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My neighbor's an elderly lady and needs help with daily activities and companion care. Her doctor says that she doesn't know how to help her. My neighbor needs a home health aide or someone to assist her. She doesn't want to go into a nursing home. How can I help her? She doesn't have a social worker or case manager and her doctor's office doesn't know how to make this request to help her with this.

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Her drs office says they can't help? That seems wrong to me.

Drs are the ones who make the dxes about state of mind and capabilities, etc. They also SHOULD know of facilities that take elderly patients. Or of Home Health Agencies in your area.

OF COURSE she doesn't want to go into a NH. Is she telling you all this? I'd take it with a grain of salt and help as much as I felt like I could handle, if that was what I could do without getting too involved.

I bet your neighbor would love to have YOU step in and be her CG.

And people don't generally HAVE social workers working for them. IF they start looking at NH's, then they WILL--and they will facilitate the move as much as they can. This will cost something, I would imagine.

I have really very little personal knowledge of moving someone to a NH, but the times we've had mom in one, and my MIL, it was all done out of the drs office, or at the hospital.

IF you want to help her---you can take her to visit some facilities. It may not be a great time, with COVID, to be making this move, but I know it's still happening.

Please be super careful not to involve yourself too much in her life. Your kindness can end up blowing up in your face.

Does she have family? A contact with one or two members of the family would not be untoward. She is not your responsibility--I know of which I speak. I have gotten myself deeply involved in situations where I thought I was 'helping' and I was actually just used and abused by the 'friend'.

She can call CG agencies on her own and have them come to her, if she can still live on her own and just needs some shoring up. That, you can help her with, finding numbers, etc.

You are very kind. Just be careful about getting too involved.
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You start by contacting any family she has. Start with local ones. You need to find out if any of them are her PoA. If you find the PoA, then you can step away knowing you did all you can do. If I were this woman's family, I'd want to know what was happening to her and that she needed help.

If you don't find any family or a PoA, then you must call and report her to APS as a vulnerable adult. This will just get her on their radar. Without you having any legal authority to advocate for her you won't be able to do much, even if she needs it -- because she can reject your help but APS will act to get the authority to help her. You are not betraying her by calling APS, you are protecting her. BUT, start by finding out if she has family first. Also please be aware if she is having any cognitive decline or memory issues, she may not be telling you accurate information so please take everything with a grain of salt. My MIL was telling me she was eating every meal, every day and turns out she wasn't. She thought she was. She'd even describe to me what she ate. None of it was true, but she thought it was. Thanks for being a sweet neighbor. Do what you can and then let those with the legal authority do the rest. Bless you!
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Did the doctor's office tell you this?

Or is that what the neighbor is reporting to you?

I suspect the doctor's office is suggesting something that your neighbor is not wanting to/able to hear.

Have you suggested to your neighbor that you and she call the doc's office together? Perhaps she needs some assistance in understanding the steps they would like her to take.

You can call the local Area Agency on Aging and request a "needs assessment". Would your neighbor be ammenable to that?
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The doctor's office can't help! These are the people who should be able to help you.

I would not take on care of this woman but I would call Adult Protection Services. They can contact family and evaluate her for services.
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Does she have family?
They are the ones that should coordinate any help that she needs.
If you are offering to be a caregiver for this person let the family know and you MUST HAVE A CAREGIVER CONTRACT.
The doctors office can only do so much. If the woman does not have anyone to help her and the doctors office feels that she is unsafe to live alone they can contact APS for an evaluation. (as a matter of fact they are mandated reporters of abuse and this might fall under "self abuse" if she truly is unable to care for herself) you also can contact APS and report an vulnerable senior.
All of that said. If she wants help she can hire you. Again a contract is a must. But if she is not competent then any contract she signs is not legally binding.
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Do you have a local Senior Citizens Center near by? I would get the number for her and tell her to contact them. Sometimes these centers have advocates that will work with the elderly to help them understand what services they offer and what services should be offered by a Dr's. office etc. It's confusing to so many people where home health aides come from what part of insurance etc. covers this etc. These advocates can work with the elderly to get them the numbers/resources etc. Some towns have special shuttle services for seniors that will take them to grocery stores etc.
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If she does not have long term care insurance or a lot of money put away, she probably can not afford home health care for the length of time she needs. If you do not know her family, you should call Adult Protective Services. They can get her a placement. In the meantime, make sure she gets regular meals and help with her personal care.
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disgustedtoo Mar 2021
"In the meantime, make sure she gets regular meals and help with her personal care."

