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My grandmother has always been a battle axe, but now it's working against her. Efforts to convince her of the need, and tips or tools to help her remember that she needs to keep up on her hygiene and cleanliness have not been successful. Hired help to provide her meals or clean her house are met with refusal at best, violence at the worst. Its been like this for about 5 years and now her mental and physical health have declined so much that her home must be hazardous to her health, let alone anyone else unfortunate enough to have to go inside.


My sister, who has been away and hasn't seen the gradual decline was in for quite a shock. She now is accusing my father (my grandmother's son) of criminal neglect. He is the only family member who lives in the state with my grandmother, but as far as I know holds no legal authority to force my grandmother to accept others into her home to clean and maintain it, and as far as I know he hasn't been legally designated as her caregiver. To be sure, my father is aware of the situation, and the situation could certainly be seen as harmful to my grandmother, so it could meet some of the definition of elderly neglect, but he hasn't the time, money or ability to do much about it other than what my grandmother allows. Is this really a case of criminal neglect by a caregiver?


Can you be saddled as a caregiver without knowing the ramifications, without accepting the responsibility, and against the will of the recipient of the care, simply because you tried and failed to help, or because your positionin the family puts you closest to the person in a deplorable situation? It seems to me at this point that my father would need some legal framework to gain the authority his mother and allow him to force the hygiene, cleaning and maintenance needed to get her back to healthy and decent living conditions before he could be accused of neglect.


Web searches on this topic have not been helpful. Prior to your site they were all dead ends with lawyers promoting cases against nursing homes or definitions of neglect and hardships of caregivers without explanation of how one becomes legally responsible (willingly or unwillingly) in a situation where the recipient actively refuses care. Your site seems helpful however, could you point me in the right direction or reccomend better search phrases to get to the process or circumstances by which someone becomes responsible and what powers they can wield to act to ensure the welfare of their ward?

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You say your father "lives in the state" with her, so apparently not in her house. If he has not been legally named as his mother's PoA, or her guardian, he has no power to do anything. if her living conditions are bad, or she is a danger to herself or others, anyone can call social services and report her as a vulnerable adult. Your family can pursue legal guardianship over her if it can be proven that she is cognitively incapacitated and you want to spend the considerable time and money to do so. Then that guardian could force her to do whatever is in her best interest. Guardianship process varies from state to state.

Otherwise, the county can start dealing with her and they might pursue guardianship. This would be mean that the family would have very little to no say in what happens to her. They would choose a facility for her and take control of her assets, if she has any, and not reveal anything to you from that point on. But, she would be cared for and not degrading in her house by herself. I hope this gives you some clarity.
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I have no knowledge of law...sorry but a sister who 'self neglects' due to intellectial disability, mental illness & stroke.

As told to me by numerous Doctors, she has the right to live as she chooses. This includes choosing not to bathe, unhygiene environment, unhealthy diet & risky behaviour. May also include not taking prescribed medication. One Doctor called it "the right to rot".

All people have this right who are deemed to have capacity to decide. It is assumed that everyone has capacity unless proved otherwise. If proved otherwise, a guardian needs to be appointed. The guardian could be held accoutable for neglect (would be laws surrounding this).

Would your Grandmother go see her Doctor & agree to a cognitive evaluation? (I'm guessing he77 no).

After a fall, I informed the hospital of my sister's precarious home situation. It is ok at present (just) & she did return home alone - this time. But Social Workers have a file now. Each admission gets closer to not being safe to discharge home.

Unfortunately many on this website are *awaiting the fall* or other medical crises that will be the game changer. Your Dad may be awaiting this too.
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No, your father is not criminally liable for your Grandmother's choices to refuse care, treatment, evaluation, help or placement.
More importantly he nor anyone else cannot be MADE to assume care of your grandmother. Given her tendencies, I in fact would recommend that he not do so.

