Hoarding and a fall - what to expect

[ElderlyPIL]

Anyone have any advice on this situation please. An elderly relative is currently in hospital following a fall due to hoarding, they were not found for 48 hours. Property is shared ownership. Safeguarding are involved. Relative is saying they will accept carers, accept the items being moved upstairs for now and will start getting rid of things. Significant part of the collection is newspapers. But we think they will renege on the promises once they are home, we’ve let the safeguarding team know this.
As shared ownership will they force him to address the hoarding?

Can the property be cleared out whilst he is an in patient. Would he agree to this as a proviso for him coming home?

Hospital are saying they need to respect his wishes and not throw anything away, especially newspapers as they are his main concern. So all they will do is move items from the living room and kitchen upstairs and clean downstairs.

Who is saying this at the hospital?
Is it the occupational therapist attached to the ward?

I would agree with you that the chances of them getting rid of any of the hoard is probably nil - would they even be physically safe to do work like that, go up and down stairs etc?

Id prioritise some kind of pendant or wristband fall alarm tbh.

They won't want to discharge a patient to that kind of environment - think not only of the patient but of the the care support workers who will probably need to go in to support him. If it's unsafe for him, it's unsafe for them

Council safeguarding team is involved and they say a micro living set up downstairs with just the sink to wash in is fine, so they arranged the council to move the items from downstairs to upstairs. They are taking his word he will work to empty the property (still mobile despite the falls). Although this was put on hold when the landlord (shared ownership) was engaged. This is the 2nd fall, he cancelled carers last time and wasn’t wearing the personal alarm watch. I have real concerns that he will simply keep going upstairs and into the full garage, I don’t think he will empty the property, despite his promises and we know he won’t put the heating on due to financial worries (that’s a whole other thing). I’m just wondering if anyone has experience of shared ownership properties and hoarders and what their ultimate response to the hoarding might be.

I don’t understand what you mean by shared ownership? Who does he share the property with?

My mum is a hoarder and was (she’s now immobile) a falls risk. It’s advised to not just throw their hoard out. It’s one of the hardest MH conditions and it’s often from childhood trauma. Be firm with him but work with him and explain the consequences, I.e has to have carers, wear pendant and try to let go of some of his stuff.

There will be absolutely no change to the hoarding and he will get rid of absolutely nothing. I say that with complete conviction as a daughter and granddaughter of hoarders.

I’m with the person above who suggests going in there and getting rid of as many newspapers as possible while they’re not around

It’s a property where you buy a portion of the property and rent the rest, idea is you buy more over time, but he never did. So the social housing provider still own the majority of the property and he pays rent to them for the part they own.

Does he have mental capacity to make decisions about where and how he lives?

if not (and thus specific decision needs to have been formally assessed), does anyone have power of attorney for health and welfare? If so, they become the decision makers and if not the team looking after him do

The safeguarding team have said as he agreed to carers and to sort the property once home, he has mental capacity still. No-one has POA for him.

I only know about rented properties (and the possibility of eviction due to creating fire hazard for adjoining homes), but the thing I do know is hoarders. They will lie, they will cry, they will shout and become violent and, no matter what else, they will be determined to protect The Stuff. But not turn on heating to prevent it going mouldy or rusty. And if they think for one second that anything has been taken, they will go ballistic and double the hoard as quickly as possible.

You have to step away and just keep the contact details of a few clearance and skip companies to put against any estate at whatever point in future that becomes possible.

Do you mean the fall was due to hoarding? Or the delay in finding them was caused by hoarding? Sorry, I can't tell from how you've written it.

What is the ostensible reason for keeping all the old papers?

Does your relative have unrestricted access to a bathroom and kitchen?

It depends on the lease arrangements with the housing association who owns the retained equity. The standard shared ownership leases are fairly hands off (as most leaseholds are) - it being a financial arrangement not a management arrangement (except communal areas). If the homeowner goes into arrears for rent or mortgage then they will step in. Outside the 10 year repair period it is the homeowner who is responsible.

Depending on who the person is, I’d clear out as much as you can. We had this with a family friend and when they were in hospital their relative did as much as they could and it was just done and dusted. It wasn’t stripped bare or anything but enough to make it safe.

