My half brother still lives in his own home, he is not able to pay his bills in a timely fashion, refuses to go to a doctor, even if the appointment is made by his daughter and he has a paid Uber ride to the office. He is extremely paranoid and combative. He lives in Nevada and I live in Washington, his daughter lives in California. Neither of us is able to help him, as if he would actually let us - too paranoid to even let me write the checks for him. I am the trustee of his trust but that is only financial and only if I get a doctor to sign off that he has "mental incapacity." We are worried that he could be robbed or worse hurt when he is out wandering around. The police are no help, and the social workers just check to see if the house is clean and there is food in the refrigerator. What can we do short of filing for guardianship (which needs a letter from a doctor, which we can not get if he does not go to a doctor).
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Thankfully he is using Uber, one less thing to stress about, him driving, yikes!
Unfortunately or fortunately, American citizens have the right to live autonomously until they become a danger to themselves or others. And that means something different to those that love them vs the law and the law carries the power.
It sounds like you are waiting for the train wreck. Been there, done that. So, my encouragement to you, stand out of the way of the obvious train wreck, stay in touch with your brother and niece, love him through it and help your niece with the resources available to help her help him as legal next of kin, when the crash occurs.
It is a sucky place to be, however, many here are or have been standing in your shoes.
Just FYI, ONLY a judge, in a court of law, has the authority to declare a person as incompetent, doesn't matter what anyone says, that's the only route to gain authority over another adult.
Is it time for the legal next of kin to request guardianship? This is something an attorney can help with.
Prayers that the crash isn't fatal for anyone.
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Call APS.
Neither you nor other family--admittedly--can do anything here.
If APS visits and says he is competent then there is little you can do until you get the call that he is dead or hospitalized.
If he truly has dementia and is alone, then he is a senior at risk and needs reporting so that the state can assume guardianship and place him or manage his care. If they refuse he is on his own. People die in neglect and all alone every day because of poor decisions, alcoholism, mental illness, dementia.
You can only do what you can do.