Advice on ailing hoarding dad please

[Taranta]

Hello, my dad is in his 70s, in bad health and is living on his own in a house about three hours from me. We are not close but are in contact, albeit infrequently.
DB went to visit him last week and was appalled at his living conditions, he's always been a slightly obsessive collector of kitsch of all sorts but it's got to the point where you can barely get into the rooms. Dad has mobility issues, he is morbidly obese and diabetic and clearly cannot keep the house clean any more - he had a cleaner but I don't thinks she could cope with the clutter so the place is now deteriorating, dirty and smelly. He mostly spends his time on internet chat rooms, doesn't get out much and struggles when he does. DBro and I decided we would need to intervene in some way in the new year to see if we could help him turn his attention to the clutter and get the place clear to the point where we could bring in a weekly cleaner again.
But things have taken a turn for the worse, Dad had an op last week to deal with a urinary blockage but ended in ICU on a ventilator with a pulmonary embolism, he is now back on the ward, but I cannot see how he can get back home with the house as it is, unfit for someone so unwell to live in. I have mentioned this to the doctors looking after him (which he will be cross about) but I felt I had to - I wonder now why might happen? A home visit? Will social services get involved? I have a newborn so will find it hard to do much more than visit at this point given the distance involved, so I am only going to be of remotely at present. Any advice on likely process from here in would be enormously helpful! TIA.

Phone the ward, and ask to speak to the social worker and be absolutely honest with them about his home, support available to him etc. Make it very clear you can't help. Then they can make a needs assessment, visit the house etc.

IME, the doctors generally don't think about the patient going home, so they may not have passed on your comments at all

Thanks, I'll do that. He was transferred back to a ward yesterday and I did manage to explain it to the ward nurse but will ask to speak to the social worker. The main issue is going to be his reluctance to deal with his home situation.

Can you get anyone to go into his house and email you photos for you to show social workers?

Speak to the social worker at the hospital using words like "vulnerable" and "unsafe discharge". Also phone the Local Authority adult social services, they should have a help line number, and explain that the hospital is proposing to discharge a vulnerable adult back into the community. You believe his home situation needs to be assessed before this happens. Follow this with a clear email outlining your concerns, attaching photos, and giving reasons why you feel he is "at risk".

It feels bad shopping a family member to Social Services but they need to be involved at some point with all the oldies who are struggling to cope on their own. They can be helpful and a properly flagged file should help prevent unsafe discharges in the future.

(My own experience was three years ago when at about this time the hospital suddenly announced they had changed their plans and would discharge my immobile mother on Christmas Eve to an empty flat in an empty block - the rest were second homes - despite, as we later discovered, hospital notes saying she was very confused. With, as it appears, no conversation with Social Services. Luckily we had the money to put her in expensive convalescent care whilst we found a solution, but as I went up the steep learning curve I realised it was crucial that she became known to Social Services and properly assessed.)

My mother had been hoarding. Now she is in sheltered housing she does not. I would be tempted to ask the hospital or the GP to look at possible:

1. Dementia. Each time my mother went to the supermarket she would buy basics like washing powder and toothpaste forgetting she had cupboards full at home. Looking back this would have been a very early sign her memory was failing.

1. Depression. My mother was clearly very lonely after my father died and probably aware of her failing memory, yet determined to remain "independent". There are a number of mail order firms who seem to target the elderly, promising good health via over priced vitamins, or the chance to be a perfect 60s style housewife/hostess via all sorts of weird kitchen equipment (chicken shears anyone?) What is your dad hoarding and what does it represent?

A diagnosis for either might open te way to some treatment, and also help lever in SS/care support.

A personal tip is to try to keep a distance and perspective. Less can be more. If you have to go down and I would wait till you have a clearer idea of what the optins are, collect several tasks and have clear objectives. For example meet with SS, arrange a key safe, get your dad to sign a POA or get third party access on his bank account, divvy up tasks with your brother (I was able to stuff all the paperwork into a suitcase and sort it out at home, really important as knowing how much money there was helped decision making, plus she had been very vulnerable to fraud) etc. If your husband can get a couple of days off work try to stay somewhere nice (if you suggest you might be a regular visitor you can get very cheap out of season rates) and do some nice family things along with the grotty. I found the clearing of someone else's life, and dealing with a mother who was clearly very frightened, emotionally exhausting. I got a lot more done when my husband was able to come down.

Taranta I have been in a similar situation with my Dad. Only his progressing dementia allowed me to clear the mountains of junk he had acquired. CMOT and NMS are right, don't try and sort this one out between you and your brother, it's too much for you, you need to involve the professionals if only so you can hide behind them later on when they take action. Hospitals have a legal obligation to arrange safe (operative word: safe) discharges and he clearly is not safe in his current environment.
I don;t know if you have seen the website "help for hoarders" but you may find it useful, if only to see how hardwired the need to acquire and retain possessions can be in those who are affected, and how hard it is to work with them. So ask for professional help.

Aargh I keep typing replies then losing them!

Thank you for your advice and personal stories - I know it shouldn't be surprising to become the 'parent' to your parent at this stage in life, but my dads deterioration has just seemed so fast. But it's not really his mind - or rather I don't think its related to dementia - if you were to speak to him on the phone you probably wouldn't think he was anything other than a bit eccentric. DBro and I have often talked about the likelihood of him having an autistic spectrum disorder because he's always had certain traits - disliking social activity other than online, not being able to respond to others' emotions, collecting things (eg stuffed toys, milk bottles, number plates) and he's always been utterly unembarrassable. He simply doesnt care what he looks like - I think this is why I've not focussed on the clutter as ice always seen it as just the way he is. But this combined with the squalor is something new.

I've asked his neighbour about a key but she hasn't got one, so he must have the only set himself. I'm not going to get entrenched in this, at this stage but I will pursue the local authority as youve suggested - he really can't go back to that house without at the very least a plan for sorting it out. If it comes to it I will go down with my brother in the new year and get some photos, go that route.
It's all so draining, the thought of tackling it all. I think it's partly my own new baby sleep deprivation but it's also dredging up all sorts of unpleasant memories from my youth. I feel guilty for feeling so unwilling to do anything about it all, but if I don't I will feel that much worse I'm sure.