Could this be considered neglect/ abuse of the elderly?

by Annonymous

My 85 yr old mother in law has dementia and also has severe paranoid delusions. I don't feel she is suffering from abuse of the elderly so much as neglect.

She is currently causing problems for a neighbor by calling police on her for theft etc. She also writes this in letters and reports her to animal control. She is well known to police for her behaviors.

She still drives even though she has hit parked cars and fence in her driveway. She is now losing her checkbook and accusing her neighbor of writing the checks, thus cancelling checks. She found the checkbook and said it was returned by the thief.

She is having problems with her bank because of a loan she took out, forgot she did and missed payments. The bank called her and she accused a neighbor of taking out this loan using her name.

Durable power of attorney has known about problems for several years and does nothing. I feel she should have been taken to doctor for possible help for delusions and paranoia, and given driving test to make sure she and others are safe if she drives etc, but he refuses to act and gets mad if suggestions are made.

The issues with delusions and hallucinations in elderly has cost her both emotionally and financially. This has been a problem for many years now, but is getting worse.

The other siblings are afraid to voice opinion because of conflicts in the past when they have done so. The neighbor said she was reporting to adult protective services. Is it possible something might get addressed if it is reported?

REPLY from Caring-for-Aging-Parents.com
Wow, that is quite a situation and must be very upsetting for you. It is certainly appropriate for you to be concerned about your mother-in-law's well-being. Not only is her health impacting her relationship with those around her (family, neighbors, etc.) but it is affecting her finances.

Financial security is always a concern, but can be particularly impacting when seniors are moving into older years. There is big worries about whether there will be enough money and many seniors spend their final years impoverished.

It would be hard for this situation to be considered neglect by family unless your mother-in-law has been deemed incompetent to manage her own affairs and a family member were appointed (and agreed) to do this. Deeming incompetence is usually done by a physician and typically requires at least two physician's to agree and sign legal documents (and so it should as this is a VERY big deal).

Her situation as you've described it sounds more like self-neglect, however, a term that refers to an elderly not caring for their own health or well-being (includes physical, social, hygiene or financial needs).

At times, if a person is deemed incompetent and there is no family or no appropriate family to make decisions for their loved one, a public guardian or social services member may be appointed.

The process differs by country and state/province. It is always a difficult situation and takes time and commitment.

It is certainly disappointing when a family physician seems aware of an elderly person experiencing difficulties (uncalled for confrontations, poor financial decisions, unsafe driving) but does not act. Family physicians are usually considered the hub and are relied upon to take action for these delicate situations.

Has her family physician actually diagnosed her with dementia and is s/he aware of the hallucinations/delusions she suffers from?

I sometimes wonder if a lack of action might be because the elderly person "presents" (seems, appears) better in a short appointment with a physician than they do in day-to-day life.

In this case, it might be worth it to ask for a family conference with family and the health care provider. Usually it is best if your loved one can be involved or it may seem like a "personal attack" by both the physician and your loved one.

This gives your loved one, family and her physician the opportunity to present and address concerns as a group. It can be tense so sometimes having a social worker or mediator present can help.

It may be tempting to ask the police, bank and/or neighbor provide verification of the difficulties your mother-in-law is experiencing but this may infringe on her legal rights if she is considered competent.

If your loved one is putting themselves and others at risk, it may be imperative to act.

If you are very worried about your elderly loved one's well-being and are having difficulty getting help, it may be worth it to look into the resources in your community (social services) or state/province.

Some resources for this might be:

• in the USA:
  • National Center on Elder Abuse: a resource for elder abuse and where to find help in your area.
  • Adult Protective Services as you mentioned. Some states will only consider a case if the senior is over 60 years of age. Each state has it's own Adult Protective Services branch and you can find them online. Most public state websites will give a description of Self-Neglect and how to connect with Adult Protective Services.
    
  • Eldercare Locator: public service site that provides information about elderly services to elderly and their caregivers. Phone: 1-800-677-1116.
• Canada is similar to the USA where each province has a different resource for getting help with abuse of the elderly or self-neglect. For information, Seniors Canada.
  

You may also consider contacting your local government motor vehicle branch to see how to report unsafe drivers. This is a concern that should not go unreported as it puts your elderly loved one and all others on the road at risk.

For more information regarding competence, capacity or consent as well as laws regarding elder abuse in the USA or Canada, please see our answer to this question: Is this Abuse of the Elderly?.

For more general information, Abuse of the Elderly.

This is a delicate and difficult situation. I wish you the best.

If any other visitors have had a similar situation and have some advice or wisdom to share, please attach a comment below.

Thank you,
Tennille
Caring-for-Aging-Parents.com