Isolated Elderly Neighbor In Severe Danger—Are You “Your Brother’s Keeper”?

Regina called AgingParents.com in desperation. She has an 85 year old neighbor, Tony, who lives alone and he’s in big trouble. He just can’t take care of himself and he has a lot of medical issues. He says he has no family. He reaches out to her sometimes and she has been helping him pay his bills. But he got into a health crisis and she had to call authorities for him. The issue: extreme self-neglect. An ambulance came and took him to the hospital, where he was admitted in respiratory distress.

Doctors are attending to his urgent medical needs. With enough testing, treatment and medication, he will be released after he is stabilized. They will send Tony to “rehab” which means a nursing home, for physical therapy, occupational and speech therapy. And then what? Regina knows for sure that it would be extremely unsafe for him to return home without any help. He has none.

Regina is under no obligation to help Tony at all. They are not related. She is just a friendly neighbor. And she wants to do the right thing for this vulnerable gentleman who is all alone, losing it, and nearly died because he can’t care for himself safely. She looked through his papers and records and found no estate planning at all. He owns a paid-for home in an expensive part of the state. He has some funds in the bank that he can’t keep track of. He’s a perfect potential victim for a predator. What can she do?

Here is the advice we offered Regina:

While Tony is in the hospital, Regina visits. Those in charge there gave Regina informal “authority” to help him with decisions. He is easily confused. There is simply no one else to ask when a doctor wants to do a treatment and Tony can’t understand the questions. I suggested that Regina ask for an evaluation by the neurologist for Tony’s “capacity” to appoint her as his health care agent. If he does have at least the capacity to understand that he wants her to be in charge of helping with health care decisions, she can have him sign the advance health care directive. That legal document gives her formal authority to help with medical decisions.

Ask the neurologist to order a psychological evaluation as well, to determine if he can understand the need to give Regina a Durable Power of Attorney for finances. She can then at least take over for him in handling his banking and money matters. She thinks it’s doubtful that he will understand but legally it is important to have a doctor make the determination. If he does have such capacity, she can then protect him with that legal document, which gives her broad authority.

Assuming that Tony does not have the capacity to understand what it means to appoint a power of attorney for himself, there is only one choice left. That is, to request that the counsel for Tony’s county of residence apply to the court for guardianship (called conservatorship in CA). Tony will lose many basic civil rights with a guardianship but at least a person will be court appointed with complete charge of Tony’s life and his assets. Regina is willing to serve as the one in charge, but getting a guardianship done if it needs to be done is scary and overwhelming for her.

Regina understands that Tony will need full time care after he leaves the hospital and after a nursing home stay for rehab. He wants to go home, of course. If she has legal authority, Regina can hire home care workers for him and have them be accountable to her, not Tony, for what they do. Tony has the funds to pay for this 24/7 care for a couple of years. With the right legal authority, Regina could also borrow against Tony’s house, (perhaps a reverse mortgage) to create funds for him to pay for good quality care at home if he lasts longer than the money in the bank lasts.

The Takeaways:

1. No one is obligated to do the right thing for someone who never appointed you in advance to help them. It is a choice. There is no law that says you have to help someone like Tony, even as his next door neighbor. But it is a beautiful thing that Regina is trying to do for Tony. She does not want him to die alone from self-neglect. She does not want a scumbag thief to steal all he has. It would be too easy for that, given his condition. She is stepping up and being a good neighbor beyond what many people would be willing to do.
2. Helping will take time. It will be inconvenient for her. She will have to make a lot of decisions for Tony. She is prepared to take on the responsibility. He is all alone in the world, but for her. What would you do?

If you happen to know someone like Tony, whom we in the aging field call an “elder orphan”, consider that you have a choice to help or do nothing. If you decide to help, you will likely not regret it. It is rewarding and satisfying to put yourself in another’s shoes when they are desperate, and do right by them. You can get guidance from Adult Protective Services, elder law attorneys, county-employed attorneys, and Legal Aid offices in the area where the elder orphan lives. They can offer direction as to the needed steps you would need to take to protect a person like Tony. If you don’t get a clear answer from any of these resources right away, persist. Keep calling and reporting until you get the needed help.

I am inspired by Regina’s concerns and her honorable actions for Tony. It reminds me, in the midst of all the chaos in our society and our world, that very kind, unselfish people are out there among us.