What is neglect, and can one sign documents where rational thinking is absent?

You might want to call Adult Protective Services as they may be able to check on Mom for you so that it does not turn ugly.

coumadin clinic is required monthly at the least, whatever the dose level is, as i was told, the problem is that her husband refuses to take her because he does not believe in doctors and he just does not think it is necessary, not due to religious beliefs, he has always been that way, since we are out of the picture for now, due to the abusive behavior towards my wife and i, from my mother for the the last 10 years of our caregiving from 3 hours away, we could no longer take it, in order to save our marriage and our own health and happiness, we've over seen all of her needs, and he would do nothing while we were looking over her and his welfare, he is not taking care of her medical needs, according to her doctor, we have been trying to contact him to check on her, and we were told to mind our own business, we know that she has lost all her rational thinking, but now he is acting very strange and we suspect he is having issues himself. we are going out there to see for ourselves, we honestly believe senior services or other agencies will have to step in very soon,

Regardless of the reason, one can always refuse tests or for that matter, medication even in a SNF. We in the medical field cannot force any adult to take
anything or accept any care they do not want.We often think we can force medical tests etc like we do a child but we can't.So with that said, you can force the issue of neglect or even guardianship but medical staff still cannot force treatment. Good luck

Have you found out why the spouse will not take your mother to the doctor? Is he having issues as well? If it is religious reasons, a Court and only a Court can order medical tests, but even then the person's life has to be in immediate danger. An incompetent person cannot sign legal documents. When signing legal documents the notary will ask some questions and if they cannot be answered, then the notary would not notarize the signature. In any event, consult adult protective services and have them investigate the situation.

Unless someone is judged incompetent (not an easy process), they can refuse medical treatment for whatever reason they choose.
If you think your mom is not able to decide that she doesn't want the tests, then you or someone else could take her or try to persuade them to allow someone to come to the house to draw blood (pretty easy to arrange and not expensive if they have documented mobility issues).

Get an attorney that is familar with dealing with elderly issues.

You can also get home testing for INR, which might make compliance for the spouse easier.

yes it would be neglect refuses to take him or her to the docotr for tests as needed, you could call elder care abuse and if you feel she is mentally unstable you could go into court to obtain guardianship over her, you would need 2 sepeparte doctors to state that she is incompetent, hope this helps you, God Bless