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If an elder is considered competent and makes bad decisions, must family bail them out? If family knows that elder cannot safely live alone, and elder refuses to get the care they need, can elder insist that family do what is necessary so elder can live alone? Can they blackmail family with possibility of neglect charge? Can family insist elder go into assisted living, nursing home, etc. and wash their hands of responsibility if elder refuses? (and tells family to rescue them or face being charged with neglect.) How could family that felt it necessary to go no or low contact protect themselves from being roped into elder's agenda? After all, most child abusers do not die in prison; should they be able to torment people just because they are parents?

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When they refuse needed care, it is time to call APS before they call you. Failing to report their self-neglect can easily lead to them accusing you of abuse or abandonment. Family can't force them to do anything or go anywhere, but the Social Worker can get a court order for competency testing. If you go no contact, fine. If you are a POA and don't contact, not fine. Your safest course is to send a written plea for intervention to both the MD and the SW, notifying them you will have no further involvement.
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Thank you Pam! I understand that one can refuse to be POA or guardian for that matter, right? Please understand that I'm not suggesting that anyone neglect or fail to care for parent, just that a caregiver needs to know what the laws say, so that they cannot be coerced or blackmailed. Often elders do not know what is actually best for them - was involved recently in convincing an elderly woman who insisted on staying in her home, despite the fact that it was now unsafe for her to live alone, and that friends and family were continually "rescuing" her, that she could go into assisted living and that her health would improve, which of course it did. For one thing, regular nutritious meals make a great difference. Many elderly people cannot or will not prepare food, just nibble on what is handy, so of course they go downhill.
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Yes, rovana, you can refuse to be POA or Guardian. But once you accept the responsibility, you can't just walk away from it. That becomes neglect. POA's resign in writing. Guardians must notify the Judge that appointed them.
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Thanks Rovana for asking this question and Pam for answering. After I finished posting yesterday, it was time for kid’s school and then time for work. By the time I was back in town the day was gone.
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Neglect is a passive form of abuse in which a perpetrator is responsible to provide care for a victim who is unable to care for himself or herself, but fails to provide adequate care.

Neglect may include the failure to provide sufficient supervision, nourishment, or medical care, or the failure to fulfill other needs for which the victim cannot provide themselves. The term is also applied when necessary care is withheld by those responsible for providing it from animals, plants, and even inanimate objects. Neglect can carry on in a child's life falling into many long-term side effects such as: physical injuries, low self-esteem, attention disorders, violent behavior, and can even cause death.
Neglect is one thing that the elderly are so vulnerable to.
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Neglect is also when carers don't take time for themselves.
Get so caught up in their roles they don't eat/sleep properly.
Our cared for need care, but so do we,
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"Medical professionals are mandated to report suspected abuse (neglect). Below is an outline of some of the things we look for.
(These come from the Elder Assessment Instrument which was created for this purpose. Stephanie modified them to apply primarily to people with dementia)

This information may be helpful if you suspect abuse of your LO either by a family member or the staff at a long term care facility."
start quote
Observe the general condition of your LO.

Is their clothing clean and are they dressed according to the environment?

Are your LO hygiene needs being met? (Bathing, dental care, incontinence care?)

Are their nutritional needs being met? Needs will change according to stage of the disease. The key is to observe for weight, hydration, redness or irritation on bony prominence as inadequate protein can add to the risk of decubitus ulcers. In the later stages of dementia when a person becomes bedridden and has problems swallowing, weight loss is expected but there should be an assessment of swallowing and adjustment of the diet to accommodate their needs (perhaps finger foods or puree foods and thickened liquids)

Skin integrity – Are there decubitus ulcers? Were they avoidable? (Ask a professional to assess this) Are there contractures of the arms and legs and fingers? (Unable to straighten out due to lack of range of motion exercises) Contractures are very preventable, when they occur they are painful to the person and are usually permanent.

Possible Abuse Indicators:

Bruising. Occasional bruises and skin tears will happen in the older adult, especially in the later stages of dementia. However bruises in unusual places (like the middle of the back or stomach, inner thigh, upper arms, etc.) and unexplained bruises that occur regularly, are red flags. These MAY be coming from rough handling or even hitting. HITTING, SLAPPING, PINCHING, KICKING, ROUGH HANDLING ETC. ARE ALL PHYSICAL ABUSE These need investigation by the staff and if the explanation is not satisfactory, call Adult Protective Services (APS) and let them assess it.

