Q: My 87-year-old father lives alone. His house has become increasingly dirty, but he refuses to get help, even though I’m sure he needs it. I’m worried that he’s becoming incompetent and in need of elder care, but he doesn’t want to go see the doctor. What can I do?
A: This situation does come up a fair bit with aging parents and relatives. I’m sorry to say there usually are no easy solutions. But there definitely are things you can and should do, and it’s better to act sooner rather than later.
Let’s review what you can do. I’ll also explain what I’ve learned about “incompetence” over the years, and how doctors usually play a role in the evaluation of such older adults.
Then, I’ll share some thoughts on how older people and families can plan ahead, to avoid facing this kind of dilemma. And then last but not least, I share a few thoughts on taking care of yourself as you go through this.
The usual concern, for a person of this age, is that the person may have developed memory loss, or a dementia such as Alzheimer’s disease.
This is a pretty reasonable worry, since an estimated 30% of people aged 85+ have dementia. (Wondering about dementia vs Alzheimer’s? Here’s where I explain dementia and how it’s related to Alzheimer’s.)
And of course, if your older parent seems to be doing worse than before, when it comes to activities that require mental organization (such as keeping a house reasonably clean), that further increases the chance that some kind of brain deterioration is causing problems.
But, we should never start by jumping to the conclusion that someone has developed dementia and needs elder care.
The main thing you wrote above is that you’re worried about a dirty house and a refusal to get help. This could be due to thinking problems. But it could also be due to pain and mobility problems, combined with a common reluctance to accept assistance.
Still, I have to admit that in many similar cases that I’ve encountered, the older person does have cognitive impairment. And we do often find it’s substantial enough and irreversible enough to qualify as dementia. (For more on dementia diagnosis, see my post “How We Diagnose Dementia: the Practical Basics to Know.”)
Now, even if he does have dementia, that doesn’t mean we can’t improve his thinking. I often find that by adjusting medications or the older person’s situation, we can optimize brain function and help the person manage better, despite the underlying dementia.
We also sometimes find that an older person is experiencing delirium from an illness or other health problem, which can make the thinking worse than usual.
So, getting him the right medical evaluation and optimization is key. You might even be able to get him to the doctor not by saying “You need to be checked for dementia,” but by saying “We need the doctor to help you feel your best and be your best, since that helps you keep living at home for as long as possible, which you’ve said is important to you.” (It’s key to frame your suggestions as ways to help your father achieve his health and life goals.)
Of course, these are all things that can be found out after the older person has been medically evaluated, and by someone who knows how to assess cognitive symptoms correctly.
Part of your frustration is that your father doesn’t want to go see a doctor. So you’re stuck: worried that something’s wrong, worried that your father has become “incompetent,” and unsure as to how to move forward since your father is refusing to cooperate. Let’s talk about your options for doing something, despite your father’s reluctance.
How to get elder care for an aging person
Start by asking yourself whether you think your father really might have lost mental insight and abilities, as opposed to simply making choices that you disagree with. (See “8 Behaviors to Take Note of if You Think Someone is Getting Alzheimer’s“.)
If you think he really is cognitively impaired, then you probably should consider pushing things a little more, to get him the help he seems to need.
For more tips on how to get an aging parent to see the doctor, even if they’ve been resisting, watch this video:
I would also encourage you to make a list of specific concerns and red flags. You can use the “Quick Start Guide to Checking Older Parents” or a similar checklist, to help you identify specific problems that need attention.
Once you’ve decided how worried you are about dementia, and listed the key problems to address, here are some resources that can help:
- Your father’s regular doctor. This can be a good place to start, especially if it’s a doctor who has known your father for a while. Contrary to popular opinion, the HIPAA regulations (which govern the privacy of health information) do not preclude you, an adult child, from contacting your father’s doctor and relaying your observations and concerns. You can see if the doctor is willing to hear you out on the phone, and then do send in your concerns in writing, since those will usually be scanned into the chart. The doctor may be able to help you persuade your father to come in. On the other hand, if the doctor waves off your concerns saying there’s nothing to do, you’ll need to look elsewhere for help. And you’ll want to look for a doctor who is more up-to-date on the medical care of aging adults with cognitive impairment. For more on how the doctor should evaluate cognitive impairment, see here: Cognitive Impairment in Aging: 10 Common Causes & 10 Things the Doctor Should Check.