Had this been me, had this been MY mother, I would have called Adult Protective Services and reported that my mother was, in my own assessment in so far as I could MAKE any assessment, not mentally well and living in dangerous circumstances. Then it would have been up to APS to open a case file on her. They would almost certainly have reported back to your father that she was unsafe, needed evaluation, and that he should "apply for guardianship". If this were to occur I would REFUSE TO APPLY for GUARDIANSHIP. That would mean that APS would go to the Courts and a guardian would be appointed. This person would then be responsible to get grandma evaluated and safely placed, to empty and dispose of her home, to evaluate her assets and sell them for the cost of her care, then apply to medicaid when assets are gone. Your father nor anyone else would be able to handle Grandmother's care nor her assets.
This would mean that your father and other family members would have NO SAY in what happens as to Grandma as they have "washed their hands of it". To my mind easier than trying to deal with grandma. Not everyone is up to being a guardian for another unwilling and ill person. I am not. I know my limitations.
But in short, your father is not criminally liable, and what he says to any asking is that "I offered my help to my mother and she would not allow me to help her; I have not known what to do with her or about her. They will tell him that he should have called Adult Protective Services. He can reply "thank you for letting me know that".
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Just my opinion, I think Dad needs to call Adult Protection Services and tell them he has tried to help his mother and she refuses it. That he feels she and her situation needs to be evaluated for her safety. This way, it on the record that he called. APS will evaluate and determine if she can stay on her own. If they find there is nothing they can do, she can live the way she wants then Dad is off the hook.

I just want to say that unless a person is proven incompetent, a POA cannot be used. There are those that are in effect at time of being drawn up. Others not till the person can no longer make informed decisions.
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worriedinCali Oct 2019
A POA can absolutely be used before a person is proved incompetent.
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These issues are all up to state law. Look in Findlaw for your state and plug in "elder neglect." That said, I have never heard of a case where someone who was not a live-in caregiver was found guilty of neglect, and even that only happens when something serious happens, usually the disabled person dies of malnutrition or some easily preventable illness. I doubt your sister would have any standing to file a complaint in any event or that the authorities would open an investigation based on her complaints.

Why don't you suggest to your sister that if she wants to be helpful, she should file for guardianship of your grandmother? This strikes me as your type of situation where somebody points the finger wanting somebody else to take responsibility, while taking no responsibility themselves.
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AlvaDeer Oct 2019
Amen on this idea with Sister.
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drhart,
After much confusion on this thread I still believe that IF you never were the guardian, never did live with a person, never had the person live with you, never were POA or caregiver for a person, do not have any proof a person is adjudged incompetent, that you cannot be help criminally liable for not caring for a person who is refusing your care. If all the aforementioned are in fact A FACT, I might place money on it.
However, many here feel your father could be prosecuted. So ask a lawyer. It's the safest way. And I would love to know what he or she says.
As to Sister, I suggest she assume POA and guardianship of Grandma. It sounds they may be a match.
Again. No one has judged this woman incompetent.
This woman has refused all care.
No one has POA for this woman. No one lives with this woman.
This woman lives with no one. No one has guardianship for this woman.
This woman is free to make her own choices and decisions unless APS says that she is NOT. In which case I highly suggest court guardianship for her, and wish the court much luck ongoing.
As I wish you. Sure do hope you will update us.
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PowerOf3 Oct 2019
I’d say you nailed it Alva. I see nothing but someone saying “he lives closer and isn’t caring for her” I cannot imagine he be liable for anything whatsoever.
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I read so many times, about the struggles so many have with family members who refuse to have in home help, refuse to move to an in care facility, refuse to do any of their ADLs, etc and they are always told, get poa or worse, guardianship...then they can force the person to get help......but even if someone, anyone, including the state, has guardianship, how would they physically handle getting the person out of the house, make the person take a shower, any of the things that the family has been trying, sometimes for years, to get them to do.
just so easy to say, get guardianship then you can force the person into compliance.....my question is how do you physically do this?..
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disgustedtoo Oct 2019
You can't. Even with POA you cannot force someone to do anything.

When mom developed dementia and was living alone, we tried bringing in help, more a sanity/med check, just 1 hr/day and within a short time she refused to let them in. Plan B was to have her move. Brothers suggested moving in with them. Nope. AL - paugh wouldn't live in one of those places (BTW, AL was in her plans before dementia kicked in!) Our EC attorney told us we can't force her to move, despite having all the POAs in the world. He suggested guardianship. The facility we choose said they wouldn't accept her then. Great. We had to resort to some "trickery" to facilitate the move.

But, as you say, even if you have ALL the power in the world, how does that get the person to move or comply with anything? IF it doesn't involve dementia, but facility care is needed for other reasons, you *might* be able to reason with the person and/or show the paperwork saying it has to happen per the law, but with dementia???

I also stress to others when they suggest getting POA (if it isn't already too late) that this doesn't change anything. It is better to have it, for other reasons, but it doesn't give you absolute power over anyone. The staff at mom's MC facility even told me that ALL the residents still have rights, including the right to refuse whatever it is they need or should be doing (taking meds, a bath/shower, medical treatment, etc.) They just have to keep at it to find a way to coax the person into doing whatever it is that is needed.

