Can a person that is mentally competent but physically disabled refuse social worker visits but keep bath aides?

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My brother is partially paralyzed, lives at home with his adult grandsons. Cleanliness has never been a priority to my brother or his grand children, So the house is dirty and he is often dirty. He often refuses to bath, but when he does the bath aide only provides a bed bath instead of using his shower. He was told that in order to keep the bath aide he must have social worker visits. I understand that these are not ideal circumstances, but I also believe that as long as he is mentally competent he has a right to make these choices. They don't just round up the homeless and stick them in a home because they or their environment are dirty.She continues to pressure him to go into a nursing home. He wants to keep his bath aide but does not want the social worker to continue. He feels threatened and pressured by her. She is telling him that if he doesn't agree to go into a home, it will eventually not be his choice and he would have no say over where he goes.
So 3 questions...Can he refuse social worker visits and keep the bath aide?
Can he be forced into a nursing home while he is still competent?
Can he be forced into a nursing home because his home and body are dirty?

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If the rule is that he can have bath aides as long as he is monitored by a social worker and your brother doesn't want to be monitored by a social worker then the social worker has the power to discontinue the bath aides if he refuses to see her. If your brother refuses to see the social worker and the social worker discontinues his bath aides he always has the option of paying privately for bath aides.
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Who is paying for this service?

I'm going to assume this is a Medicaid benefit. Is your brother really of sound mind? Not bathing is a frequent sign of dementia and other mental illness. Is the house becoming a health hazard to others in the neighborhood?

Do the adult grandsons work? Why can't they keep the house clean, or hire someone to do so?
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