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My friend of many years, Kathy, fell in her home and broke her hip. She had surgery to repair it, returned home and developed either MRSA or Staph-no one has been able to tell me. When the ambulance came to get her the second time, an unknown well-meaning busybody, called APS and said she was living in squalor with animal feces in the house.. This is in Avery County, NC. She was placed in a local hospital and then moved to a more advanced hospital to clear up the infection. Her medication was all over the place and she sounded like she was crazy to the average person. Kathy has always been a little different but the word I'd use is eccentric-not crazy. Kathy has now been moved to a rehab facility not far from her home. Her medication is back under control and she is sounding more like her old self. I went to see her-both in Charlotte and back at the rehab. I cleaned her house and found not a single animal fece or urine stain anywhere. I have her dog and am caring for it until she can return home. The social worker who is assigned to her case, has questioned me regarding her finances and property she owns. I have been paying her bills with checks she signed for me during our visit.

My concern is this, what power does APS have over her and her future? Can they deem her "unfit to take care of herself" and force her into a home? She owns several rental properties in addition to a very nice home in this very poor county in NC. Kathy has never been "normal" by our standards-but that's just who she is. She lost her husband to pancreatic cancer 15 or more years ago and wants to donate her property to a local college because they agreed to name a building after him, in order to preserve his memory. I am her executor when she passes but she is only 62 and has the potential to live many more years. She keeps asking me-when is she coming home and I can't seem to get a straight answer from the rehab. Unfortunately, she did not sign a POA naming me or anyone else before this happened because she has been healthy. This means her bank won't speak with me so I'm collecting mail and viewing bank statements to keep her solvent while she is recovering.

Would someone please let us know our options in NC regarding an APS investigation? Do I need to hire an attorney for her? It's really scary that they can come in and decide your future for you if you have no family.

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You say you went and cleaned her house and it is now spotless. Was it actually dirty and cluttered? It may have been seen that way if her weirdness did not include housekeeping. Was there adequate food in the house? Was the fridge a lab experienment. Some people who are passionate about things spend their money on their interests and not what others feel are essentials for healthy living. Growing a garden and storing the potatoes in the bath tub would come under this heading. No dishwasher or hot water? You know she waits till all the dishes are dirty then boils up a big pan of water and washes the whole lot spotlessly does she go out and forage for wild food, shoot her dinner or set traps for rabbits. That is probably how the majority of her neigbors live but to a new MSW with the ink barely dry on her certificate from the big city college it will look as though she is incapable. I hope things work out for Kathy she will be miserable if she is confined
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You have a lot of insightful and accurate comments here but I wanted to clear one thing up.

MRSA is staph. It's a strain of the staph bacteria that is resistant to antibiotics.

(You can learn all kinds of stuff here!)
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I agree with the being watched part. She'd do the same for me if the shoe were on the other foot. My life is richer for having her in it. Guaranteed to be NEVER a dull moment!
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For many people in her situation, the words, "I'm from the government, and I'm here to help you," strike mortal fear in their hearts. ;)

From everything you've said (and not said), I'd say she's being watched.

And I'd also say she's very fortunate to have such a good friend.
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That is excellent advice Maggiemarshall. I've already been urging her in that direction and can only hope she'll listen. She has been getting rehab now for the better part of a month and according to the facility where she's staying, is more cooperative following my last visit than she was prior. She recently had the local county attempt to take a piece of her property via the Eminent Domain method and she fought them with an attorney and won. So she is already suspicious of the local county government and their offers of "assistance".
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My only concern would be if social services (or any authority) determined she couldn't live by herself anymore. If they determine she's unsafe to live alone, they are mandated to interfere. You don't say anything about her getting rehab after her hip break. If she refused it and just went home, then she's already on their radar big time. If she refused home care after her hospital stay as well, that's another indication that she's maybe TOO weird. I understand eccentricities, but too eccentric will get her into trouble.

It's not unusual for paramedics to report unsafe living conditions to APS. That may be what happened.

I'd say she may be on thin ice by now. Her FUTURE conduct is probably more important than her past in this case; as it can be chalked up to the infection. I'd explain this to her and suggest that she allow home healthcare and be very cooperative with any suggestions they have for ongoing services in her home.

