Dear Amy: My mom is 90 and has had a hoarding/messy home problem, gambling addiction and money issues for the past 25 years.

She is a compulsive shopper and was shopping almost every day when she was driving. Last year she had a minor car accident that totaled her car, so she does not drive anymore and depends on me to take her for groceries, errands, doctor appointments, etc.

I had to clean out her car, which was so full of stuff that it took me five hours to clean it out. I filled five large garbage bags of trash and 12 boxes of stuff.

I have had to "clean up her mess" many times over the years, sometimes at my insistence, and sometimes because she needs to let someone into her apartment and they can't get in because of the mess. Clothes are piled on the bed, groceries on the counters and boxes on the floor.

My daughter, who has helped me clean in the past, has very good organizational skills and works quickly. She has agreed to help me this weekend. (I have a sister who lives locally but isn't very helpful.)

In the past, Mom has told me that my cleaning makes her anxious.

Should I insist she let us do this? Mom's apartment makes me sick and I feel so overwhelmed when I am there because it is so bad. I have trouble sleeping because it bothers me so much.

I have tried to get her counseling help in the past, but she only went to a few sessions.

If I clean now, it would be on my terms, but if I don't force it now and something comes up with her apartment or health, I would be forced to clean it immediately.

She procrastinates until things become urgent with her; then she makes me deal with this urgency.

I want to honor my mother and also be the responsible daughter. Any advice?

Amy says: At the age of 90, your mother is probably not going to make dramatic steps to change. She might not be physically and emotionally able to deal with her hoarding disorder in any truly substantial way. (Hoarding seems to be related to anxiety, and — longer term — you should ask her primary care physician about appropriate anti-anxiety medication that might help.)

Because you seem to be her primary caretaker, I suggest that you take this on — on your terms.

Ask your sister if she can take your mother on errands/outings for the day. Tell your mom that you and her granddaughter are going to handle this for her, and reassure her that when she returns, her home will be much easier for her to navigate. If your mother isn't in the space and is instead distracted during the day, she might feel less anxious.

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