- Adult Protective Services (APS). To find contact information for your local APS office, enter your father’s zip code in the locator at Eldercare.gov. APS caseworkers respond to reports of abuse or neglect of older adults, including “self-neglect.” Generally, the identity of the person reporting a concern to APS is kept confidential, so your father wouldn’t be told you reported him (although he may have his suspicions of course). APS offices tend to be overworked and underfunded, as is often the case for social services. But in principle, they will look into the situation, visit your father, review medical information from his doctor, assess his capacity to understand risks and give informed consent, and take action to ensure his safety if warranted. APS does sometimes initiate a court petition for legal guardianship of an older person. For more on APS, click here.
- Social worker experienced with older adults. To find a social worker to help you troubleshoot the situation, you can try calling your local Area Agency on Aging (see the Eldercare.gov locator again). Some primary care offices also offer social work services, especially if they are bigger or serve vulnerable populations. You can also try asking around at local senior centers. That said, in my experience, it’s rare for social workers to visit aging adults at home unless they are sent by a home health agency. So although it’s worth looking for one, if you want someone to go see your father at home — which you probably do — you may need to pay for a geriatric care manager or other “eldercare problem solver”.
- Geriatric care manager or eldercare expert. These professionals usually have to be paid out-of-pocket, and they specialize in helping aging adults and families get through all kinds of late-life challenges. They usually have a background in social work, gerontology, nursing, and/or family therapy. I have worked with several of them and they are quite helpful to families. They can do things like coach adult children on how to more constructively discuss difficult topics, mediate family conversations, and help families find the right kind of help. To find a professional affiliated with the Aging Life Care Association (formerly the National Association of Professional Geriatric Care Managers), visit AgingLifeCare.org.
How to know if an older person is “incompetent”?
Now, you’re getting help because presumably, you want to help your father with his goals, which for most aging adults include maintaining independence, dignity, and quality of life.
But you also mentioned a worry that he is becoming “incompetent.” This is an important question to address, and families often ask me to weigh in on this. What I tell them is that as a doctor, it’s not for me to say whether the person is “competent.” Instead, my role is to help assess an older person’s capacity to make medical decisions, and also to identify underlying medical problems that might temporarily or permanently affect decision-making.
You should know that the term “incompetence” was historically used to refer to a legal determination. In other words, it’s up to courts, not doctors, to say whether someone is incompetent. This is governed by state law so different states have different criteria. But overall, if someone is found in court to be incompetent, they often will be assigned a guardian or conservator to manage decisions on their behalf.
To decide whether an older person is legally competent, the court will need to know about the person’s ability to manage certain major types of decisions. These might include:
- Medical consent capacity
- Sexual consent capacity
- Financial capacity
- Testametary capacity
- Capacity to drive
- Capacity to live independently
For more on incapacity, see this article: Incompetence & Losing Capacity: Answers to 7 FAQs.
The tricky thing about capacity is that it can certainly change depending on the day and situation. For instance, a person who is sick and delirious might temporarily lose all the above capacities. A bad depression could also affect capacity for some time. People with dementia or other forms of cognitive impairment are also prone to have their mental capacities fluctuate somewhat, depending on the day and whether their brains are functioning at their best.
So how do doctors and psychologists weigh in on capacity? The truth is that it’s pretty variable, and it’s also an area of law and clinical practice that is evolving.
For the best information on how clinicians should address issues related to capacity in older adults, I recommend this resource, which was created as a joint effort between the American Psychological Association and the American Bar Association: Assessment of Older Adults with Diminished Capacity: A Handbook for Psychologists.
Obviously, as it’s written for clinicians rather than for the public, it’s rather long and technical. (There are links to similar handbooks for lawyers and for judges here.) But if you really want to understand this topic, that’s the best info I’ve found.
