a pile and it took hours or days for her son to realize what happened and get her to the hospital. She went to a nursing home and died not long after.

Her 3-4 years of falling behind on chores and trash resulted in 8+ dumpsters being removed from the house. It had to be taken down to the studs and the subfloor had to come up. Luckily it had appreciated significantly, but it was still a disaster.

OP, I hope that you can negotiate with your MIL and find a better way than what I described. I watch Hoarders on A&E and I wish they could give you one of those kind intervention professionals to help you all. Good luck.