My inkling is that, if she refuses all assistance and is completely against their recommendations, she's going to have a difficult time of it. They will act in what they perceive to be her best interests.
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It sounds as if there will be a court hearing before anything is determined, if I'm reading you correctly pamstegman? Kathy always assumed (as we all would like to do) that she was fine-would stay fine and that was the end of it. We have talked about the POA and she is kicking herself that she didn't do it before this happened. We have agreed that once she is through this, we will take care of it right away. I have documented every dime spent on her bills from her accounts and my own credit worthiness is A+ so I am not concerned in the least that I will be suspected of spending funds that are not my own. Truth be told-I've spent several hundred dollars of my own on various Kathy-related expenses. But I'm not looking for that back-she needed it and I was glad to be able to do it. If the situation were reversed, she would do the same for me. I will ask her to consider the "Guardianship in case of Incapacity" statement referenced above. In the event there is a court proceeding, I will be happy to appear as an advocate for Kathy. Do they allow us to have an attorney? I spoke with her tenant this morning who is collecting the rent on her property to deposit into her checking account, and he agrees with me that she is functional and capable of handling her own affairs, once her hip surgery is healed completely. I'm saying a prayer that all goes well from here on out as she is getting better every day. Thank you AgingCare for giving us a place to bounce these questions off of others!
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If you are not POA or Health Care Proxy, obviously she does not want you to know anything more or control anything more. APS can petition the court to have a Guardian appointed for her IF the MD's have determined she cannot handle things on her own. Much hinges on her ability to pass a competency test and her PT goals. The power lies with the Judge to decide, based on the facts presented in court.
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Does it seem that she is returning to her old eccentric self? If so, and she is ambulatory (even if with a walker, cane or other item for assistance) and can by & large manage her ADL's (activities of daily life), she can leave the facility once she completes rehab. Since she didn't have you already as her DPOA or MPOA, everybody has their hands tied in ever telling you things. But she can ask ? about her care, her medications, etc and there is no reason why you cannot be in the room when this happens. She can say, "I want my friend here to take notes for me". They have to allow her to do this. If she is manageable on her ADL's she can sign herself out or the facility and if you can set up for a home health care service to provide "care" like 3 or 5 days a week (the minimum is usually a 4 hr day & they can bill it to her credit card), then that will offset any APS concerns on her return. When you go to visit her, try to take an activity for you to do with her, like playing a game, or putting together silk flowers in a vase, or doing a drawing. Something to establish at least for staff @ the rehab, that there is a preexisting relationship between you two.

I would also get the house all nice and clean looking and take pictures and a video of the home before she returns to it. Open the cabinets and take shots of how the bathroom shelves look with the supplies for daily care; ditto for shots of the open refrigerator, pantry shelves.

Now at some point in time, she will need to get all her legal together. So you may want to start to find an experienced elder law attorney for her. I would suggest you contact a couple in larger towns (like in Charlotte rather than one in the more remote area where you live) and you also want to mention to them that there could be a malpractice issue with her getting a hospital based MRSA infection.

There are some things you need to do for yourself in all this. Please carefully document to the penny everything you have paid for from the checks she gave you. Xerox all this and make sure to keep all the original receipts. Just to be extra careful, think about your own credit situation and if there could be any sticky issues for you (like you have a foreclosure or any police record or anything that APS or some long lost family could throw at you. If she is deemed unable to do for herself, in order for the state NOT to have her become a ward of the state with a state appointed guardian, the potential guardian (you) will need to have a pretty spotless record and have enough income so that there could be no incentive for financial impropriety. I don't know if all states do this, but for my mom the attorney did in addition to the DPOA, MPOA and codicils to her will, he also did a "Guardianship in case of Incapacity" statement - which names who she wants to be her guardian if that situation should arise. It gets around having to do the whole rather expensive several probate court hearings that go into establishing suitability for a guardian- if SC allows for that you want to get it as it helps solidify your standing as you are not a relative.

I would hope that she recovers enough so that she can do the DPOA, MPOA and get all the banking done so that you are a signature on the account and be able to get back to her old odd self!
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