So, unless you are part of the SkyWalker family, you can't 'Use the Force.'
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Geaton777—Even if the facts happened as in your last paragraph, about someone being placed as guardian, APS involved, how could the person be forced to accept care, forced to take a shower, etc....how would this physically be handled if the grandmother flat out refuses to budge? We all read the questions and replies, get APS involved, get guardianship, but still, how is the care physically forced? I know there are many out there in this situation....
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Beatty Oct 2019
I suppose the natural consequence of not eating well or drinking enough will eventually cause dehydration, weakness & falls.

Then bed washes by care staff or family when too weak to protest?
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No, there is no legal responsibility here. If you are concerned about your Grandmother you should call APS. They will do a welfare check and find possible solutions to help your Grandma.
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Michigan has recently initiated a task force against elder exploitation and abuse but I cannot find any cases where seemingly innocent people were wrongly prosecuted. The article Tacy mentions is about charges that resulted from a Genesee County (Flint) task force assigned to crack down on elder abuse. The task force was formed in 2007. The article mentioned 4-5 cases and leaves out a lot of detail.

The most ambiguous case was about a man who had neglected his elderly mother to the point where she had wasted to 63 pounds and her body was covered with fecal matter and bed sores. In that case, it wasn't clear to me from what I read whether the son was intending abuse or whether he was mentally ill himself and just overwhelmed with the care, but the mother died. He was charged with manslaughter, served less than a year, and was recently arrested on a new charges because he was acting as a live in caregiver for his cousin and their home was found in filth with rodents, maggots, etc.

The other cases are clear cut cases of financial exploitation or criminal neglect by people who agreed to be caregivers.

Below is a link to the 17 year old's story from Michigan. The brothers were self-proclaimed caregivers to the grand-dad and were arrested after getting into a fist fight over their grandpa's pain drugs on their front yard, and had not administered his insulin in over a week. The police were concerned because the elderly man was delirious. In this case, the brothers were neglecting the old man. I can see how it was too much for them and wonder who thought it was ok to dump that responsibility on such young people. But it's not like the police showed up because some busybody called APS.
https://www.mlive.com/news/flint/2009/06/flint_brothers_charged_in_elde.html

Elder abuse laws are written to prevent/punish the physical abuse and financial exploitation of the elderly. Neglect and abandonment laws tend to be more ambiguous but usually have three components: a person accepting responsibility for a vulnerable person's care, then either failing to administer food, meds, etc. or leaving that person, and failing to provide a contingency. In most states, intent is specified and typically charges are brought against facilities and paid caregivers, rarely family caregivers although some states are more aggressive apparently than others.

The situation the original poster described is not considered neglect in most states. The OP should check laws in her own state to be clear. There is a potential for the laws to be enforced carelessly so it's good to be vigilant. But it's also important to read the laws and not alarm people who are already stressed.

Link to article below. I recommend searching the names of those charged because there are more detailed articles elsewhere describing the accusations.
https://www.mlive.com/news/flint/2011/02/elder_abuse_cases_bring_big_ch.html
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mstrbill Oct 2019
Thank you, helpful information.
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Search phrases: Geriatric care manager. Senior move specialist.
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Most states would call this "self-neglect" and probably wouldn't hold you or your dad responsible. If gram does not have the mental capacity to make decisions, then she is a risk to herself. It seems her behavior suggests that she is harming herself by not getting hygiene or home help completed.

Try calling the local police or department on aging in her area for an assessment of her situation. She may need somebody with the force of the law behind them to get her into more hygienic environment, She may need to be medicated against her wishes or placed on a locked memory care unit that treats behavioral issues to get this changed around.
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I'm addressing the responses to Tacy's Oct. 20 post, here in the main column just b/c it's easier to follow.

I haven't done the research anyone else has, but there was a case in Macomb County of egregious abuse.   It involved apparently unqualified private sector intervention if not interferences, private so-called homes for elders, and abusive and unqualified guardians, as well as apparent judicial malfeasance.

https://www.wxyz.com/news/local-news/investigations/michigan-ag-opens-investigation-into-macomb-co-probate-case-following-7-action-news-report

I haven't followed it after becoming very upset and angry that the legal system could be distorted, abused and compromised by these irresponsible, greedy people,  This case really made me sick to my stomach, and very angry.   And it provoked anxiety and fear that this could happen to anyone, including to us.

My thoughts were that the legal system needs to step up and put these people in jail where they belong.  And that includes the judge who apparently wasn't adhering to the standards of judicial conduct, or of impartiality.

