Where do I begin when I have a tenant who is slowly getting dementia?

I would speak with the family.
If they are non responsive I would place a call to APS and ask for assessment and intervention if needed explaining that this is a tenant and you are very worried about safety issues for her and for the building in general.
I would consider discussing this with the tenant first, in all truth, dependent on just how close you have become.

I addition to Alva's suggestions, I'd call the local Area Agency on Aging and ask them for advice.

I agree with Alva but would tell the relatives if you don’t see any help happening soon you will be forced to report her to APS.

Also I wouldn’t bother discussing this with the tenant since she has pretty bad memory impairment. She won’t retain it.

If you have a lease, you could inform tenant that you won't renew the lease and that she'll need to find another place to live. This could open the door for the sister to take a part in finding her a place, which could be in assisted living or memory care. You would not be part of helping tenant to find the new place. I understand that you care for her, but you have too much on your hands already.

Do you have to give a reason for not renewing the lease? No. But you could say that it's not in your plans to rent the property anymore. Why? Maybe your parents need to live there. Maybe you've suddenly decided to remodel and repurpose the property. Maybe something is wrong with it - like electrical wiring needs to be brought up up to date, and it's unsafe for tenant to live there.

If you don't have a lease, same thing except that you don't have the excuse of the lease's expiring. You just decide and tell tenant that she has to move. Be sure to comply with laws; give tenant the required notice, etc.

Good luck.

If no lease, its automatically 30 day notice. You need to contact sister again and tell her your tenant is a liability. She could leave a pot on the stove and cause damage to the unit. If Sis does nothing then call the son. Tell them you are not happy doing this but the mother/sister needs supervision. She needs to be evaluated. Maybe Sis can come for a visit and not leave. If no one steps up, tell them u will need to call APS and report a vulnerable adult.

IMO its not up to you to call Office of Aging. You do not have the authority to have ur tenant evaluated. Family has to step up. Its nice that you feel you could look after her if you did not have ur parents. But she is not ur responsibility. We have a number of posts where a neighbor or friend started out helping and found themselves doing the caring. One lady had a roommate who had a stroke I think it was. The lady took her roomnate home and found she needed more care than she is willing to give. Was too late, when she walked the roommate out that Hospital door she was now responsible for her.

If she's forgetting five minutes after you tell her something, she is not slowly getting dementia. She is at the point where she cannot live alone anymore.

She is a huge liability to you and herself. She can as JoAnn states in the comments, leave a pot on the stove. Or wander off some night get lost, and forget where she is.

You would be right to call her sister because clearly her son can't be bothered. Unless a live-in caregiver moves in, she has to go.

This is a new subject matter for me to read about.
I don't know if 'slowly getting dementia' is actually accurate although it may seem like that. Cognitive functioning / brain cells dying may seem slow - I do not know if parts of the affected brain change quicker than other parts, and there are many different kinds of dementia.

As the owner of the building, you need to protect your property, This doesn't mean you do not care about your tenant; clearly you do.

1) could you explain how she is a liability?
This sounds like where you need to start.

Then, contact the sister (or another family member) and tell them that you are concerned that she is not well / capable of living alone - and that she needs a MD assessment. They may not diagnose her with dementia though.

2) I would put in writing what your concerns are - and provide to both your tenant and her sister (or another family member).
Who pays the rent?
Is your tenant still legally responsible to pay you or a family member?

3) If there is any resistance of the family member(s) taking some action, i.e.,
- moving her into a facility / assisted living or whatever may be needed
- have 24/7 or appropriate daily hours of caregivers
- insure that she is not driving / even if she has a car
- concerns of her falling or injuring herself (are their stairs?)

4) As the owner, I presume that you could give her a 30-or 60-day notice to vacate? Is this correct?

Based on what or how you feel she is a liability, you may need to do this.

5) If the sister doesn't look into her benefits, ask the sister who will / can. She could call the County, Senior Services Dept, or hire a social worker. People do this work for hire.

If I were you, I would keep the relationships 'clean(er)' than how it sounds.
You are the home owner; she is your tenant. Once you cross that line and 'help' her, it is a never-ending spiral of need and care-giving. And, you are taking care of both your parents. You cannot take on any more nor should you.

- Offering to help her once a week for an hour or so is one thing.

- Being on call or doing laundry, or taking her shopping or picking up prescriptions and on and on is quite another.

- Realize that 'if' you feel you need to ask her to leave (for her own good, as yours), and you are helping her / are 'friends,' she (may/) will get very angry at you for 'kicking her out.' As well, the family may also feel that way.

Do protect yourself legally.

Set your boundaries.

