How can we get support for MIL and BIL living unsafely?

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TLDR: I’m looking for some advice and maybe some sign posting for help for support for my MIL (68) and BIL (45) who are living in a unsanitary, unsafe, disgusting condition.

It’s long to avoid drip feeding.

My MIL health isn’t great, her mobility is pretty much non existent, she sits in her chair all day and hardly moves, she doesn’t drink any water, only 4x Red Bulls per day and her diet comprises of high sugar. Her health has rapidly declined over the last 10 years. Every 18 months or so she’ll start to have falls and then get admitted to hospital for 2 weeks, starts to recover and the falls stop. Then the cycle will start again. She has got CKD3, Diabetes, Edema (the watery leg swelling thing) and she’s obese.

Her eldest son (my BIL) lives with her, he is unemployed (has been for 10 years), is super mobidly obese (definitely over 26 st, he’s 5ft 8). He has health problems too and is deeply unhygienic - hasn’t showered / washed since 2005.

we visited my MIL today and had to call 111 who called an ambulance. My MIL has been admitted to hospital again after a weeks worth of falls, plus she was slurring, drowsy and incoherent. BIL admitted that she’s been like this for over a week but only told us last night. We believe the cause is dehydration but will know more tomorrow. We could not have discovered this sooner as we live an hour away, work full time plus im 32 weeks pregnant and was blue lighted to hospital at the start of the week with significant bleeding which resulted in a 3 day hospital stay.

My husband is so unbelievably stressed. When we were at his mums house today before calling the ambulance we were deeply shocked at the state of the place. It’s not only unclean, it’s unsanitary. Like shit and piss all over the toilets - her ensuite stacked full of bagged soiled continence pads, it stank. You can’t see the floor in any room, my DH blocked me from entering the kitchen because it’s so disgusting he didn’t want me / his unborn child being exposed to it. DH attempted to clean the downstairs WC so I could use it but instead told me to ‘hold it’ and go to Tesco instead as it was too unsanitary in there.

We called the paramedics and one of them
was close to tears about the state of the house and how two people can live this way. They pulled me aside to get as much info as poss and said they’d raise a safe guarding concern.

My BIL mentioned that he’d been asking the neighbour to help him pick my MIL up off the floor when she had fallen in the week. I went and spoke with the neighbours and she said that she has been looking into how she can raise a safe guarding concern to see if MIL and BIL can get some support.

The issue is, MIL and BIL are both in huge denial about their situation. I don’t know why BIL doesn’t clean or tidy, he’s obese but can walk around and he is a massive contributor to the pigsty.

My MIL refuses to accept any help and will blame us now for her being admitted to hospital again. My DH and I are at a complete loss we don’t know who can help - it is not possible for us to go clean their house as we work full time and have our own house to clean, plus we live an hour away and are expecting our first child. And quite frankly - they are both adults with capacity and my MIL can afford a cleaner.

I guess I am looking for advice on if it’s possible to get someone round to inspect the place, assess both of them and make some recommendations. My MIL is super excited about the arrival of her first grandchild and I need to break it to her that absolutely under no circumstances will I be bringing a newborn to her house as it’s too disgusting and unsanitary there.

Sound like the ambo men are doing it - calling Social Services. What SS will do is visit and report.

Whether they take any action eg carers and/or cleaners is up to them, but you’ll know more after the report.

Thing is, everyone’s got capacity until it’s proven they don’t so SS might argue it’s their choice. Falls raise the chance of action.

I’d argue back hard MIL doesn’t have capacity given she was slurring and incoherent on admission to hospital.

Get the neighbours to tell SS about the falls by calling the local council safeguarding number - it’s anonymous and MIL won’t find out, but SS should act on this trigger.

Social services might not touch it. Happened to my aunt- she was 98, unable to look after the house, caring for her disabled daughter (I know!!) and they said it wasn't a priority!

GP might be a route to try, but unless she lacks capacity you're scuppered unfortunately 😕

Thank you both - when the paramedics were there earlier they asked her if she needs any additional help or support and my MIL snapped back ‘NO’. They said as MIL hadn’t consented their hands may be tied but they can raise a safe guarding concern.

The neighbour asked me if I can seek help - I honestly don’t even know where to start. The house has always been unclean and untidy but it’s next level now with literal shit everywhere. She shit herself when she fell a few days ago which is now smeared on the carpets. It’s awful.

Everyone needs to report each occurrence to the adult social care team at their local authority. There will be a form on their website for raising safeguarding concerns. Your DH will need to contact the hospital and make them aware of these issues so that a care assessment should be carried out before discharge. Adult social care may not 'do' anything but it's very important to report as it creates a paper trail and a history.
My mum developed symptoms of dementia around 4 years ago, part of it was she suddenly started hitting my dad who was physically disabled, he refused to tell any one and it took a whole host of professionals witnessing different things and reporting it before eventually she was moved into a care home. Make sure it's fully documented at the hospital, we had paramedics do a safeguarding alert after my.mum sat in the living room laughing because my dad couldn't breath. It's really important that each set of paperwork ties up with others.