The birth family was if I understand correctly, literally pushed out of the care circle, but had it not been for their perseverance, this blight on the elder care system in this area might not have been exposed.

And although I have no proof, I suspect that this kind of takeover was nascent when I cared for my father.    Some meddlers had decided to assess him themselves and advise me on what they had observed, after they had also walked back on their so-called church's commitment to help with his care (their offer, not mine; I wanted nothing to do with them.)

After this tragedy, I can understand why Michigan's legal system might be overly aggressive.
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rovana Oct 2019
Thanks for your post - I was confused by Tacy's post - is it possible that someone who had no legal power over a person, who was refusing help, could be prosecuted? I mean, what are they supposed to do here, knock grannie unconscious, bathe her, clean her house against her will.  Wouldn't this be assault?  Somehow it does not make sense to me.  Michigan is still part of the US, right?
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If your dad has no authority then he can't do anything - nobody can force someone, who has not be formally declared incompetent, to do anything - this includes keeping the house & body clean - unless the health board issues a clean up order or the house will be declared unfit for human habitation .... but it needs to be really bad for this to happen otherwise there wouldn't be TV shows about hoarders

Your dad can't be charged with elder abuse if your grandmother won't allow him to do anything - if he was an official caregiver that's another thing but it doesn't seem that he is - if worse came to worse your grandmother could have him arrested for trying to do a clean up against her wishes

Your dad could only be charged if as an official caregiver he with-held money, food, medicine or if he was actively harming her financially, emotionally or physically - from what you say the only person who is harming grannie is herself & being stupid isn't illegal
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I don't know why you couldn't call APS (adult protective services) and tell them that your grandma is living in deplorable conditions and is no longer able to care for herself, nor will she allow anyone else to intervene.  Explain how your dad has attempted without success.  They will send someone out to assess the situation.  Be prepared that she may become a ward of the state and placed in a nursing home.

If your dad had your grandma in his house and was allowing her to not be kept up...bathed, fed...whatever, then he could be liable, but since she is living on her own, I don't know how they can hold anyone else responsible.
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dads1caregiver Oct 2019
You are right that you can call APS. But, family members need to be ready to take responsibility or give up the responsibility of their loved one. If responsibility is given up, they may never get to see the person again. Some states cut off ALL rights to even visit or see loved one, if they are put in an assisted home.
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From https://www.agingcare.com/articles/the-hidden-dangers-of-elder-self-neglect-146760.htm
(follow the link to read the whole article)

"Some even resort to filing reports with social services agencies like APS to get their loved ones help. This can be an effective intervention if APS follows up on the report, conducts an investigation, and confirms that the elder is at risk and requires assistance, but this is not always a guaranteed solution. Typically, elders have the choice to accept or reject the services and supports offered to them."

and

"Sadly, as their situation deteriorates, it may take more than one APS report, a major medical setback or some other kind of emergency to instigate a full intervention and get a self-neglecting elder the help they need."

While a call to APS might do nothing, at best it gets YOUR report on file somewhere. I have read too many times how APS lets people fall through the cracks (same as for kids in need/peril.)

I would stress the facts that grannie doesn't live with anyone, REFUSES help from anyone and that no one has any kind of legal authority over her as well as providing as many details as possible about what she is neglecting in her own care.
I would also follow up my call with a certified return-receipt letter documenting the above and what the conditions are.

As for finger-pointing sister, if she is so worried about grannie, why doesn't SHE step up and do something? Does her finger-pointing somehow absolve her of any responsibility? No? You can try to enlighten her about everything that has been tried and how grannie refuses to the point of violence, but I wouldn't hold my breath that she will listen, accept or understand any of it. People like that are close-minded.

I would suggest that dad call APS (followed up with a letter) asap to report the situation (absolutely asap in case nosy sister decides to report HIM for failing his "duty.") If possible, would those who were hired to help and were blocked from doing what they were hired to do be willing to make a statement to the fact(s)? Hopefully dad has receipts to show he has tried to send help over. This can be used to show APS he had tried everything to no avail.
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https://elder.findlaw.com/elder-abuse/adult-protective-services-what-you-need-to-know.html
Near the bottom of this article is an APS locator (OP doesn't list area grannie lives in.)
Also, when reporting the situation, make it clear that it is SELF-neglect along with refusing any help and that she is vulnerable.

If she refused the hired help (or tried to toss them out), one would wish to be a fly on the wall to see how well this poor APS rep handles trying to "develop a relationship of trust" with grannie, given they are trained to do this! On one level it would be sad, but on another, a video of this given to your sister *might* knock some sense into her.
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Although an agent as a POA is responsible for certain decisions, there is no one person who is obligated to provide care.
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Thank you everyone for your help so far, there has been some really helpful information here.

