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In the last several months, I've assumed more responsibility in my Grandmother's affairs. She is 83, lives alone in a 2-story home in NY state, and is declining. I live several hours away and am supposed to be moving out of the country in a few weeks.


Here are some previous posts on her:


https://www.agingcare.com/questions/what-can-we-do-can-we-compel-grandma-into-a-safer-living-arrangement-and-how-do-we-pay-for-it-448248.htm?orderby=recent󺇩


https://www.agingcare.com/questions/did-a-home-aide-make-all-the-difference-for-your-struggling-loved-one-looking-for-success-stories-or-459333.htm?orderby=newest


Grandma has already had Adult Protective Services called on her. She has an APS social worker, Zack. He has been very helpful in some ways, but now I feel like we are in a never ending Hell of chasing our tails. I need something to change, fast. Her helpful neighbor, Maureen, is pulling away.


Grandma has many, many health issues. She struggles to walk. She has good days and bad days, but is often confused, can't hold a conversation, or becomes emotional and upset. She has diagnosed Borderline personality disorder and other mental health concerns. She is incontinent and has not bathed in months. She smells terribly. She refuses home aides. She refuses to wear any new clothing I bought her, and wears literal smelly, stained, soiled dirty rags that are ripping off her body. She refuses to answer the door for home-visit doctors like podiatrists, and has toenails that curl under her feet and she can no longer wear shoes. She has fallen several times, and has been transported to the hospital (she has not been admitted). She has been refusing to answer the door for the volunteer shopper (or will answer without dressing), and will often allow herself to run out of food, and appear to not understand how this has happened. She will often not answer the phone for days at a time, and if she does answer the phone, she often complains of feeling very tired, "mixed up", dizzy, or confused, and then will become defensive at the drop of a hat, and say she needs to go and rest, and to "give her a break" and not call for a while. She's back to saying she doesn't need any help at home, and had canceled the newest home aide evaluation that Zack (the APS social worker) set up. I'm feeling very hopeless. During previous police welfare checks, Grandma is filthy, but a charmer. I think she made Maureen, the neighbor, her proxy. Now Grandma's making up accusations that Zack made inappropriate advances towards her.


There is no one else who can help, and I don't know her finances. She cannot live with me, I cannot pay for an aide or residential care, and I was supposed to be moving out of the country in a few weeks.


What are my options here?


Wait until she falls again and is injured, and needs SNF rehab?


Wait until she is having a "bad day", is ranting, undressed, and unwashed, and has allowed herself to be completely out of food, and then call for a welfare check and hope they transport her somewhere?


If she goes to the hospital, what if literally everyone says she is unsafe at home and refuses to pick her up - will she be transported somewhere?


Can't APS be doing more...?


I thought we could keep her in her home, but I'm feeling very discouraged. I have explained the reasoning for the home aide, visiting doctors, and volunteer shopper all to her very clearly, and framed it as positively as I can as often as I can. It's not working. I'm starting to think it's better for her to be somewhere that she can get regular care, if she won't allow anyone to help her then I don't think she can remain at home much longer. I think I keep holding on because I'm worried about the welfare of her cats (who I will arrange foster/ permanent homes for when the time comes).


What can I do?!

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It honestly sounds like you've done all you can; and you can't delay your life forever due to a stubborn elder. She's in the system with APS, so you should just leave the country and let nature take it's course, one way or the other.

Do not delay your moving for any reason.
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APS won’t do anything unless your grandmother is incompetent. I’ve talked to APS several times about my almost 96 year old mother. My mother is competent but has some undiagnosed mental illness. I was told just because someone has mental illness doesn’t mean they are deemed incompetent. My mother won’t bathe or wash her hair or go to the podiatrist. She gambled all her money away. She lives in a hoarded mess and blames everyone else instead of herself. I was able to wash her hair last Sunday with a shampoo cap. She hadn’t let me wash her hair since last summer. It was full of knots that I tried to get out. I wanted to cut her hair but she said no because she said I did a horrible job last summer cutting her hair. I had to cut all the knots out!! She has natural curly hair. I said if we washed it more often and cut it more item it wouldn’t be full of knots!! I told her her hair is longer than mine!!! When her hair is wet it comes down to her shoulders!!!
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Maybe contact ASPCA or local animal services about the cats? If they see any neglect they can take the cats into their custody.
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Get cracking on this now, as once you leave the country there may be no-one left to make things happen. Talk with Maureen about whether ‘propping her up’ is giving a false idea of her independence. Does Maureen have any suggestions? Put the cats out of your mind, they are more capable of looking after themselves than your grandmother is. See if the next inspection of any kind can happen when there is no food in the house – that might tick a different box. Grandma needs care, and she needs you to make it happen.
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CirclingSkies Jun 2020
Thank you, she has been very combative on the phone and has been refusing to allow the volunteer shopper to come. Her last shopping trip was about 2 weeks ago, and although she gets a bulk Meals on Wheels every Wed, she simultaneously hates them and goes through them very quickly. All those things considered, I imagine she'd run out of food early next week. When that happens, she usually waits 24 hours, then calls Maureen and yells until Maureen brings her a pot of chili. I was just texting with Maureen, she agrees that things cannot continue as they are. We'll chat tomorrow and come up with a plan - I guess we'll put in a welfare call when Maureen gets the "I'm out of food" phone call. I'm going to continue to research this. I send Amazon packages of cat food, and she does actually remember to feed them, so you're right- they're ok for now.
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It may come to someone doing the ER Dump which means exactly that. Everyone refuses to bring her to their home or take her home, and gives evidence that it is unsafe for her to be home. Ask for a social worker. Do not buy into "We will help" and "We can make this work". They will not and they cannot. Yes, the only way to get her in placement is a complete evaluation of Alzheimers or other illness, and the recognition she cannot be home alone. Guardianship runs around 10,000.00. That is pretty much out. And she cannot now confer POA on anyone. The state will have to take this on as it is clear that no one is doing it, nor can do it.
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CirclingSkies Jun 2020
Thank you. I've started researching this. She has been falling periodically, and I think it's a matter of time until she falls again and is transported to the ER. I will inform anyone she could possibly call to not pick her up from the hospital. No one thinks she should be living at home without any help. Is there some other way she could get home- will the hospital let her get into a taxi or arrange other transportation for her to get back to her home?

I'm sorry if I sound cold. It's been several months and I feel like I just can't do this anymore.
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You have to wait for the next crisis. If she’s considered mentally competent than APS really can’t do anything, they can’t force her to do anything. You are not alone unfortunately, many here are in the same situation, waiting for the next emergency to happen.
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CirclingSkies Jun 2020
Thank you, I think we will probably have to wait for the next fall. She fell last month, was transported to the hospital in an ambulance, and later called the neighbor Maureen to pick her up from the hospital. Grandma wasn't admitted to the hospital that time... If she isn't admitted next time, could we all still refuse to pick her up?
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