Caring for an elderly couple and wife is deteriorating fast. Should I call APS?

Unless you are witnessing abuse I don't think APS is going to be interested - I imagine the husband has POA for his wife so since you say he is "perfectly normal" it is well within his authority to determine whether or not to choose palliative care or hospice, and she has been seen by doctors and nurses at the hospital who are mandated reporters if they felt there had been a need.

I want to add that people have the right to make medical decisions that you or I wouldn't agree with, even ones that might cause pain or suffering. As a paid caregiver you must be able to go along with those choices, if you can't then it might be better to let someone else step in.

Your heart is in the right place. My two cents are that if you are working with an agency, to bring the situation to the attention of your supervisor or manager. However, do not stop there, follow up with your agency staff to make sure steps are being taken to address what you have unearth. On the other hand if you are working privately, I concur with Grandma1954, involving other family member might be very helpful. Be gentle, loving but firm about a course of action you want to see taken. Legally, you are obligated to notify the authority because it can be interpreted as negligence or abuse for failing to report your concerns. Hope this helps

I'd start with talking to family, then doctor, then APS if no action.

But where's the hospital? The woman has been in hospital multiple times in last 2 months. I'm assuming that she's a Medicare patient. Hospitalized are penalized if patients are readmitted within short periods of time with the same diagnoses. She should be getting home health nurse visits at least weekly. Where are those who should be helping this woman?

Before you take a very drastic step like this, you need to contact any available family members and tell them what’s going on. Are you aware if anyone has POA or guardianship over either of them? That’s who needs to be contacted before APS. From what you wrote, this woman has health problems. APS deals with abuse and/or neglect. Medical issues aren’t really their concern. I would not hesitate to call 911 when she has a seizure. Don’t let the husband tell you not to call. If you don’t call and something happens, it could not go well for you. At some point, her family will realize they need to do something.

Do you accompany her to the doctor’s? Next time, ask for a family member to go with you. As “just” a caregiver, you do not have the power to make medical decisions. If you aren’t on the HIPPA (privacy act) form, the doctor can’t even discuss her condition with you.

Who pays you? Speak with that person. Or, if you are employed by an agency, go to your supervisor. If you are privately employed and have no luck making voice contact with their family, find an address for the person who pays you and send a registered letter. Tell them your lady is declining rapidly and you feel she either needs Palliative Care or even Hospice. Share this with the doctor as well. Leave it to the doctor to make the first contact, it share everything you’ve observed. If

I am sure that you have talked to husband about the purpose of palliative care, but he probably doesn't get it. That is not 'perfectly normal'. Does he think it would shorten her life? Does he not accept that she is deteriorating and will die eventually? Would he feel he is losing control of the situation? Are there financial issues involved?

It might be helpful to talk to the palliative care agency yourself about the situation - they will surely have had experience in similar situations and may have good suggestions. Even some printed material from them might be a help.

If you think husband is losing patience with you bringing this up, can you find someone else to do it? If finding 'family' is too hard, perhaps a letter to her doctor could explain what you are seeing and the difficulty in dealing with it. The doctor can't talk to you about it, but it could alter what questions they ask and what they actually see. You could even make the letter anonymous if necessary. But Ahmijoy is right - you don't want to appear to be talking about abuse and neglect.

Good luck!

Personally I would never tell anyone not to call APS if they are worried, perhaps with the proviso that at first they do so in confidence and without naming names. The worst that can happen is nothing at all, and it can be helpful in terms of getting advice and putting a potentially vulnerable client on their radar; so why wouldn't you?

That said, it doesn't sound like the right step in this poster's situation. The elderly lady is already under close supervision from healthcare professionals, for one thing; and for another it would be better to think specifically about what additional care is needed.

What is not being done for her at the moment that you would like to see done? What has the husband got against her being assessed for palliative care? A rose by any name would smell as sweet - rather than pushing the whole package, concentrate on particular tasks and see if you can get him to accept more help with those.

Well, first as people have said, involve the family. And the doctor. If she had been taken to the doctor multiple times to try to figure out what is going on, and she has been brought to the ED, then it is not neglect. He may be thinking palliative care is same as hospice and means she will die. So he says no so she does not die? Maybe you tell the husband that you are going to set up a consultation with a palliative care provider so that he can hear about it. He may be competent to make this decision for her but he needs to make it as an informed decision.

Call your supervisor and tell them what you know. Give it a week and then go above your supervisor. Give it five days. If there is no improvement or logical reason than go to the authorities. If it's a life and death situation call 9-1-1.

No You would not be wrong to call for help for this por Elderly Lady Who is obviously suffering. Ring The Adult Protective Services in Your area immediately to get relief for this Lady. As Carer it is Your duty to seek help for the Person or Persons Who You Care if They are suffering or in distress.

You could call her Doctors office and and inform them of the situation. Suggest the Doctor insist on seeing her within a few days for so. That will get oversight on her when she cannot go to the appointment due to her ill health.