But bear in mind that although the handbook above describes the best recommended practices, many clinicians may practice a little differently, often due to lack of time or training.
For instance, because medical problems often interfere with an older person’s mental capacities, doctors are routinely asked to weigh in. In principle, when asked about someone’s capacity, a doctor should first want to know “Capacity to do what, or decide what?” And then the doctor should write a statement specific to that question, providing documentation supporting his or her conclusions. The doctor should also ideally state whether any incapacity seems likely to be permanent or not.
But that’s not how things often work in the real world. In practice, I’ve often been asked just to say whether an older person “has capacity” with no additional specifications. I’ve also seen many doctors write vague statements saying “Mr. So-and-so has lost his mental capacities.”
How valid are such statements? I suspect it depends on the jurisdiction and the purpose to which the doctor’s note is used. For instance, some people have trusts or other services that require a “doctor’s statement” in order to allow someone else to step in, and these may have different standards compared to the courts.
How to plan ahead to avoid these problems
The very best approach, of course, is for an older person to have previously planned for this situation. By this, I don’t mean simply completing paperwork in order to designate a relative or friend as durable power of attorney for health, and also for finances.
Don’t get me wrong, planning ahead with such power of attorney paperwork is very important and very helpful. (Read more about this here: How to Avoid Problems Due to Aging Incapacity: The (Better) Durable General Power of Attorney.)
However, such power of attorneys don’t quite address the situation that all aging adults should plan for: the possibility that they’ll be cognitively slipping and unable — or unwilling — to admit it and let others assist as needed.
I have only rarely seen older adults prepared for this, even though everyone has a fairly substantial chance of developing Alzheimer’s or another dementia provided they live long enough. (Remember, about 30% of those aged 85+ are cognitively impaired, and it goes up to about 50% of those aged 90+.)
Being a doctor, rather than a lawyer, I’m not qualified to say what constitutes the best preparation. I will say that the better situations that I’ve encountered occurred when an older person had:
- Created a trust,
- Designated a trustee or fiduciary to take over when needed,
- Specified what conditions would trigger trustee take-over, and
- Specified what the care priorities should be in the event that the older person became permanently unable to make decisions.
But again: I am not a lawyer and this is not legal advice. The expert advice consistently is to plan ahead, plan ahead, plan ahead.
To that I would add:
- Hope for the best
- Plan for the likely (eg eventual severe dementia if you’ve been diagnosed with mild dementia)
- Plan for the quite possible (a fall in which you break a hip, eventually developing dementia, etc)
Your father did not plan for this situation. However, as you help him work through the current situation, keep the above planning principles in mind! You’ll almost certainly have more to plan for, especially if he does end up diagnosed with dementia (which means you or someone else will need to make decisions at some point).
If you’d like to learn more about how to talk to your father about your concerns, and how to know when to step in, I cover this in more detail in my free training for families; see below.
As I said at the beginning, this kind of situation is hard to sort through.
It’s messy, and complicated, and stressful, and also tends to bring out whatever family tensions tend to come out when families face problems.
So. If you are worried about an aging father who lives at home alone and might be “incompetent,” you can’t just focus on helping your father. You’ll also have to start equipping yourself to handle what is likely to be a stressful and messy time for the next several months to years. Investing a little time — and possibly a little money — in this will pay off for your father, for you, and for those around you.
The basics of this include making sure you get enough sleep, regular exercise, nutritious food, activities that refresh the soul, and all the other things that are good for humans.
I would also recommend cultivating a mindfulness practice, if you don’t already have one. A variety of free resources are available online, and there are also apps such as Headspace and Calm. The key is to do at least 10 minutes every day. Or for more support, enroll in a mindfulness-based stress reduction course, such as this one.
Last but not least, you’ll need support from friends and family. It’s also usually helpful to get support from others facing similar challenges with aging parents; you can find these in-person and online. You’ll connect with people in similar situations, who will provide helpful suggestions and will completely understand when you need to vent your frustrations.
Good luck!!