Put everything in writing. Give time lines; dates as necessary. Do not leave things 'open ended' - ie she needs to get to her MD for an evaluation ... while it could take time to get an appt., be sure that there is one - 'if' this is going to hold you up on deciding to evict or not. Same with the sister or whoever researches her benefits. This needs to be done by xxx. If you leave things open ended, it could go on for months.

I believe / feel the bottom line is why you say 'having her at my rental is a liability.' Start there.

Write out liabilities to you as the home owner.

Decide if you want her there as a tenant and if not, take appropriate action.

Realize it is NOT your responsibility to find her alternative housing even if you want to help out. I wouldn't be surprised if you felt guilty asking her to leave and guilty for not helping her more. However, she needs more / some ongoing support now that she doesn't have. Her safety and welfare is critically important.

Keep a journal / write what is going on, when, time, observation(s).

Depending on the relationship and how it goes, be very clear that you really care (they may know this already) and it is a hard decision you need to make). Show empathy and compassion, which it sounds like you do already, if not naturally.

Let us know how it goes.

Gena / Touch Matters

It’s between tenant and her sister. Tell sister you think she’s getting worse and the sister needs to either move in or make other arrangements for her. If nothing happens and you fear for her safety, call Adult Protective Services for help…but tell her sister you will resort to that if sister does nothing.

As long as she pays the rent she's with you. At the point you think she is unsafe to be alone, you tell the family they need to have someone in the house with her or you will have no choice but to involve the authorities. If there's a lease involved, you can even offer to break the lease if they want to move her elsewhere to avoid additional financial burden for her/her family. And you can find another tenant for your own income.

I would speak with her sister and say " You are concerned about your tenant and could They Look Into assisted Living where she would be properly cared for or have social services / elder services Hire People to come In and help with grocery shopping , Light Housekeeping , companionship , etc. " If they are Not responsive speak with the tenant about getting herself into assisted Living If you Know her retirement benefits are great . You are Not a Doctor or a Family Member . ///////////////////////////. I Had a tenant and the Realtor was Not honest about his situation . The guy was being released from a rehab and the VNA was coming In . When I went to Meet him he was Missing a arm and thumb . We Both went to St. Pauls Catholic school and were the same age . I did Not ask him " How he Lost His arm ? " I did ask him for a Family Members phone Number in case he got sick . He refused to give it to me . I called the Realtor - they claim to not know anything . He tells Me " I have to go back into the Hospital " I did Not hear back from Him for 3 Months - I did Not Know if he died ? Looked at His Mail Piling up and I was able to track him down and get him back home . We did Not charge him for the 3 Months he was in the Hospital . His Brain was Bleeding and he had a steel Plate Placed in His shoulder . Everyone took care of him and sat with him and Brought in food . The Other tenants Helped him when he fell Out of bed . He Knew he should be Placed In a SNF as This is what His Nurse had told him . He decided to commit suicide . The Nurse found his Body . After Much Investigation This guy Had tried Committing suicide before By Jumping in Front Of a Subway . His brother had sold the Family Home for a couple Million and Kicked him Onto the streets . He was brain injured from a car accident and left to live with His parents . He had never Lived on His own before so His brother Throws Him $150,000 and Sayonara . He decides to go to court , Loses , has a couple drinks and Jumps in front of a subway . My advice let the Family deal with her . APS could drop by and encourage her with a social worker to find assisted Living before she falls down and breaks a hip .

I wonder how advanced her dementia is and what could be done to help her.

If her dementia is further along than you think it may be, I don’t think it would do much good for you to speak with her at length about this situation.

Speak to her family members about it. I know this most likely feels awkward to you but you really don’t have any other choice.

This kind of thing happens and it is challenging. Dementia affects every aspect of a person’s life.

During my last hair appointment, my stylist’s phone rang. She said to me, “Do you mind if I take this call? Make yourself a cup of coffee to enjoy, because I will have to spend a few minutes with this woman on the phone. She has dementia and is getting worse.”

After my stylist hung up the phone, she told me that the woman couldn’t remember any of her hair appointments and that she had to call her the day of the appointment to remind her.

Fortunately, my stylist is a very understanding person. Her own mom is in memory care with Alzheimer’s disease.

Harkeybabe: Speak with the family.

As long as she is safe and healthy, she can stay in place. It seems that her days of doing so are limited. You can address these concerns with her family and Adult Protective Services in your town or province/state.

Its been a week and I'd love to know if OP was able to contact anyone? This is not a resoinsibility the OP should take on. As we have read on this forum, neighbors and friends start out helping and find they get stuck in a caregiving roll they did not want.

Personally if your getting nowhere with the family I would make a call to APS or your local division of aging. I'd be scared she would get hurt, have an emergency and not be able to make appropriate decisions on what to do, ect.