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At what point will city, county and/or state agencies step in and force a single, elderly and medically disabled woman who is not able to care for herself and who is currently displaced due to a building fire that destroyed her apartment building, to either accept to move and live in an available/approved Section 8 HUD apartment that is outside the country where her apartment used to be or move to a nursing home?
In this scenario, the woman is 65 and lives off her social security benefits and Section 8 HUD support to pay for all her expenses including the 55-plus community apartment she had lived in for more than a decade prior to the fire in Nov. 2016. In this scenario, the woman has no friends or family living in the state of NY where she is located. The closest adult child lives more than 3,000 miles away and none of this woman’s children are able to provide her the care she needs in their homes. Additionally, the woman is not medically cleared to travel on an airplane and it is unknown what other form of transportation would be suitable to transport the woman from the East to West Coast given her medical condition and poor health. In this scenario, the woman is very adamant about making 100% of the decisions regarding her health and where she lives, and will not accept any reasonable short or long-term solution that is not 100% what she wants. In this scenario, the woman has consistently refused trusted counsel from family, friends, medical professionals and volunteers from helping agencies, etc., who have all tried an infinite amount of times in-person, on the phone, video webcam, etc., to get her to make the right and best choice for herself and the level of care she needs, but all this communication has proved futile for more than two decades.
Since the fire in Nov. 2016, a person and/or organization stepped up and provided her temporary refuge/shelter at a local religious retreat through Dec. 31, 2016, and went as far to extend her stay a week or two, hoping she would have secured new Section 8 HUD approved/funded living accommodations; however, this did not happen, and when she went back into the hospital for medical treatment, her belongings were boxed up and she was told to have someone come and pick them up as they were not going to allow her to come back. Currently, she was released from the hospital to a rehab center; however, this is not fixing the current ongoing situation for this woman. She needs a new place to live. It sounds like a pretty simple process of submitting necessary Section 8 HUD paperwork and finding an approved apartment that meets her needs; however, nothing when it comes to this woman is every easy. She is adamant about staying in the county where she has lived for the better part of the last two decades and out-right refuses to accept to live outside the county, period dot, or inside the county if it means living in a nursing home of any kind, period dot. She will only accept to move and live in an approved Section 8 HUD apartment if it is located in the county where her hospital is located and services. She has and continues to refuse to accept and move outside the county to an approved Section 8 HUD apartment that meets all her needs. She also refuses, regardless of how short or long her stay might be until a Section 8 HUD approved apartment that meets her needs in the county becomes available, to move to any kind of nursing home as she repeatedly states these kind of places is where people go to die and that the cleanliness and professionalism of some of the people who work in them is unacceptable.
In this scenario, her children have no legal grounds/rights to force her to do anything she doesn’t want to, nor do they have the financial ability to pay for such legal services, nor do they want to take such legal actions either as such a trial would likely cause her to go into cardiac arrest and die during the trial due to her current health condition. What actions can city, county or state agencies or medical professionals take to force her to either move to an approved Section 8 HUD apartment outside the county and/or move to a nursing home until a Section 8 HUD approved apartment opens back up in the county where she wants to live? The word “force” is used because to get her to do anything she does not want or like, will require someone to legally “force” her to do it. Surprising enough, the children of the woman had contacted the area hospital and various family law attorneys in the county or adjacent counties where the woman has lived and none of them will return phone calls. Naturally, this posting is a condensed version of the entire story due to website limitations and am appreciative of any dialog you can provide which may shine a light on how this is likely to play out for this woman.

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Extremely frustrating, yes!

As a calming exercise, try this thought. This lady is exercising her autonomy. Fine. The flip side of that for her is that she is insisting that her problems are her problems. Fine. Then let her propose, identify and implement the solutions. All you can do is point out to her the jeopardy: if she fails to do so by the deadlines which exist in this cruel material world, and still declines to choose from the range of valid options offered to her by others, then on her legitimate eviction from rehab she will bodily be carried to whichever location the state deems most appropriate, and tough.

Essentially, it's this. The lady is insisting that this is her problem. So let it be her problem.
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Oh dear. This is a painful situation, isn't it? I can't speak to the legal question; I hope others here can.

How are her cognitive abilities, besides being stubborn and unrealistic?

Does anyone have healthcare POA?

Her apartment burned down. Did the other residents all find new places? Do you know if they had to go out of the county?

How long are the waiting lists for the HUD apartments in her county. Obviously no one can predict that exactly, but do the administrators say "a list this size usually takes about 6 months to clear" or a year or two years, etc.

Even if she were paying for this out of her own pocket, if there are no suitable apartments available, there are non available. Does she expect them to evict someone so she can have their apartment? What is her idea for making what she wants happen (aside from demanding it)? This kind of reasoning process may get to the question of her competence to make decisions for herself.

Competent adults are allowed to make decisions for themselves, even very bad decisions. But making impossible decisions makes one question her competence. When only two choices are possible, insisting on a third choice does not sound like a decision coming from a sound mind. Has she shown other signs of cognitive problems over the years?

This is so sad. She is so young to have such problems! Please keep us updated on how this works out.
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If she accepts a nh or all placement voluntarily, she can leave when she wants. If she's placed by the courts, under guardianship, then she won't have a say-so.
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I think that you are correct, that the county or the state will try to find her incompetent, assume guardianship and make a forced placement.
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I like CMs thought. Another is, you (or whoever has taken on the thankless task of dealing with her) can give a forced choice. I.e.," Sadie, there are two alternatives, you can go to HUD senior housing in Columbia county or you can be declared a ward of Putnam county and they will have right to decide where you live." And id Sadie says, oh, but I want to live only in Putnam county, the answer is "that's not one of the choices, Sadie". Make sure that the choices are viable, available and doable. If she can't or won't make this kind of clearcut choice that you can help her with, then she's probably beyond your ability to help.
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This woman needs 8 hours of one-on-one assistance each day, and she stays in bed although she does have an electric wheelchair? That really sounds like nursing home level of care to me. Even aside from the loss of her apartment, I wonder if placement in a care center would have been better than the cycle of hospitals and rehabs and home she experienced.

I really feel sorry for this lady. She did not ask for these problems.

But if there is only spaghetti or roast beef in the kitchen you can't insist on a chicken pot pie. No matter how much people would like to please you they cannot repeal the laws of physical matter.
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If she's still mentally competent people have the right to refuse treatment. Now cops or Social Worker (with a Master's degree) or doctor can Baker Act a person and their competency will be assessed. If a person is mentally competent they still have rights.
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Suggest to rehab to discharge her to a hotel/motel that accepts longer term guests until her apartment opens up. A social worker at rehab may be able to arrange for payment of the hotel fees based upon being displaced by the fire. Call the Red Cross and/or United way.
Have all available resources/caregivers, PT, and nurses visit her at the hotel.
Sorry, that's all I got.
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You might consider contacting the local Area Agency on Aging and, if this qualifies as self-neglect, the always overburdened Adult Protective Services.
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Well CarmelNY...seems you've come to the answer yourself. What will be will be. You can not help this woman who only wants things on her terms or no terms. You've tried, and Kuddos to you for that, and it's applaudable that you feel so deeply for her. I only hope you can find solice in the fact that you did, indeed, go above and beyond to try to help, and have peace in coming to terms with whatever will be will be. It's all up to her now, sad as that is. But the addage, you made your bed and now you must lie in it, seems to be tailor made for her situation. God bless you...and help you find peace beyond this woman. Live your life now and let her live (or die) hers as she sees fit. Good Luck!
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