This article was first published in 2015. Because I have gotten SO many questions about these types of situations, I wrote a book to walk families through what to do, and it covers the question of incompetence. Learn more here. This article was last reviewed & revised with minor updates in June 2024.
jan keegan ronk says
I am the wife of a person who has this disorder. he is now 82. his children stop coming to see him a number of years ago (daughter 18 years ago and son, who does call, but has not seen his father in 3 years plus) I am 10 years younger. I do have a trust with him that protects mine and his financial interests. we are lucky enough that that is not a problem. however, what is a problem is that my husband is not going for medical tests such as a bone marrow and the family is telling him that is all right. also he gets lost and he forgets who is in the house. his priorities are totally mixed up. he is also refusing to eat food prepared by me and others but will go to restaurants and fast food places all the time. he has had a couple of doctors who tried very hard but his constant screaming at them has left them helpless. what is the next step? I feel like we are living in a vacuum and he is just getting worse. it’s been 18 years that he has advanced through strokes. I am tired and exhausted. he did give me medical power of attorney years ago. how do I enforce this, sending him to the doctor, etc.? I feel that he is very sick. the doctors agree but say they can’t do anything.
Leslie Kernisan, MD MPH says
Sorry to hear of your situation, it sounds difficult or stressful. It’s good that you have power of attorney for health but it’s true, this doesn’t make it particularly easy to get someone to do things for their health when they don’t want to and are in a physical condition to refuse or make it difficult for the health providers to accept your guidance.
If he’s refusing medical care, then it becomes very important to step back and review the overall goals of his medical care with his health providers and probably also with other family members. He sounds impaired but he seems to be expressing a preference to not get care. Probably he doesn’t understand the implications, but before you really try to push him to accept care that will likely upset him in the short-term, you should ask yourself how this would further his overall quality of life, wellbeing, and whatever other goals seem to be important.
Trying to help people live as long as possible is the conventional goal of medical care, but it may no longer be a good fit, given his circumstances. Is it likely he could be treated and get much better? If not, is this the best use of your limited energy, or could you support him in other ways as his memory and thinking continue to decline?
You may want to see if you can arrange a consultation with a geriatrician, or another type of expert with experience counseling dementia caregivers on overseeing medical care. Good luck!
Karen says
Hi,
My dad has been between skilled nursing for physical therapy, he’s a below the knee amputee, he’s also on dialysis which has had a hard affect on his body and mind. He’s been back and forth between hospital and skilled nursing, however this last hospital visit he went into a state where he didn’t talk or feed himself and just cryed, after few days he became combative and needed to be restrained which was just so horrible feeling so helpless. Between the dialisys and now the hospital says baseline dementia we can’t seem to keep him lucid to move him to skilled nursing where we we’re told we have to wait for his mind to get up to his body. And if he continues to be lucid for the next week then we can bring him home. I would be his caregiver and would be home with him all the time, I guess my question is how does a dialysis patient with dementia progress and what to expect and what can I do now to help these episodes of such sadness or the opposite, combativeness, not to resurface for him. To make this the best I possibly can for him.
Leslie Kernisan, MD MPH says
Sorry to hear of your father’s situation.
He may have dementia, but if the issue is that he’s gotten much worse while in the hospital or rehab, I would be concerned about delirium. I have more on that here: Hospital Delirium: What to know & do.
People with pre-existing dementia are especially prone to get delirium in the hospital. They do often improve with time and rest, but it can take a long time and lot of patience. If you read through the article and comments linked to above, that should give you ideas on how to support him. Good luck!
Deborah Rothstein says
So thankful for people like you! I have a mother who is 84 and definitely has some form of dementia that is undiagnosed. My mother has been living in the basement of a two family house with my baby sister who is 53 unmarried with no children living in the apartment upstairs. My mother is in the basement because she is a hoarder and her apartment is packed and unlivable. I’m the second daughter of four and there are three brothers. I have not been happy with her living conditions which have only gotten worse. My sister gone along with whatever my mother wants which means showering maybe once a month, molded or no food in the refrigerator. My sister insists she cooks for her. My mother barely leave the basement other then going to her doctor. She also broke both femur bone about five years ago and never really been the same. Refusing phyical therapy she can barely walk with a walker. The last few weeks my mother has been placed in the hospital for an infection on her foot so bad it went to the bone and she needed surgery to remove part of the bone. I was also told my mother was malnourished when she arrive into the hospital. The problem is my mother is brainwashed by my sister and her other three daughters are unable to know what’s going on because my sister will not communicate with anyone but one of my brothers. I don’t believe my sister is mentally able to do what’s in my mother’s best interest. Along with her excluding my mother’s other children. We found out a day after she was admitted into the hospital.