He fell over because of the hoarding and was not found as he wasn’t wearing the alert watch. I’ve no idea why he wants to keep all the stuff, mostly newspapers. Despite saying he will sort it out once home, he’s actively collecting papers while in hospital. The kitchen is full, but the council said they would empty that as well and move stuff from the kitchen and living room upstairs out of the way, but upstairs is already rammed in all 3 bedroom and the bathroom. He has a downstairs loo, but no bath/shower downstairs. The property is effectively rented so I’m not sure what ultimately the landlord will do now they know how bad it is and if he refuses to empty it.

Ok I think I understand. He doesn’t live with anyone else, it’s just him, in a property where he owns part and rents the rest from the HA.

Are you concerned about his wellbeing or his being allowed to continue living in the property? What’s your relationship to this person and how involved are you - or willing to be?

What does his lease / shared ownership agreement say? Has anyone asked the HA? I imagine they have plenty of clients living in difficult situations.

If it is shared ownership it is not rented. They are very different with the landlord obligations that are very different to a leasor obligation.

Edited to make it grammatically correct.

We want to get him back home, but only if it’s going to be safe for him. HA/Landlord or whatever it’s called can’t say too much to us as we have no POA. Council seem to be rushing a plan to get him home, taking his word he will reduce the hoard. No idea what’s in his lease, it’s buried somewhere in the hoard! We just wanted any experience people had of dealing with hoards in property where the HA/landlord own the majority of the home and insure the buildings. I’m sure the volume of stuff is a fire risk.

Housing and health are 2 very different areas.... And different to adult social services.

The hospital may be trying to get him back home if they need to free up the bed. The adult social services working with occupational therapy at the hospital are the people who ensure the house is safe. Depending on the type of local authority (unitary or district) it may be that social services and housing are 2 different organisations. In a district it is the county council that looks after adult social services and the district does housing.

The landlord ( rented) or retained equity leasor ( shared ownership) looks after the fabric of the building.... Generally unless it is truly owned by the council it will be owned by a housing association. Most houses that have council nomination rights are owned by housing associations. They do not have an obligation to provide social or health care. They look after the fabric of the building... Other leaseholders can report issues if the hoarding impacts their safety.

If your relative is in a shared ownership house then it will be the health or social care peeps you need to speak to.... Although without power of attorney they will be limited as to what they can discuss.

I work in a hospital and have done time working for the discharge team organising packages of care etc before discharges. I dealt with a couple of hoarding cases and in both cases the houses had to be at a safe level for people to return. I always remember one family said they had to basically get skips and clear things to allow their relative home it was really sad - they showed me some photos on their phones and there was all sorts of stuff just piled up, it was a fire hazard and the patient was as desperate to go home but he was told not until it was sorted.

The other case was a woman and she was in a council property and the council said it posed a man environmental health risk and they went in and cleared but were really good and kept paperwork and photos and stuff but she was very traumatised by it all but apparently she’d been given lots of opportunities to sort it out and hadn’t so they had to intervene as it was affecting neighbouring flats as she had tonnes of stuff in the garden and rats nesting.

Have the safeguarding team suggested a referral to the local fire safety community team at all?

Staff from that team would assess the home in terms of fire risks linked to the hoard and potential barriers to rescue.
If the household is willing to engage, they would set clearance targets for specific areas within the home.

I’ve no idea why he wants to keep all the stuff, mostly newspapers.

It's just because he's a hoarder. And I'm not bring snippy - it's what they do.
He won't be able to explain why he keeps them, and at this stage it's irrelevant.

Even if the papers are moved upstairs, or even thrown out, he'll just acquire more.

Sorry, I haven't got any useful advice. You have my sympathy. Hoarding is a very difficult thing to address.

Still not clear what your role in this is. You don’t have POA and in any case he apparently has capacity so you are not able to intervene in the decision to discharge. Are you offering to help clear the board? Or are you waiting to object to him being allowed home with the stuff all moved upstairs and him washing in a downstairs sink? Or him falling again?

What’s your relationship to the elderly person? Can you influence them at all - to wear a pendant, to not cancel carers? Do you visit them or do any care for them?