I am a social worker, but not the kind that usually goes to people's homes. I had a decent office at a community mental health clinic for years and would see clients there. Once, though, I was seeing a little girl, around age 8. Her mom had a lot of health problems and was relying on a family member to bring the girl to my office for our sessions together. The family member, though, had to go out of town for an extended period of time, so the mother contacted my office, spoke to my supervisor, and it was agreed I would visit the girl at their home about once a week. My supervisor went with me the first time, because I was not really liking the idea of going to a strange house by myself.
We walk up to the door, knock, and the little girl opens the door. Immediately, the smell hit me. It was a mix of urine, body odor, and something I still can't quite identify (kind of like soup? maybe?). We put on our best professional faces and walked inside. There sat the mom, all 500lbs of her, in a recliner in the living room. The only other furniture in the living room was a modified portable potty, a TV on a stand, and a plastic lawn chair. We walked into the kitchen and saw dishes piled high and just yuckiness everywhere. It smelled so awful in there. The little girl was making something on the stovetop, standing on a stool. If I could have just picked her up and taken her home with me at that moment, I would have.
As we stood there talking to the mom, whom neither of us had ever met in person before, it became very clear to us that this little girl was taking care of her mother while their other family member (I think it was mom's brother) was out of town. We watched her empty out the potty chair thing - it was modified to accommodate this woman's very large size because she was physically unable to walk down the hallway to the bathroom. She would sit up in the recliner and would somehow get on to her feet, shuffle over to the potty chair thing, do her business, then sit back down.
As social workers, we are mandated reporters. We had to report this issue to social services. The little girl was placed in temporary foster care until the relative came back home, because there was no way the mother could care for her child. The mom wasn't mad at us and, in fact, appreciated that we were looking out for the child's best interest. She did not know there could be a voluntary and temporary foster care arrangement made. We also worked on getting her into an assisted living facility. She was not just obese, she had a multitude of health problems and needed assistance.