What is the full-power of adult protective services?

Thank you Lymie61. I agree totally with your response.👍

Moms26 & countrymouse on the diaper accident, isn't that what the diaper is for? I mean if she wasn't having bladder and or bowel control issues she wouldn't be wearing them in the first place. Seems to me it should take more than one soiled undergarment for APS to determine they need to step in, particularly in a situation where there is family actively involved in care/help. Sorry I found the answer suggesting things aren't working a bit harsh, I think we have all had situations during the care of our loved ones when things didn't go smoothly or the way we planned/wanted and dare I say we will again. In fact there have probably been times we would shutter to think some government agency person might stop in unannounced, heck I feel that way in my own home at times! We are all doing the best we can and so are our senior loved ones who are still fortunate enough to live at home because they are still capable enough for us to make it possible (with some work).

So two weeks ago your 87 year old neighbour/friend/acquaintance called you seeking urgent help with a burst? just not working? water pipe. Presumably you - what, called a plumber for her?

Perhaps as an end result of this emergency, somebody reported her isolated living situation to APS. APS either called or visited her, explaining that they were there because a mandated reporter had contacted them.

Most regrettably, instead of finding APS's concern reassuring and helpful, the elderly lady freaked out about it and again turned to you to find out what right APS had to "interfere" in her life and where did it say she could be "forced" to accept this.

You contacted APS, quite correctly, to report her anxious (over)reaction. APS responded that if they are satisfied that she is competent to make decisions AND she refuses help, they will close the case.

This does mean that if in their judgement she is NOT competent, they won't close the case. If she is competent, they will offer help but she will be free to reject it, and then they will close the case.

What more do you expect of them?

Are you a neighbor that she called you?

I found APS to be useless. I recently received a frantic call from this 87 yr old woman. She wanted to know what rights APS and wanted a copy of the law that mandates any help. When I related this to APS the immediately backed off and said if the woman doesn't feel she needs help and APS thinks she can make decisions they will close the case. This woman only has an estranged adopted daughter and woman wants absolutely no contact with her. She also has a cousin but doesn't want them contacted either. I am not related or have POA or anything that allows me to help without her permission. I'm fine with that except she delays on making decisions and the doesn't understand when things aren't done fast. It all started 2 weeks ago when I received a frantic call that this woman's water pipes broke.

My mother had an accident in her diaper, which is probably to be expected on occasion when you are 84 years old, on the day APS visited. Based on that ONE experience, it was a nightmare with APS. We are very happy with the care she receives from her healthcare person and Meals on Wheels. I feel it is unfortunate that APS does not take into account all the good care put into keeping a loved one in their own home vs placing them in a nursing home and focus on an issue that happens on a rare occasion to make decisions that negatively effect the elderly they are supposed to help . Being able to stay in your home as long as possible is far better choice than going to a nursing home where unfortunately the resident will probably be sitting or laying in a soiled diaper more than once.

She may seem perfectly lucid to the policemens' well being checks because she is "actressing," or often called "showtiming." She should be seen by her physician stat. She  also may be very scared and is not understanding what is happening to her mind and body.

I was responding to Moms26's post.

Countrymouse, You wrote "your mother is still answering the door to APS in wet or soiled clothing" - that hasn't happened. Are you suggesting that if that were to happen at an APS visit, then it would be good for them to visit? Because the way I read it, she presented fine to police wellness check but refusing to let anyone else in.

If you've worked to get everything in place and your mother is still answering the door to APS in wet or soiled clothing, then it's not really working is it? I'm sorry for the heartbreak behind this, truly I am. But I can't see how APS was wrong.

Do not get APS involved if at all possible! Even if you have worked to get everything in place to help your mom(i.e. home health caregiver on daily basis, meals on wheels, etc.) they can show up randomly and if it happens to be a "bad" morning for your mother and she has wet or had a bowel movement in her diaper and daily caregiver hasnt arrived yet to help her clean up, APS assess the situation based solely on that visit and say she can't be in the home alone, period. We have gone through this with our own mom. Once APS steps in and sees ANYTHING they feel is detrimental to your mom, they don't let up. If at all possible, only involve them if you have no other options. Call your local Dept of Aging first!!!!!!!! Good luck and prayers to you in this hard journey.

ArtMom58, it should also go without saying that You ought to record your observations and provide them to your mother's PCP provider before she arrives at an appointment.

I was once told by someone from APS (in Pennsylvania) that they usually find the situation is either much better than expected or much worse, but seldom just what they expected.

Thanks for all your answers. I should have said that I am there about every weekend. The last weekend I was there, she wouldn't let me in, which prompted my question on this site. Since I asked this question, I have had a APS assessment and a dementia caretaker is there every other day. It's amazing what a different a week makes! Thanks again for you concern and answers, they've been very helpful.

Try to get her to a doctor, go to see her and take it from there. Try not to involve APS as then the situation will be completely out of your hands. I know some social workers are competent and caring, but many are just bureaucrats.

Your idea of a housekeeper/ dementia caregiver is good. Please try to make that happen before involving APS. I'd say only get them involved if her life is literally in danger, but that's just me. I think even CNA's are mandated reporters.

