My neighbor is 90, very independent and "with it." She lives alone and has no family. Her friends are dying, dead or have moved away. Any advice?

Lucy, you are quite sure she doesn't have carers coming in, are you? Are you there all the time so that you would necessarily see them?

As you're in the UK, my first suggestion would be that you look up Social Services for Older Adults on your Local Authority's website and give them a call for advice. You can do this in confidence.

It depends on how involved you want to get, but, I think I would report to the doctor or try to get her to go to doctor with you, so you can slip him a note about what you're seeing. It could be an infection, something treatable, or it could be dementia. Some people who I know who have dementia started out with delusions, hallucinations, as you describe. She is likely very frightened by what she's experiencing and could probably use a confident and support. I know someone who was frightened by an hallucination, ran outside his house, fell, fractured his hip and never recovered.

She may be putting on a good front, but, she may not be eating that well, using good hygiene or paying bills. APS is another option. I'd keep notes so you can tell them what you've observed. I hope you can get her some help. She's fortunate you are observant.

If you have the time and energy to spare, you could offer to help her make that annual visit. Barb has an excellent idea with the idea that you must go 1x year to keep the insurance active.

The alternative is to call adult protective services. That takes a long time to make progress as it seems there have to be lots of reports of a senior in need of help before anything happens. I will say my mthr was saved by her county APS who tracked me down out of state with only my husband's name to go on.

Mthr would only see lady doctors, and APS made an appointment and then took her. They assumed she was indigent and didn't ask if she *wanted* to go. They asked if she'd like to go to McDonald's for a burger and ice cream. In the car, they asked if she minded if they went to an appointment at Dr so and so's and then get the burger. In court testimony, I called that positive manipulation. It was brilliant and it worked - and it saved her life. Once at the doctor's, mthr was on good behavior and went in to see the doc, had a blood draw, and exam. Thank goodness for manipulating social workers!!

You say no one is there, but she has to be eating - right?  Maybe you could "visit" her and casually look around and notice the kitchen to see if she has food - especially perishable items like fruit and milk.  Also, when you make something you think she would enjoy eating, take her a serving.  If you don't feel comfortable doing this, call her when you're making a trip to the store and ask if you might pick up something for her.  Let her know you care.  If you still have concerns, call your local Senior Center and ask them for advice.  Bless you for your concern! 💛

Yes.

She may have a UTI (these infections often have no other symptoms other than psychiatric ones in elders--who knew?).

Or she may be developing dementia. In any event, living with delusions like this is scary and she may benefit from meds.

Will she believe you if you tell her that a once a year with the doctor is a Medicare requirement?