Lacerations and fractures can occur with falls. When this happens, or especially if there is no explanation (ie: no one saw it happen) an investigation should be done. If this happens more than once, or you are not satisfied with the explanation, call APS and let them assess it.
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Malissadel- rules to this forum- stay on topic and stop hijacking another persons question with your requests for money.
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There are many child abusers who die at the hands of fellow prisoners, or get sodomized frequently so that they hang themselves. I can only tell you from personal experience of being a case manager for Child Protective Services for AZ, neglect is defined as withholding care for another (i.e. food, water, lodging, schooling, cleanliness, etc.) and not physically abusing a person. There were incidents where the house was not kept really clean, but that did not warrant "abuse". If your elderly parent is not accepting help which the family thinks he/she needs, then report your concerns to adult protective services. All referrals are anonymous. Once a report is made it shows you have concern and you have tried everything else to get your parent to into a better living environment/care, and the parent will be unable at a later date to file charges that you "neglected" them. Make sure their is an agency doing the investigation so you will be in the clear. Short of doing your best to help your parent, you are not legally bound to do so. If their mental status is of question, the investigating team will make the appropriate recommendations. Be well, and take good care of yourselves.
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Vunerable adults have a right to protection from abuse, neglect and exploitation.
Competent vulnerable adults have a right to self-determination, including reusal of services. Vulnerable adults have a right to the least restrictive available alternative in living situatin and treatment.
Physical Abuse: Is the sustaining of any physical pain or injury by a vulnerable ault as a result of cruel or inhumane treatment or as a result of a malicious act by any person.
Exploitation: Is any action which involves the misuse of a vulnerable adult's funds, property or person. This would includ sexual exploitation.
Neglect: The willful derivation of adequate food, clothing, medica treatment, or rehabilitative therapy, shelter or supervision from a vulnerable adult.
Self Neglect: The inability of a vulnerable adult to provide for himself the services that are necessary for his phyical and mental health; and also the absence of which impairs or threatens his well being.

Keep in mind that a person has a right to personal dignity, quality of life, privacy and the "right to make choices."
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Rovana what you are saying hits very close to home with me too. My mother is a narcissist. She insists that she is going to stay in her home. I understand that she has lived there and raised family there--it's her home. BUT, it's all about her and she expects me to move back "home". Give up my job, marriage and home since she lives out of state. This is the only solution acceptable to her. She will not accept anyone coming in to provide help, but threatens me with neglect because she hasn't gotten her way. She has always manipulated her kids so there is no unity to work together. Her mind is sharp and clear. Can she report me for neglect and then expect me to go live with her?
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BKlorida - you hit the target exactly. When you have narcissistic parents you must have or get the answers so you know you can call their bluff as necessary. So if I notify APS about the situation, then I've met my responsibility? If the elder exercises their legal rights to make decisions, then they cannot demand that anyone rescue them, right? You need to know where your stand, so you can be strong. By the way, husband and kids and YOU always come first.
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Since you live in Florida shakingdustoff you might want to report the conduct of these "professionals" to the Department of Elder Affairs which can be found at the website for myflorida.gov. There should also be an office on aging at the local county level in whatever county in Florida you live. At the very least do not allow people to treat you like a piece of furniture. Also how did your Mother end up being cared for in a psychiatric hospital? Did a sibling of yours have her admitted? It would seem to me that your Mother certainly wouldn't have walked into such a hospital on her own. (Also I do not believe "borderline" dementia is a diagnosis per se. Please make certain that your Mother's doctors are forthcoming with you as far as her level of dementia and her needs, and you do not have to have a Power of Attorney for medical clarity such as this. What are your Mother's wishes at this point in her life. Is she able to tell you and would you want to honor them and follow through for her, because when it comes right down to it, this is not about you and your feelings, or even what you think of her choice of doctor. Without supplying the specifics as to how your Mother is being taken advantage of there is little else we can do to help you or your Mother. However it seems you are in a position to help her. Please be strong and consider doing this and do not allow those professionals to mistreat you or your Mother.
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