If Fallout 4 is set on the East Coast i say let it be messy. Many people are still struggling on the Eastern coast and may not have lived in one place for long enough to call it home. In places like Rivet City, i would say individual rooms, depending on the individual, should be more or less clean and livable but lower level stairwells and such should remain messy. I wouldnt go down their to clean up if it wasnt my job. Im sure paint isnt easy to find either. The Left Coast is probably a bit more civilized and more places should be spruced up and appealing. The middle of the country would depend on the level of civilization the story supplied us with.
Well i didnt put that skeleton there why would i clean it up? You can find neckbeards sleeping on stained mattresses in their own filth now, ever see Hoarders? Why would this change post apocalypse?