Can a doctor or adult protective services force someone into a nursing home against their will?

It sounds as though living at home is not going well if she is easily prey to these negative predicaments that have happened. I know that is not unique to her. Porch theft is very real for many these days. I would also worry about ongoing scamming. Can she advocate more strongly for herself by continuing to live at home?

She should more or less go to no to nearly no contact with her brother as he provides no kindness or care. Hope the meal delivery may help even if she just eats a portion of it. Also some home health aid would be helpful.

It simply sounds as though living alone in the future may make her prey to circumstances that she might be protected from if living in a facility not to mention her existing physical ailments. I wish her well. I am sure she is fortunate to have you as a neighbor.

No. If a person is competent they can’t be forced into care..

If she has original Medicare the doctor can order her home health care. This is a nurse once a week to take her vitals, help her manage all those prescriptions and basically keep a medical eye on her. If she needs help with bathing a cna can come a few times a week and help her bath and change her bed linens. A physical therapist can evaluate her to see if she needs a bit of help with her balance or strength training.

This care is covered by Part B with original medicare for anyone who has a difficult time leaving home and needs intermittent skilled nursing. Patients are generally already considered home bound when they qualify. Her doctor might be willing to order it to help her get things under control even if she isn’t typically homebound. Doesn’t mean that can’t leave home, just that it’s difficult.
It’s worth a try. If the doc will order, the RN who comes out to evaluate will know if she qualifies to continue seeing her. If you go to the doctor with her, stress that she lives alone.

It sounds like your tenant may have IBS, irritable bowel syndrome, which can be aggravated by stress. I’ve had that for many years and it can be dormant for a long time and then as you suggested, stressful events can trigger it. Many, many people have it. At my worst it is accompanied by nausea and vomiting, stomach cramps and diarrhea. Oddly another symptom is sometimes constipation. If it is unchecked and fluids not replaced, dehydration can cause a lot of problems.
Gastro doc suggested the low FODMOP diet, (Stanford Medical School version). You basically eliminate foods high in FODMOPs for a few weeks and then add them back one at a time to see which might be a trigger. It’s kind of a reset for the stomach and allows it to calm down. I noticed there were several foods I had to eliminate which are healthy foods. You don’t have to eliminate them forever unless of course they prove to be a problem. I was also told to take Benefiber daily.
There is a tablet that dissolves under the tongue that will stop the cramping almost immediatly. Hyoscyamine. It works like magic for me when I need it.

Even if she won’t eat the meals on wheels everyday, there will be someone checking on her which is a good thing.

About the home killing her. Home health can help a senior live at home a lot longer than they would be able to otherwise …in my experience.
However, they have to be willing to accept the help.
Diet and exercise are foundational. If she doesn’t want to be bothered, she will continue to decline at a faster rate and eventually the regular care from a nursing home might benefit her. Each person is different, their circumstances are diff, their support system is diff.
Do you intend to stay in her life as her caregiver? It is a huge responsibility. The IBS (if that is what she has) can’t be cured, it has to be managed. She may not have it for years, or at least that’s been my experience then it’s back and I have to manage it.
You mentioned kidney issues. Of course, dehydration is a biggy and you indicated she takes many medications. Probably her diet is awful. If she eats a lot of processed foods she won’t like the taste of healthier foods. That takes awhile to adjust to. She may not be willing. So it really depends on how willing she is to make changes that will keep her healthy at home. A housekeeper would be something else to encourage. Even if it’s only once a month it can really make a difference.

Unless she has funds to private pay for ALF then she would need to qualify physically and financially to go to a NH on Medicaid.

You could contact Area Agency on Aging to see if she qualifies for any additional services. They are affiliated with the Meals on Wheels group. You might ask about any resources for grieving they could refer you to.
Check her ADLs periodically so you notice big changes as they happen. You are kind to help her. Good luck.

In order to force someone (who is cognitively impaired) into a facility they first need to be their legal representative (PoA or court-appointed guardian). Please call APS and report her as a vulnerable adult to get her on their radar. Keep reporting her.

As you have experienced, "talking" at her has gone nowhere. This is because she either has short-term memory impairment, hearing impairment and/or the beginnings of dementia.

Dementia starts slowly as shows up as "stubbornness". It robs people of their ability to use logic, reason and judgment. This is why "informing" her goes in one ear and out the other. It also robs them of their ability to have empathy for others. So, don't expect gratitude for what you're doing for her. Or understanding how hard you're working on her behalf, making sacrifices, etc.

My MIL is in LTC on Medicaid in a wonderful facility. Maybe you should take her to see a modern facility to see how nice they can be. She is currently being killed by her own self and decisions right in her own apartment. It can't get much worse than that.

Lainey, Medicare (which I assume your tenent has) will cover very limited home health services, generally after a hospitalization.

Medicaid (which she would have to apply and qualify for due to very low income) might cover some aides at home.

Have you and your tenent ever called your local Area Agency on Aging? That's where I would start in trying to see what services she would qualify for.

For starts, you want them to do a "needs assessment" and ask about "case management" services,

Hi Barb,

Thank you for your reply!!

Yes, I did call them and put her on the list for Meals on Wheels. Not sure how long before that starts and not really sure how much help it will be - She can be persnickety!

She has Medicare and another insurance.... Really hoping we can get some home health aid for her!!!

I will definitely ask about needs assessment and case management!!!!
Thank you so much

With regard to her stomach reacting poorly to stress, some folks have a second "brain" in their gut. I assume this is a lifelong issue.

Has she tried any meditation programs? They can really help. And yes, she should see a gastro doc.

Your tenant has a brother who may be asked to be temporary guardian for your tenant who clearly may not be safe living alone now, especially if she is not taking her medications, or able to manage her own care at home. The brother, as guardian, can ask a doctor if in his judgement she is safe at home. If the doctor suggests placement then the brother can see placement as your tenant is no longer making her own decisions competently.

It may also be a case where Adult Protective Services are moving in now to arrange for guardianship by the state. That would also likely mean placement in facility care for her own good at this point. If she wishes that not to happen, that being a court case, she will have representation, but if doctors examine her and judge her not safe and competent to now live alone their word will count for a lot with the court.

This ultimately--concerned and loving as you are--isn't your business. The details aren't shared with you and you cannot know what is happening. You will be notified by your friend or her family.
Clearly you are very kind and loving. But this happens to so many.

Thank you to all who have taken the time to respond! I greatly appreciate it! We had company today for my brother to visit 90 yo Mom - whom I am living with and caring for. So, no, I can't be the tenant's caregiver also.

Praying for God's grace, guidance, direction and timing!

Thank you ALL again.

Lainey