Squalor Syndrome: Living Happily Among Cats, Fleas and Filth

Violations included infestations of rats, mice and roaches, no heat, no fire alarms, broken toilets, exposed asbestos, raw sewage backing up into the sinks, no running water, broken door locks and windows painted shut.

Many blame national policies in the 1970s that closed psychiatric institutions and released thousands of patients without giving communities financial support to care for them. The topic was chronicled in a book by Harvard University's Jon Gudeman.

In California, a focus on the hoarding aspect of this syndrome began when landlords -- worried about public health and fire hazards -- evicted tenants and made them homeless, according to Belinda Lyons, executive director of the Mental Health Association of San Francisco. The association holds annual conventions on the topic.

In private homes and among the rich, odd behavior often goes unnoticed, she said.

"When it's a rental, there are quarterly inspections. But in these huge homes nothing is done unless a neighbor complains or someone passes away or a family member comes in to help declutter," Lyons said. "But there is huge resistance and it's a source of strain for the family."

Shame and Isolation

Those afflicted have few guests and experience shame and isolation, Lyons said. Often the inspectors are called in when the squalor spills out into the yard. And poverty often has nothing to do with it.

In 2002 in California, a Solana Beach home with an "ocean view to die for" was so cluttered the owner had to crawl "almost crablike" over piles of newspapers, mail and rubbish to get anywhere inside the house, according to an article by Denise Nelesen, spokesman for the San Diego County Office of Aging and Independence.

The reclusive woman was living alone in a dilapidated house filled with rubbish and infested with vermin. Excrement and decomposing food were strewn around the floors, and the stench was unbearable to all but the owner.

The woman eventually moved outside and used buckets as toilets that she would dump over the neighbor's fence.

That same year, the local humane society also reported five major cases of animal hoarding, involving 245 animals. In one, a litter of dead kittens was found mummified on someone's living room floor.

Self-Neglect Kills

The San Diego office receives about 1,000 calls a month for cases of elder abuse, and nearly 40 percent of them involve cases of self-neglect like these, said Nelesen.

"It's very common and not much is being done," she said. "A lot of people just don't want to get involved or don't want to bother someone, but you are setting a person up to killing themselves."

The elderly also have physical impairments that can make Diogenes syndrome worse. Add to that depression or the loss of a loved one.

Or -- as in the case of Edith Beale, shunned by her husband, and Edie, distraught over a broken engagement -- an overwhelming sense of unresolved grief.

"They've given up," said Nelesen, "and they don't care anymore."

For more information on elderly abuse or call 800-677-1116 to find an agency near you.

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