APS will also get involved in an elderly person needs help and is refusing it, even with family in the picture. My Papa is in a NH and refused to accept staying there. He kept saying he would leave with or without his doctors approval. He refuses to live with family or AL. We were told that APS would take him out of his home, by force if necessary, and put him in a NH of THEIR choice, if they agreed that he could not be left alone. This is in FL, by the way. So do some research before involving them. Contact Area Aging Agency first maybe.

I would involve APS only as a last resort. Once they are involved, it is hard to get them to go away. AND, they don't have the full history and background, and often (in my opinion) make incorrect and hurtful assessments, like that the person caring for the elderly person is abusive because they are not allowing the elderly person to make their own decisions. They will meet and talk with your mom once or twice and render an opinion, which they then tend to "stick" by no matter what YOU may know and express to them. I have experienced this personally with them, and now my 85 year old mom is living where she has no friends or relatives other than my brother and is extremely unhappy and depressed. She refused to go into AL after a series of trips to the hospital followed by weeks in rehab each time, and APS told her she had the "right" to make her own decision and not do what I wanted her to do, even though it was in her best interest. I known she would be much happier in AL, with people around her, activities for her to do, etc. Now she sits and waits for my brother to come home every day, refuses to go to any senior center or activities that he has tried to get her into, and then complains about how bored she is, how hectic my brother's life is, etc. It is only a matter of time before my brother and his new girlfriend start feeling the "burden" of having mom living with them, and the situation will only get worse. They have already started leaving her alone on weekends, and now tentatively a whole week, while they go away on long weekends, vacations, etc. She doesn't drive, and as I stated before, doesn't have any other friends or relatives nearby to look in on her or visit with her, so tell me how this is better for her? But, because APS got involved, that ended any progress we were making on convincing her that AL was a better option. They actually told her I was "harassing" her by continually talking to her about this and could "press charges" against me if she said the word. They also, however, "offered" to take over caring for her finances and anything else she wanted them to do, which seemed out of line in my book. I think they saw an opportunity to get their hands on some serious cash (my mom has the means to live in a nice AL place and pretty much do whatever she wants for the rest of her life) and thought they had someone they could manipulate to their advantage. Fortunately, my brother stepped in and got mom out of their grips and that ended their involvement....for now. So, my advice, is be very, very careful about getting APS involved. For many reasons.

Basic answer....APS are for adults that don't have family to assist them with what services they need. You should instead contact Dept of Aging in her area and find out what services are available to her.  Having a companion or meals on wheels is helpful but she probably needs an assessment by a Dr or nurse and then go from there.  Dementia has many different faces,  can seem fine for a visit and next time be so out of it you think it is a different person.
Good luck to you.

It is important that you not only protect yourself and others but that you understand that you are protecting your loved one from harm. Also, every counselor you encounter, in fact, I believe anyone in the social services professions are "mandated reporters", and that is a good thing. Our loved ones, as their condition deteriorates, presents so many scenarios that we so often cannot control. If you can, and you have not done so, join a support group and talk with members privately about your concerns. I wish you peace.

I see yo asked this 3 days ago, just so you know this is the first I'm seeing your question and that may be the same for many members here so you may be getting more responses today.

I agree with those above on getting her checked for a UTI. Depending on her primary that may be a great way to help your situation too. I would be hesitant to bring in protective services myself unless it becomes obvious she is in danger and wont cooperate at all but we have had real success using Mom's primary as the source insisting on certain things (and often she is) or reminding Mom that the doctor may step in if she isn't cooperative with us and take this test or do this therapy, whatever the issue might be. There was a time last spring that my mom was digging her heels in and being very uncooperative about the structure and milestones that needed to be met for her to live in her house alone again, things that she had been on board with,agreed to anyway and that had been talked about and part of the plan for quite some time so not new. But she suddenly didn't agree and wasn't cooperating as she could taste the freedom, they were safety issues though and she was the only one comfortable with leaving he r alone without them in place, it got ugly. So I took her into her PCP who knows her well and mom respects, actually is a little afraid of because I have indicated she has the power to force something Mom might not want, her and let the Dr make her own assessment. Mom always shapes up for doctors, although she is comfortable enough with her PC to speak up when she doesn't like something but she is also very honest even when she's minimizing something and the doc was as concerned as I was about things particularly medications which is what mom and I were fighting over heatedly, that and having her come face to face with a real person daily and handled it all perfectly coming up with the perfect plan. She arranged (insisted) for VNA to come out asses things and make sure all the "tricks" for making things easier at home were being employed. They came out and set her up with a nurse that came 2x a week overseeing her meds and making sure she was up to doing it herself, a PT assessment and a speech therapist who came to the house 2x a week as well so a professional was seeing her at least 4 days a week (the other 3 is another story). Even though we were less than happy with that first outfit that provided VNA, Medicare covered it and I was able to go home knowing the responsibility was in professional hands and they were seeing her regularly.

