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she refuses to shower or wash her hair and she doesn't have clean clothing she puts on soiled and wrinkled clothing. she lives with her handicapped son and refused to do anything to help herself or let anyone help her.

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I agree that asking adult protective services to conduct a welfare check is about all that you can do.

As ferris said, being dirty isn't a crime. If the condition is so bad that it affects the disabled son, then they will likely take actions for his sake. If they feel that the sister is in danger, they make take action to protect her but that could mean going to court, which isn't likely.

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Carol
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Unless "your friend" has MPOA/POA over her mother, there is not much she can do. Being dirty is not a crime, and unless she is deemed incompetent by a doctor or courts, she has a right to do as she pleases. Yes, you can make a call to Adult Protective Services which never discloses who called for a "welfare check" and let them visit with her.
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Adult Protective Services should be notified.
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I experience this first hand with my MIL and we all live together. She rarely showers or changes clothes, refuses to wear Depends and says she does not need them but poops and pees herself and her bed. She eats food and leaves it every where. She won't flush toilets when she uses them. She refuses/does not want help from anyone, to shower, to change, to really do anything that pertains directly to her. Tells us that we don't take care of her, she takes care of herself, which is laughable. She'd be in a home if we didn't all live together. We cook, we clean and maintain everything, she does contribute 1/3 of mortgage. She can be ok sometimes but she is usually combative too if you ask or tell her to do anything. That's on top of her constant paranoia and delusions.
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If it was up to my father (vascular dementia), he would never change his clothes or take a shower. It's a combination of not caring and, of course, forgetting. He's very proud, and gets angry if someone challenges him. On the other hand, he is a very affectionate person and loves hugging. I use this as a reason for him to maintain his cleanliness, and when I talk to him in a gentle, humorous tone of voice, it allows him to put his pride aside and do as I suggest. I have to be a bit persistent once he agrees, and that can be challenging - walking with him to his room, pulling out clean clothes and standing outside his closed door, continuously talking to him through the door as he changes and reinforcing that he's doing a wonderful thing - but it's worth it in the end. I offer a lot of positive reinforcement once he's clean and smells great, and then he gets a big hug. Over time, this has become easier. Often, the caregiver needs to put his or her own pride aside, and even if it feels as if you're pleading with someone, at least it allows them to keep their dignity and not feel overwhelmed. Of course, this won't work with everyone! And as noted in the other comments, being dirty is not the worst thing in the world. My favourite part of being a caregiver is the incredible opportunity to learn how to "let go."
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Agree with Ferris1. Adult Protective Services is usually most effective when someone is a danger to themselves or others. If the son is unwilling or unable, maybe guardianship is an option to help get the sister into a place that can support her.
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As the mother of a severly disabled adult son AND the DPOA and daughter of an 89 year old mother - a mother who has dementia and lives in a NH, this is a subject that I spend some time thinking about. I could go on forever about my hopes and fears, about my "plans" - which I've learned take with a grain of salt - John Lennon sings "life is what happens when you're busy making other plans". But most of all I hope that if my plans don't work out or I loose my ability to think rationally before implementing them - I hope someone will care enough about me and my son to remove him from my home if I become unable to care for him.
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Yes indeed I agree. What type of handicap does her son have and how old is he
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Actually while she MAY (and I don't think this is necessarily the case) not have any influence over the sister she probably DOES have influence over the son's welfare and well being. If he is handicapped he is classed as vulnerable automatically as is the sister in actual fact therefore the courts would probably act to serve as guardians (or whatever the term is in the states) and act to protect and safeguard them both. It isn't a crime but it IS a safeguarding issue particularly as if she has dementia then she is clearly losing capacity.

You do say that your friend in caring for her - in what way? As a carer especially if she is getting remuneration there will be obligations that go along with the duty of care I would have thought but the USA people will know more than I on this one. In the UK there is a duty placed on a crew to act in the best interests of their clients and to address concerns over health (hygiene would be included in that sphere)
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Sorry, I guess what I was trying to say above is clearly and unfortunately this is par for the course for some of the more stubborn dementia patients.
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