Everyone but my sister lives out of state. No one was able to get much information from the hospital because my sister has been in charge and we are told to speak to her for any information pertaining to my mother’s health. After three weeks in the hospital she is now being sent to a rehab facility of my sisters choice it is in such a bad neighborhood i am afraid to go there but it’s what is convenient for my sister and it breaks my heart to see my mother there although she wants to be with my sister it’s what she’s use to. If not with my sister she would be in a nursing home. What’s the better of the two evils any advice?
Leslie Kernisan, MD MPH says
Hm, this does sound like a difficult situation. If your mother is malnourished and getting infections while living with your sister, it’s certainly possible that your sister is unable to provide adequate care to her. You could report the situation to the hospital social worker, who is presumably a mandated Adult Protective Services reporter, or you could report it to APS yourself.
It’s true that if APS concludes your sister cannot care for your mother, then other arrangements will have to made, and she could end up in a nursing home. Probably she’d be adequately fed and cared for. Whether her quality of life would be better, and whether that’s in line with her preferences, I can’t say.
Unfortunately, it’s common for families to end up in these difficult situations where all the available options are distressing and involve serious downsides. You will just have to do the best you can and remember, there is almost certainly no perfect or easy solution out there. Good luck and take care!
Vanessa says
How would all this apply to a 74 year old father who lives in an RV (no permanent/stationary home) that is going blind (but still drives his RV from place to place), lives an extremely filthy lifestyle (minimal showering, sweats, etc), can’t take care of his dog properly (not feeding her appropriately & tosses her around & doesn’t hear her pain squealing), won’t accept help, losing his hearing, not making sound decisions regarding large purchases (bought a $10k “new” RV that wasn’t smog checks & had TONS of problems including frame damage) & extremely depressed as some of the issues we’re dealing with regarding him. I feel like he’s out of control & incompetent but he can hold a conversation, rememberers things from his childhood, is able to follow through with his own agendas & gets medical attention. I’m having a hard time trying to figure out if he’s on the line or past it. Any insight would be helpful. Thank you in advance.
Leslie Kernisan, MD MPH says
Well, what you describe does sound concerning, so I’m glad you are paying attention and considering what you might do.
I can’t say whether he is “past the line” or not. I will say that many older adults fall into a “gray area,” in which they are clearly at risk and experiencing some impairment, yet it’s not clear that it’s reached the point at which it’s clear that intervention and/or a declaration of impaired capacity is justified.
As noted in the article, your key resources to consider contacting would be his usual health provider (if he has one), your local area agency on aging, the Adult Protective Services office, and then a professional geriatric social worker or care manager (often effective however often requires paying out of pocket). Significant financial risks, in particular, might trigger action, but so much depends on the agencies and involved individuals where you are. In almost all areas, it takes a lot of work and effort and time trying before progress can be made. Sorry that I cannot offer any definitely successful approaches to try! Good luck!
Connie says
I found many of these things you have listed to be helpful.
My dad is 89 has to use a walker or on good days lean heavily on a cane due to back issues and weakness.
He has a grandson he cannot say no to who takes advantage of him constantly. This nephew is 30 and now has a 6 week old baby that he wants my dad to babysit for a couple hours a day between his and his wife’s work shifts.
I have been cleaning and cooking for him for almost a year now. My dad feels he is capable of taking care of this baby, while climb up on chairs to reach high stuff, even told me recently that he will climb up on the edge of the bath to clean the ceiling. I am not sure if this is true since he seems to mention things he would do 15 to 20 years ago.
