My 85-year-old father and his 96-year-old companion live alone in his house. I'm not sure what to do from here.

Update*** after a long talk with her daughter in law I explained some of my concerns and included stimulation mentally is better than isolation for dementia. Her mom his pretty much alone up there; and now the daughter is coming up to take her to their house for a few days in a “transition” effort instead of just laying down the law. I feel bad, but I can’t take care of both my aging dad and her declining mom too. Some relief and movement anyway.

You're shoring up this situation so it can continue. If you stopped all aid, something would have to happen.

Her children will not respond and will not help. Ever. That is clear, and it is their right. We don't have to help our parents, and you're doing it, so they're off scot-free. Whee!

Do you have POA for your dad? If you don't, you should. He may, if his dementia is not too noticeable, still be able to grant POA. The lawyer you hire will assess that. You could then evict her, sell his house, and use the money to pay for 24/7 care in a facility for dad. He needs it. His dementia won't ever get better, and you might as well deal with it now before it gets so bad he burns down the house or wanders over to the next town looking for bunny rabbits or whatever takes his fancy at the moment. Yes, it does get that bad.

If you don't get POA, you can apply to be his guardian. That's a whole 'nother can of worms, though. But at least you're in charge at that point. When you're in charge, you prepare formal eviction for the woman, notify or have your lawyer notify her children, and demand that she's out by such-and-such a date. It may take a while, but at least she is gone. Dad may object. So what? He is in no condition to make his own decisions now. He probably shouldn't be driving.

If he continues to drive and has an accident, that might take care of the problem altogether. But you don't want that because they both might die in the process, taking out the family down the street as well. Then dad is charged with vehicular homicide, and you're dealing with that too.

Or, another idea is to call APS and report two vulnerable adults in danger so they'll send social workers to assess the situation. You tell them you can't be responsible for dad or the woman, and they must find a place for them. Then you let them handle it and stay out of it.

Your choice of choices isn't looking good. But even the worst choice is better than letting things go on as they are. Decision by indecision is what it is called. I think you DO know what to do. The question for you is, how long are you going to wait to do it?

I would definitely start working on getting the 2 medical diagnoses for your Dad's competency. I communicated with my Mom's primary doctor through her medical portal and told the doc I needed an official diagnosis of sufficient incapacity so that I could start managing her money to pay for her care. I needed an actual diagnosis written in a letter, signed by the doctor on the clinic letterhead. The primary doc was happy to do this after my Mom's "wellness" check.

You may have to use a therapeutic fib to get your Dad in to be seen for this purpose ("If we don't get in now for your free annual wellness check, you'll have to wait a long time" "You need this appointment in order to be able to renew your prescriptions" "You need this appointment to prove you are competent to take care of yourself and your companion") Tell him whatever you think will motivate him to go. You can ask his primary what would be the "best" / "easiest" way to get a second opinion on his competency. You will increase the odds of a diagnosis if you make his appointment in the later afternoon, when possible Sundowning starts to happen. My Mom is pretty fresh in the mornings but as the day wears on, so does she.

I agree with informing her kids about reporting her to APS but I would NOT tell them until after you report her: you really don't need to get the 2 of them worked up over this and start fighting you on every little thing. The element of surprise will work in your favor. Also, it is apparent that her kids pretty much don't care and are happy that you are their workhorse. Don't put any hope in them stepping in. This means you get to call all the shots on how you solve her permanent care solution.

You can also consider calling 911 right now for the companion and tell them "she's not herself" and may have an undiagnosed UTI. At the ER you tell them you're not her caregiver and that her actual children are not responsive to her situation. You tell them your Dad is not capable of caring properly for her and that she is an "unsafe discharge" and you will not be taking her back to the house. You keep repeating this to the discharge planner. Do not believe any promise of help if you take her home: this is a lie they tell in order to get her out of the ER.

Then, ask to talk to a hospital social worker. Tell them she is an unsafe discharge and that you're not her caregiver or PoA and you will not and cannot take her back to the house because you can barely care for your Dad and your Dad is very obviously not able to care for her. You ask that she be discharged directly into a facility, like maybe even LTC. Give them the contact info for her kids and then leave and do not answer calls from the social worker, the hospital or her kids. You're done. If you have to do an eviction process to keep her kids from bringing her back to the house, then so be it.

I wish you success in activating your PoA authority. It will feel very hard for a while but eventually they will both have more permanent sustainable solutions for their ongoing care and she will no longer be your responsibility in any way. Yes, your Dad will be VERY angry for a while but then he will get over it. Caregiving happens on the caregiver's terms, not his.

Since her children are doing nothing, you need to call APS and tell them Dad can no longer care for her. You can only be responsible for Dad. Her children need to do something or APS because you are not caring for her. Then give APS's childrens phone #s. If the children do not do anything APS will need to get the State involved.

Frustrated, that is excellent news. With luck these "few days" will open the family's eyes to the reality of their mother's need for full-time care.

It's interesting that the person you finally got through to was the daughter-in-law. Not meaning to project since we don't know details, but often we read here that a daughter-in-law is the one who sees the reality while the rest of the family is in denial.

This will still be a slog for you, but I hope this is the first step in resolving the multiple issues. Keep us posted.

Your father should probably be going now to assisted living. At that point you will notify the children she is alone and helpless and that you have notified APS. She will be a senior at risk at that point.

So time to have the sitdown talk with the two of them in the coming year. Let them know they are not safe and well cared for at home. If there are currently aids through a medicare or medicaid program, time to enlist the social workers. If they are hired aids that won't work.

This is now a matter of two people in unsafe conditions. You have control of one, but not the other. If they do not agree to appoint you now as POA, understanding what that means, this is a case for the intervention of APS.

So sorry. What a mess. But suspect this has been a slow seeping in over time. It won't be cured in one day.

Take away your father’s keys right now.

I would call APS and open a file on her and see if they can make her a ward of the state and then she can go to a nursing home. It’s obviously not going to be all tied up in a bow like that but perhaps they can give you guidance on what to do.

Plus you may as well open a file now so you can keep adding to it as things happen because she isn’t going to get better.

Next time she falls, call 911. Look for any reason to call 911 and send her to the hospital. Then maybe her children will engage.

Also, you can tell her kids that you are calling APS and opening a file on her.

Frustrated, thank you for your reply to Fawnby below. There are two separate issues. One is getting the two letters from doctors to activate the POA. The other issue is the companion. You don't need to use the POA to take action regarding her. You can inform APS that you have no relationship to or legal authority over her, that her own children are not responsive to requests that they step in, and that your father is not capable of caring for her, so she is vulnerable and in need of their intervention.

Hopefully they will intervene and place her somewhere. (Her children might step up and work with someone "official.") Then you will still have the issues with your dad. I'm very sorry about that. But at least you'll only be dealing with one instead of two. Do contact his doctor(s) about his diminishing capabilities.

I understand why you chose your screen name. You have my sympathy. Keep us posted on how things go.

Great! Make it very clear that the woman cannot return because you will not be caring for her. Actually, you do not have a legal leg to stand on because she is in no way related to you.