What age your MIL and BIL?
How did the BIL end up moving back at home ?

What’s the relationship like btw your DH and his brother?
Are there any other siblings?

has your MIL ever expressed concern about the state of the house ? does she see any need to change ?

long story short though, if they have capacity to choose to live like this, you can’t do much to stop them. You can only help pick up the pieces when it falls apart - and it will.

What age your MIL and BIL?
Op said 68 and 45

look up the number for your local council adult social services, it's normally a voicemail you can leave a message detailing everything. Even if nothing happens now with SS then it's at least on file for later.
and as an aside at only 68 she's that bad already??? That's not good at all.....

SS will assess and make a referral to the fire brigade, who will fit free smoke alarms. That will be the end of SS involvement. You and DH need to step in or leave them to it.

Please ask your DH to speak to the hospital discharge team and tell them that sending her home would be an 'unsafe discharge' and that somebody needs to do a discharge assessment before she is allowed home. Explain exactly what an awful state the house is in, and tell them your own family circumstances and that you cannot possibly help in any way. Also tell them that the BIL is incapable of looking after her safely, and that he is morbidly obese to the point of disability.

Remember the words 'unsafe discharge' and keep saying it.

The GP has a form that a patient can complete so information can be shared with family. Ask her to do that. Then they will talk to you.
Ask about the GP carer liaison worker
raise a safe guarding concern with the GP

Report to social services.
You could send a professional cleaning company in but they would need to be able to deal with bio hazard.
I write letters to the GP when I have concerns.
But really right now you are pregnant and need to concentrate on you and your baby.
This has to be your priority.

I'm sure the paremedics will have raised a safe guarding concern especially as your brother lives there.
I would suggest asking the envorimental control team at the council to come in and sort the hygiene out at the property.
I would continue to express your concerns with the nurse in charge, fully explain what is happening as they will know the appropriate people to contact.

The state of the house might be of concern to environmental health. I know they can condemn houses, of course, that opens another can of worms, but support will be provided.

Do they own or rent their home?

If they rent from a council or housing association, their housing department will investigate.

I think if they are both mentally competent and refusing help that no one will do anything. The council will be busy with people who want help and legally require it. I have a NDN who lives in a council house that is filled to the ceiling with rubbish, water coming through the walls and dead rats lying in the living room. The council only care that his boiler is working.

If MIL is reasonably well off financially, I’d start by trying to persuade her to have a daily cleaner “temporarily” when she gets out of hospital. Perhaps, if BIL isn’t doing any cleaning, come at it with her from the point of view of there being too much on his shoulders.…..

Did you read the OP? There’s literal bags of shit and piss soaked items lying around. A cleaner isn’t going to touch that.

There are quite a lot of cleaners who specialise in houses that need this sort of cleaning. Hopefully op would be able to find someone suitable if she can get mil’s agreement.

How are they doing their shopping? Who is providing the red bull?

Regardless of capacity what you have described are risks related to self neglect: medical, falls, hygiene. The presence of risk can override capacity and the need for consent.

Contact their GP and share concerns for on gong medical issues and social service requesting a care assessment of needs.

This is hard OP and I’m sorry you are both going through this. Please look after yourself and recognise you can only do so much.

If they both are deemed to Have capacity and refuse social care input. Unfortunately there is little they can do. I had a similar situation with an elderly friend who was living in squalor.

It’s really sad that these cases fall between housing and mental health services that neither are well placed to support.

Hoarding is a complex issue and is often rooted in trauma. There have been cases where housing will clear out and the person de stabilises with tragic consequences sometimes. So there maybe a reluctance for that reason for the council to step in.

They likely need long term support for both the practical issues and psychological. They should be registered with local fire brigade as a ‘heavy load’ as their is heightened risk of a large fire due to the density of materials present.

It must be awful to live by though as problems can extend to nearby properties with vermin and smells but knowing someone is living like that.

Absolutely no useful advice except to say that you and your DH should do your best not to feel guilty or responsible. You have enough with your own domestic situation.
It’s good that MIL is excited about the baby. Gives you at least one incentive that holds a glimmer of hope she will take action in order to see the baby. She’ll either have to sort herself out to come and visit or sort the house to be visited.

Op I would organise an adult social care assessment. Pay for a one off spring clean and then step back. They are choosing to live this way. It’s their choice. As unfathomable as it might be to the rest of us, you can’t force them to clean and take care of themselves.

I would never take my baby there, ever.

The Council can put a closing order on the property and move them out.

Is it rented or owned?

why should op pay?
mil and bil should take some responsibility, even if they are requiring support to facilitate the clean, the payment of it should come from them