I am frightened what could happen to the baby. My nephew, who abuses my dad verbally all the time, nor my dad will listen to reason.
Any advice before something does happen. Again the baby is 6 weeks old and my dad has no idea how to make a bottle, change a diaper or handle her if she becomes fussy.
Leslie Kernisan, MD MPH says
Hm, I can certainly see why you are concerned by this situation. I cannot tell you what to do, I can only offer a few possibilities to think about and consider.
If you are concerned about your father being verbally abused or otherwise abused by your nephew, you could consider calling Adult Protective Services. Not sure they will take action but they are the agency to be called when one suspects or observes elder abuse. I have more on what you can do if you suspect financial exploitation by a relative here:
Financial Exploitation in Aging: What to Know & What to Do
If you are worried about the baby being in an unsafe situation — and it does sound like your father may not be able to provide adequate care for an infant of this age — you can potentially call Child Protective Services. If you’re really uncomfortable with your nephew’s proposal, you could potentially tell him (and the baby’s mother) that based on your long-time observations of your father’s physical and mental abilities, you don’t think it would be safe for the child to be left with him and you’d consider reporting the situation. This might cause your nephew to change his plan.
Good luck!
Just concerned says
We have an aunt on my husbands side who has dementia I think. She has been going on and on about things that happened in the past but recalls them now as if they are recent events. She is saying a lot of hurtful things to everyone in the family and accusing people of trying to kill her even. It’s not true but we don’t know what to do. She has no children. So no one wants to help her because she’s basically destroyed every relationship she has has with her cruel words. I keep reminding people she may have Alzheimer’s or dementia but people are very upset. Again she’s my husbands aunt. So I’m not sure what to do or if my say is even important since I’m not a blood relative. Her brothers do not live nearby and are unwilling to help her as well.
Leslie Kernisan, MD MPH says
This sounds like a difficult situation. If she has become increasingly paranoid and you’ve also noticed her memory and/or thinking getting worse, then it’s certainly possible she’s developing dementia. I have more on causes of late life paranoia here:
6 Causes of Paranoia in Aging & What to Do
I agree it can harder to speak up when one is an in-law. I do think your say is important as you have made important observations and you are advocating for the family to be more understanding and compassionate towards this older woman.
You might find it helpful to contact your local Agency on Aging and/or your local Alzheimer’s association. Perhaps if someone else validated your concerns and told your family members that your husband’s aunt might be mentally impaired, they might view her behavior in a different light and feel more motivated to try helping her. Good luck!
Christi says
My mother is 67 years old, fairly young compared to other’s parents. She is a severe diabetic, legally blind and is severely depressed. She has been living on her own but with a recent trip to the ER due to her blood sugar dropping too low, I was forced to move my 20 year old son in with her to assist in taking care of her. He is not a certified care giver but at least I have eyes and ears in the house with her and he can call someone if something is not right.
I took my mother to the doctor yesterday to get a referral for home health care. We talked about this a couple of weeks ago and she was all for it. In front of the doctor she decides she does not need home health care. She tells the dr. she can care for herself, bathing, cooking and her meds. (She cannot do any of these things on her own) She can bath by her self but doesn’t bath like she should, she goes weeks without bathing, her meds are scattered all on the floor and she does know if she took them or not and she hasn’t cooked for her self in years. I tell the dr. this and my mother calls me a liar and threatens to change her papers. ( I have medical and financial POA on her and I am the sole beneficiary to her will because my brother is deceased). She is over drafting her bank account and does not remember conversations., people coming to visit her and so forth and so on.
I am at my wits end and the only option I see is having her declared incompetent, PLEASE guide me on what I need to do.
Leslie Kernisan, MD MPH says
Her problems do sound concerning. The general approach is as follows. On one hand, you should keep working with the doctor to get her mental capacities assessed. You should let the doctor know that you are concerned about her abilities to manage her affairs. The medical team needs to assess her cognition and also help assess her ability to manage key life functions. We covered these issues in this podcast:
066 – Interview: Addressing Potential Self-Neglect in Older Adults
On another front, you need to find ways to coax your mother into accepting some help from you. This is not easy to do. Insisting that an older person “realize what is wrong” or “realize they need help” is usually counterproductive. It is better to do whatever you can to reinforce the relationship and find more positive ways of getting her to accept help a little at a time. Sometimes families resort to white lies, if they really think their older relative is having memory or thinking problems that interfere with judgment.
