‘My relative’s extreme hoarding and self-neglect are out of control’

Question

My husband and I are extremely concerned about a female relative. Her extreme hoarding and self-neglect has reached new heights (rodent infestation, not using a fridge, not managing finances, self-neglect/not washing) and is such a worry to us. We have tried over the years (it’s been going on a long time) to help her – hiring skips, helping with laundry, replacing appliances – but nothing seems to work and only seems to exacerbate the situation.

She was a carer for her (very controlling and narcissistic) mother for years and has a lot of anger about her loss of freedom and yet ironically misses “being bossed around and told what to do”.

We have written to and called her GP, but when he has visited, she cleverly manipulates the situation, so the GP doesn’t see the entire house (every room is unusable and full of stuff). She sleeps and eats in one dirty room.

We are at our wits’ end and we worry constantly about her. She is single and very isolated in her community as no one enters the house and her garden is overgrown. Nothing we say seems to have any impact, and we have run out of ideas. We have offered to pay for counselling, but she’s not interested or has excuses as to why she cannot attend. Your advice would be so much appreciated.

‘I am worried about my sister. She seems to have given up on life’

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‘I now realise that my son is in a narcissistic relationship, completely controlled and manipulated’

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‘I am struggling to help my two children, who still live at home. They are both very isolated’

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‘My family don’t particularly like me and I despair about retiring and spending more time with them’

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Answer

Your concern for your relative is apt, and it seems she has got into a state of not caring for herself or her environment. You are right in considering counselling as it is likely that her behaviour is linked to either underlying conditions and/or early childhood negative experiences such as her controlling mother. The usual route to help is via the GP and this may be worth another try as your own distress is escalating.

The GP will also be alert to conditions such as OCD or other psychiatric conditions that may need investigating, but if they have already assessed your relative and found nothing particularly amiss, you may have to accept that the behaviour is the choice of your relative, and if this is the case, then your own reactions will need to be adapted. Another route to consider is to tell your relative of your own emotional distress because of the situation, and that you and your husband are seeking professional help for yourselves with this. You could invite her to participate to assist you, and this might offer your relative a less shameful way of participating (check family therapy options on familytherapyireland.com).

Many people who hoard are aware of how this appears to the outside world and feel humiliated and ashamed, and this leads to a sense of inertia or hopelessness. There is a danger that you are now feeling this helplessness too and all of you are getting stuck in emotional stagnation. While your relative is isolated, she has you to offer support and care, and if this can be provided lightly and freely on an ongoing basis, she may well arrive at a time when she is willing to accept your help. This would require you to be alert but untroubled by her situation so that when she wants or needs intervention, you are there to jump into action. She may well meet a crisis – such as food poisoning or illness due to the lack of hygiene – and this will provide an opportunity to include her GP or others in her overall care.

Invite your relative for walks or coffee as this might bring her into another world where cleanliness is a given

It is, of course, extremely difficult to watch someone you love deliberately make their lives miserable, and yet your ability to help will deteriorate if you too become emotionally distressed. Besides seeking support from a family therapist, you could consider mind calming activities such as yoga, meditation or mindfulness. This will train you to recognise your responses and come to a calm place yourself when faced with a difficult situation.

Doing nothing is sometimes the most challenging response and yet having the patience to continue to be supportive without giving into frustration may be the response needed right now. You have your husband to support you in this endeavour and you could both learn calming exercises together so that one of you might always have the option of bringing calm when the other is feeling hopeless or angry. Invite your relative for walks or coffee as this might bring her into another world where cleanliness is a given.

You do not want to cause her embarrassment so do this with care and perhaps try a quiet outdoor place for coffee first. This will give you something to do but try not to be upset if your efforts come to nothing. The benefit is that you are demonstrating ongoing care and this is always worthwhile.

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