This is the path we're pursuing in the near future:

This is not a criminal neglect situation, we were able to prove this to my sister from your help here. It is most definitely self neglect. Since APS farms out self neglect to local agencies, we'll be calling them to do an assessment. We'll request an inclusion of competency in the assessment. We'll file multiple reports if need be, and follow with written letters with certified-receipt verification.

If APS determines she's competent, there's not much we can do, hopefully grandma sees the light, unlikely though. If they determine she's not competent, we'll have to cross the next bridge - who wants to be legal guardian.

The home grandma lives in is half hers, half her brothers, and she's destroyed it. I'm not even sure a haz mat team can clean it well enough. Hopefully her brother's heirs don't come after us for their loss. But that's for another day.
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disgustedtoo Oct 2019
"This is not a criminal neglect situation, we were able to prove this to my sister from your help here. It is most definitely self neglect."

TWO good bits of news! We here wouldn't likely be among those who think it is neglect, but it is great to get that out of the way! Even better is getting sister convinced. Some family members (and others) just don't want to listen and their mind is set in concrete!

Hope that APS can make some headway. It might be best, if they decide she needs guardianship, to let the state take over. Unless they can find a way to manage her behavior, getting APS on board and having her placed won't make this task any easier.

Perhaps getting conservatorship (managing financials, etc) but not guardianshipmight work. Not sure if those can be split or if anyone in the family even wants to tackle it. None of this is for the faint-hearted! The biggest issue with state taking over is that none of you will have any input to her care, finances and placement.

Consult with EC attorney might be advised, if any of you do want to take on oversight of her care. They can explain all the pros and cons, and answer a lot of questions you will likely have (best to do this while she is being evaluated.)
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A lot of people are saddled as you put it simply by being the only person around and being willing to assist. If father doesn't wish to be responsible, and there is absolutely no reason why he should be, it is a choice issue then see and elder lawyer about having a state/court guardian appointed - she will probably be put into care home as obviously unable to look after herself.
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Wow, this is all crazy to me. I feel like I’m putting myself in a bind caring for my godfather while I have stepped out considerably especially since he’s made nearly full recovery. Seems to me there’s a fine line between assisting and abusing if I were to force him to shower?
He has now cancelled the last of the help I setup, caregivers, prepared meal delivery, life alert button... all of it. I have no poa nor guardianship. So until he becomes a risk to himself I’m not sure what to do. I’m in California so who knows what would happen. Is there a legal way to rescind being a volunteer caregiver? I want as far away from this as possible now. Jiminy Crickets!!!!!
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disgustedtoo Oct 2019
No dementia, per your profile, so not likely that you would be able to get guardianship even if you wanted it. POA would have to be granted to you from him. If he isn't willing, forget that!

IF he was willing to set you up as his POA, understand that POA doesn't give you power over him, just the ability to make some decisions, handle finances, sign paperwork for him. Sometimes even guardianship is partial (see Babs75 postings!) So, it wouldn't change his ability to cancel/refuse. If he is considered of sound mind, he can refuse anything and everything you try to do (and perhaps even APS offers.)

If you really feel this man is a danger to himself, you could contact APS, explain the situation, your concerns about his health and safety, and the refusal of services/help. They should make contact with him and assess the situation. Depending on their findings, it may change nothing, but at least he would be "in the system." Stress that you cannot provide any more help (you are not a blood relation, so I don't see how they could even try to force it on you!)

Since you have no blood ties, were merely trying to help and had no care-giver agreement, I don't think you would need to rescind anything. You could follow up contact with APS with a return receipt certified letter (provides you with proof they received it) stating the issues again and that you are not related to this man and are not in a position to offer any more assistance (stating also that what help you tried to provide has been refused as well.)

You can lead a horse to water...

(Does this man have any family, immediate or not? APS should be notified of family if he has any, or told he has no family.)
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I know of 2 choices: petition the court for guardianship - if care giving with legal authority over the person desired. You will be accountable to the court for her care and finances.
Otherwise, I believe you are probably legally obligated to report her situation to Adult Protective Services.
Hope this helps!
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You aren't responsible for your parents unless they give you the authority to be their POA or health care agent. Can't have responsibility without authority.

Search for eldercare lawyer in your area. Most lawyers will give you a 30 minute consultation for no charge.
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This post is from Oct. and OP hasn't responded since Oct. 22.
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