Maybe if your mom can't be convinced to go into her primary for a UTI check at least her primary could be convinced to either send VNA out there to asses things and get a urine sample or just a testing service could at least get a urine sample and then go from there? If you could work out a visit to your mom's maybe you could set up an appointment with the primary for the two of you and get your mom to go along by agreeing to accepting whatever the doctor says about her needs for assistance at home. That way it takes the "bad guy" off of you and often elders will accept direction from a doctor even if they don't like it, better than from their children and I can understand that. But this way you aren't the "pill pusher" or whatever that was she called you and you can even say you want to put that responsibility in a professionals hands because the two of you have such different ideas about what's safe and best for her and you can accept that you may be looking at it wrong but it's out of love and concern...go heavy on the anxiety it causes you to be so far away and worried about her health and safety, maybe she will go along certain she is right but not wanting you to suffer so much, basically "proving" to you your concerns are unfounded (hehehe). That said if her PC doesn't know her well or isn't specialized in the elderly and you don't feel you have a good relationship with them, trust them and their judgment this might not be the best plan. Just like with the police officers the wrong doctor can be snowed, even though the people that know them see a person with dementia is behaving strangely it often doesn't look strange to someone coming in contact with them for the first time and briefly. What is off for your mom may be normal for another elderly person and look perfectly normal to say a police officer doing a welfare check. This is why hospital staff that care will encourage family to be around as much as possible when an older loved one is in the hospital, because someone them will notice much faster if their mental status changes. It's especially hard when the patient has dementia of any kind. I'm off track, my point is a doctor that doesn't know your mom or isn't versed enough with geriatrics to know how to take ques from family with them can just as easily be fooled by her demeanor as the police officers were. Well maybe not that easily, the standard is pretty low for intervention during a welfare check but still between the ease with which they seem to pull it together and the wide range of "normal" when it comes to elderly patients basing suspicion simply on behavior is subjective and not easy. Now getting someone to refer her and get her to take a NuroPsyc test would be ideal, the earlier the better to get a baseline for everyone but again that's another conversation.
Total agreement on the importance of making sure your paperwork (POA, MPOA etc) is in order too.

APS is the adult version of Child Protective Services, if you involve them you and your mom may loose complete control and any say so about what happens, do not trust a paid caregiver to make this decision about your mom, GO TO HER, plan on staying for a week or two and see for yourself. If the relationship is one that you can help her, do so, if it is not then APS is an option that takes you out of the picture, other than visitor. Just so you know it is very serious and pretty final if she becomes a ward of the State, it costs a fortune to reverse that, as well as they become beneficiary to all of her assests to pay or repay for their services. Please exhaust all of your other options before involving Adult Protective Services if you love your mom and want to do whats best for her. Also, follow the above advise about getting her to Dr. for urinary tract infection,  these are wicked nasty in seniors creating a false reality for all involved.  Good luck dealing with your mom and God Bless You on your journey,  it is a challenging one, but you can do it👍

I agree that you need to go assess the situation in person. I’d add that APS is often state specific as to their level of involvement. Some states have very aggressive programs with a lot of action, some have less, and in some it’s next to nothing. Sadly, I’ve seen the next to nothing

You may also consider contacting the local Area Agency on Aging. They may have a Clinician that can evaluate your mom and assist her in her willingness to accept help.

You need to go to her home! I went through this with my MIL. She would answer the door and tell police or anyone enquiring after her (including us) that she was fine and then she would retreat back into her world. She was also extremely paranoid that people coming to the door were there to take her away from her home that she had lived in for 63 years. When I went to her home and finally got inside it was evident that things were not ok and had not been for awhile. The house was filthy in so many different ways, she was dressed in the same clothing that I had seen her in for 7 days, her food supply was iffy to say the least, etc. As we lived in the same town we were able to move in with her to care for her and keep her as healthy as possible and her home clean. You may not have that option but adult protective service can help you out.

UTIs in the elderly causes negative behavior. Dipsticks sold in drug stores reveal only one type of UTI. I would take her myself to see her primary doctor and start there. Have the police go with you if you feel it's going to be a problem getting in the house. Authorities seem to make elders act right. Call APS and just talk to them over the phone, explain your situation, and feel them out.
Are you the Medical POA and POA? If not, I would work on that, too, if possible.
One step at a time. All the best to you and mom!

You need to go to your mother and check this out yourself. Period.

Forgot to say - you do need to rule out a UTI, straight off. Will your mother go to her GP? Can one of the visiting caregivers at least get her to a pharmacist for a quick dipstick test?

Gosh.

The police did go to the right address, did they?

I know 75 miles can be quite a journey, especially in January, and especially in some states; but if it were me I'd want to go round there and do my own assessment. Can you really not?

Social workers come in all stripes. In my personal experience most are knowledgeable, professional and sensible; but for one thing I'm not in the States, and for another how flexible and imaginative they can be does seem often to depend on what resources they have to meet what demand. You may be able to find the equivalent of consumer reviews for APS in your mother's area, with a bit of digging around online. Eliminate the more technicolor horror stories, but see what you can find out about their approach to collaborating with service users and their families.