This is going to sound terrible, but this is the information I've been given. No one in my sister-in-law's family wants to take guardianship, get a POA or help in any way. She lives a state away from me, about 45 minutes one-way. She calls me constantly and now requires more care than I can manage. She is on Medicaid, Medicare and a Medicare Advantage Plan. She refuses to even consider an assisted living facility or nursing home. I was told that the only thing I can do is to stop paying her bills and taking her calls, and eventually the landlord will have her taken away? That sounds so cruel but I am at my wits end.
There is no such thing as having Medicare and a Medicare Advantage too. Your either straight Medicare with a supplement or a Medicare Advantage.
As JoAnn29 answered, they need to call the county social services and report her. That's as much as can be done.
She is probably not on Medicaid if you know she has Medicare & Advantage. If she is telling people this info, and is having cognitive problems, it could be incorrect.
The G&C action initiated by my long-estranged NPD sib has cost my Mom's estate close to 30k and that was with my agreement to be her G&C, an essentially non-contested case. There are a number of moving parts and ppl involved, all of whom are paid by the estate. She acted purely out of spite over being disinherited and to have me stripped of my roles as Rep and DPOA.
She had done the very same thing after our brother's death, but tried to have him declared incompetent posthumously and did not succeed. That cost his 1.5 M estate close to 1/3 it's value, incl settlement to end the pain. That involved his business and a host of other issues and was very complex, thus costly.
I think it's similarly costly to bring this by the county, costs comparable to the G&C action brought by the NPD against Mom.
Sad that no one in her family cares enough to step in, but estrangement is a dynamic that occurs for varied reasons and is often long-entrenched.
You need to let go of trying to field her problems and make that call to her local adult protective services. They will assess her level of ability to live alone, her cognition, willingness to be placed in care, etc. and if she's at risk, they'll assume the role of getting her the care she needs. It's not really a 'ward of the state' so much as it's a case of a non-profit corporation assuming the role of guardian in court proceedings, likely conservator of her assets as well. You can help the process by providing some statement or testimony in written form for the Court.
You do need to step back to preserve your own sanity and know that this will not solve itself. By reporting her situation, you're bringing in the team of people who are trained to deal with these situations. Depending on how much financial support you've provided, if you need that money for your own security, you can place a claim on her estate and ask for reimbursement; that is reasonable. You may have to stop answering her calls if it's too overwhelming - and it likely is and would be for anyone. Decide the extent to which you can be her emotional support and stay within your limits or you'll be sucked dry trying to save your SIL from her own poor decisions and stubbornness.
Of course, it would be cruel to simply abandon her, as someone suggested to you. By reporting her circumstance to the very agencies designed to deal with these situations, you're getting her the care she needs. They will act swiftly.
You can decide, from whatever distance is comfortable to you, how involved you wish to remain ion her life. I'd suggest that if she continues to call you, you block her number and only call her - or you'll be caught in the chaos of her transition from supported independent living to being in care.
Wishing you all the best and for her, that she is quickly taken in by the services she needs.
I gave this question some further thought and remembered a Home Care client that we had in our service who had defeated the challenge of incompetence and was allowed to continue to live his life as he chose. He lived in quite appalling conditions in the home that he owned, has paid fiscal assistance, home care, and had meals at the senior center. Courts can be reluctant to strip persons of their civil rights just for making bad and even dangerous life choices so long as they are doing so with relatively full cognition and are not doing harm.
A Guardianship can also be of only certain limited areas of a person's life and they can retain some autonomy. You may wish to research these issues.
If your SIL is able to function without anyone assisting her or propping up her choices, she may be left free to do so.
I'd suggest you limit her access to you, cease your support of her lack of capacity, do report her, but understand that if she's competent to manage her life needs, she may continue to do so until the time comes that she can no longer manage.