Perhaps picking up some groceries and/or dropping off some meals would be okay, but I would be hesitant to get involved with any "personal care" or any other kind of "help." If OP doesn't know what the neighbor's physical and mental status is, OP could be viewed as taking advantage of her in some way. If there are any family members, OP should make effort to try to contact them. If there are no family members, contact the doctor's office and report what is seen/heard. The office can't talk to you about the neighbor, but they can take input from others. If no action, contact APS for assessment.

It's nice to want to help our neighbors, but we also have to understand we are NOT family and we don't know all that is going on, so we need to be cautious. Once you step in and start "helping", where does it stop? We have enough stories on the site about parents who do this to their own family, but there is nothing to stop this neighbor from asking more and more help from OP. Where to draw the line?
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I agree with all 7 posters already. They have seen this, read it, or lived it & said it well.

So I'll be blunt instead. Jumping in to do too much for neighbours can be overstepping.

Use your kind heart well but use your head.

Knitter, I amended my answer as I first jumped to thinking you wanted to step in & do the hands-on. It seems you want to FIND the help, not DO it? Is that right?
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Start with your local Senior Services. Large cities have PLENTY of resources. Small and mid-sized may have them too, but may take a bit more digging. Many programs are federally funded.
Help her make the first call. The senior programs will take over from there: Does she qualify for assistance and what type, etc.

If she is religious, perhaps you can assist in contacting her church, who can help as well. My church hired a part-time social worker to help the seniors and their families.

If she has family, perhaps you can let them know of the resources.

Continue to check in on her. Invite her over occasionally. Take her a meal. It's good to check in on our neighbors.
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So, neighbor has no family? If she does, they need to be notified immediately to get the ball rolling on services. Her income is going to determine what she might be eligible for. Low income can qualify her for Medicaid programs where there could be so many hrs a week of help - not full time - just a few hrs. She may also qualify for VA benefits if she/husb was in military. Call the local Medicaid office and they can tell you how to fill out the application to see what services she might be eligible for - talk to a live body at the office first to ask them what she needs to apply for. They are very good at having information about other local programs as well.

It's very possible she has money to pay for these things but is tight fisted with her savings. Some say they are saving it for their kids, old age, for an emergency, etc - well, the emergency and old age are here. The kids can have what she doesn't need at the end of her life. She can spend it to stay in the home or she can fall down and have to spend it on the NH she ends up in.

How does she get to the dr's office? Are you taking her? Seems odd that dr doesn't know how to help her or who to refer her to.
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I already posted but on reading it again her doctor makes me so mad. You have a patient who needs help and you have no idea how to help her?

I worked as a secretary for a Visiting Nurse agency. I had a folder for all the services available in the County and local. All the food closets, all the Homecare Agencies. Booklets from Office of Aging showing the services provided. United Way info. I had people coming off the street and phone calls asking where they could get help and had the info for them. If we didn't have the info, it was my job to find it.

All I can say is don't get too immersed in this woman's life. "No good deed goes unpunished". I know this is a negative way to look at things but unless you are a person who can set boundries than don't get to into helping. Let the agencies help. Like I said before, call APS. They will evaluated her situation and get the right people involved in solving her problems. They will also try to contact a relative.
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NeedHelpWithMom Apr 2021
Agree, JoAnn. She needs to switch doctors!
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Give your neighbor the phone number for Council of Aging.

Also, write down the phone number of a new doctor, since this one is not very helpful.

Call churches in your area and ask if they have volunteers that assist the elderly. Our church has various ministries that help those in need.

Finally, don’t start helping her unless you really want to. If you do, she will become dependent on you.
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Have you asked your elderly neighbour what she wants? I should go carefully.
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Only two people could have told the OP that the neighbour's doctor doesn't know how to help:

1. The neighbour. Enough said.
2. The doctor's office, who could not have discussed the neighbour with the OP because of confidentiality.

And either way, I don't think either source would give an accurate picture of what the neighbour's doctor *actually* knows about helping frail seniors who live alone.
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NeedHelpWithMom Apr 2021
I think that the neighbor relayed to her neighbor what she was told by her doctor.

It may or may not be the truth though. Who knows?

This woman may be baiting her neighbor for help.
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If you want to help with a few things, that's nice of you. But be careful it doesn't become a full time thing.

In 2013, I was helping a neighbor part time with running errands. Then it became a full time thing. I was exhausted and stopped. Don't get stuck like that.
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