All of this is hard to manage if you are stressed and frustrated. So I would recommend finding an online or in-person support group, to get encouragement and ideas. The caregiving forum at Agingcare.com is quite active and many have been through similar situations.
Since she sounds impaired, I’m not sure it would be legally valid if she tried to change her POA. To prevent problems on this front, be sure to collect documentation re her abilities, what her doctors have observed, etc.
Good luck!
Lilia Robberts says
My father has been getting really difficult to help recently. He doesn’t want to go to the doctors, but he really needs more medication to help him with his pains and aches. Thank you for the advice about wording things in a different way to help him go to the doctors. I will make sure, I always let him know that I want to help him. I am also thinking of finding a nice assisted living service. My dad is my priority, but I also need to make sure I am taking time for myself as well.
Leslie Kernisan, MD MPH says
Sorry that your father is getting difficult to help. Yes, I agree that you can help him get more out of his doctor’s visits, but also be sure to take time to yourself, as you mention. Good luck!
Dana Phelps says
Wow, this is so informative. My in-laws just had a visit from APS today. We have no idea who called them but they are blaming us. We have been paying their bills for them online for about 8 months because my mother-in-law kept overdrawing their checking account. It’s not hard to do, they are on a very tight budget with only their Social Security checks for income. They have not had any NSF charges or utilities turned off while we have been helping. In addition, we do their grocery shopping and lawn care for them. This past weekend my mother-in-law threw a fit and told us she no longer wanted us to do this for them (they still owe us about 1/2 of an $800 loan we made them to catch up their mortgage payments). we even tried to persuade them to open a separate account for the bigger SS check (his dad’s), just to draft the fixed bills out of, but they refused when we said my husband’s mom shouldn’t have access to it since she has a habit of pulling money out that isn’t really there. Now APS shows up at their door and they are convinced we did this to them. I didn’t even know this could happen, but it may be a blessing. My father-in-law refuses to bathe (we bought him baby wipes as a last resort), won’t allow us to get him help (although the VA might provide it). They have a poor relationship and he sleeps most of the day to avoid his wife. I could go on and on, but what I need to know now is what will happen now that they are on the radar of APS?
Leslie Kernisan, MD MPH says
So, what you’re describing is not uncommon, but it is indeed stressful for families and everyone involved. Sounds like there are some concerning issues going on. Interesting that you don’t know who called APS. It is actually possible that it was a health provider, as they are mandated reporters in many states.
In terms of what happens next, that is extremely variable. APS offices are locally run, often locally funded, and what they do is determined by their local policies and also state law. You could call your local Area Agency on Aging or even the APS office, and they might be able to tell you more about how the process usually unfolds in that area.
Re Social Security, there is a representative payee program for people who are having difficulty managing their funds appropriately. The SSA website says “If you are concerned that someone you know becomes incapable of managing or directing the management of his or her benefits, please call us at 1-800-772-1213 (TTY 1-800-325-0778) to request an appointment to discuss your concerns. Generally, we look for family or friends to serve as representative payees.” Your husband may want to look into this further.
Otherwise, I would generally recommend avoiding arguing with your in-laws, and trying to instead establish as positive a relationship as possible. When older adults feel heard, understood, and respected, they are more willing to consider accepting at least a little help. Of course, the problem is that adult children are often quite frustrated and stressed out by the situation, plus many have loaded relationships with our parents to begin with. So it’s not so easy to be positive and understanding and validating, but I can tell you that the more confrontational your encounters with your in-laws, the harder things will be.
Good luck, hope things improve soon!
Mary Sue Callaghan says
Great info! Look forward to learning more!
Leslie Kernisan, MD MPH says
Thank you, glad you are finding this helpful!