I am a PT. A year ago we found my neighbor lying in the snow with a fractured hip. He is 76. He had a replacement and was diagnosed with dementia after having a severe mental reaction to the general anaesthesia. Of course, being a PT, I was very active in his rehab and helping his wife generally cope with the new diagnosis. Some of us would stay with him an hour or two so she could go to the hairdresser or store. It is a year later. He has moderate dementia and is still driving which I find scary. The wife has returned to her job which entails one weekend every few months in another state. She prepares all his meals, has notes all over the house and leaves on these trips expecting we will "keep an eye" on him. We have a key and her phone number so we can "reach her". I have to tell her that I am very uncomfortable with this. We can see the house across the street, but that is it. I will not go into the house and check on him. She needs to get a carer or quit her job. He has had some falls and tries to work in the yard using tools and ladders. He hurt his back carrying a ladder. His dementia was diagnosed a year ago and I know he has deteriorated. My husband wants me to tell her that I will not participate in this with the exception of giving her a phone call if we see anything. She is 2 states away. This is madness. I have faced many families with the hard truth professionally, but feel lost dealing with this. I really feel like the bad guy here. The other neighbors think he is just fine, but I know better.
In my home state (MN): "...mandated reporters must immediately report suspected abuse, ***neglect***, or financial exploitation to the Minnesota Adult Abuse Reporting Center (MAARC). The state DHS page also notes that mandated reporters are identified under Minnesota law and must report suspected maltreatment right away."
She is endangering a vulnerable adult by leaving him as the responsibility of others because she knows he's not capable of being completely on his own safely. Think of it this way: If a parent looks at their 12, 10 and 8 year old before leaving on a date and says "you're responsible to watch the baby" (2 yrs old)... then who is actually in charge? Answer: no one because they all think the other is in charge.
Consider getting together with the other neighbors (who may also be uncomfortable with this situation) and decide as a group that to no longer be her solution. He is declining and will need more and more help eventually. Why should you be liable for his safety? She is being clueless, selfish and ridiculous. How do you know she's even actually working? Maybe she's having some Girl Time with friends or a lover? If she's only working such few hours then it won't be a stretch for her to quit or pay for a true caregiver.
Please stop being an enabler and appeaser (people pleaser). My husband, a wonderful guy, has trouble with "difficult conversations" with people, even his own family members -- so I understand it -- but it doesn't excuse it.
Your neighbor won't look for other solutions if you and others keep being The Solution for her. You do not have to tell her why you are all ending it, just that you are. No is a complete sentance.
During the conversation with her (and all the neighbors should be present for this) you can also give her names of agencies and Care.com.
I wish you wisdom and peace in your heart that you are NOT the "bad guy" in this situation.
I have a question before I start. You say you were "very active in his PT" was that as a neighbor friend that happened to know what needed to be done or were you being paid as a PT while you were very active in his PT?
The reason I as is I am wondering if your continued help may put your license in jeopardy.
Now...
Have you discussed your discomfort with the wife? I think sitting down with her and telling her that you think this is unsafe and that as a medical professional you are MANDATED to report unsafe practices and you think that she should have a caregiver helping her, particularly when she is out of town. Because you think it is unsafe you can no longer be an observer when she is gone. Obviously if you see him fall outside or happen to see him do something unsafe you will call 911.
Tell her that this is not personal but it is the advice you would give anyone that you were seeing on a professional level.
Does this couple have adult children that you know? If so can you talk to them about your concerns? If they are unaware of what mom is doing and the potential danger that dad is in they may step in and try to talk to mom. They may be unaware of what is going on and how compromised dad is. Many people with dementia can "hold it together" for brief times fooling the people that are visiting.
I think a call to APs is well within the scope of what is necessary. And I suppose if you really want to drive the point across you make the call when she is away.
Also, why is the wife working 2 states away?
Tell her that you are not able to keep him safe, and it is time for her to hire a caregiver. She probably just doesn't know, and it may come as a shock to her to hear it. If she harbors any resentment toward you, that will be unfortunate, and hopefully short-lived. She needs someone to tell her that the husband needs more help. You are able to see it, having had first hand experience with others in a similar position. Hopefully your friend and neighbor recognizes your professional experience and benefits from your opinion.
Mods can remove my post if they wish.
If the wife is not agreeing with you, then you back out of this arrangement and return her key .
Hopefully , the wife listens and you are not forced to call APS.
I know it's a rather delicate topic, and I'd be a bit nervous myself broaching this subject, but somebody has to have enough cajones to do it. What if the poor man fell and injured himself inside the home while she was gone? You'd feel terrible if you'd said nothing before she left. At the very least, he needs a First Alert lanyard around his neck to call 911 in the event of an emergency. It needs to be connected to a service too.
I'm sorry you're in such a position. It galls me how much neighbors sometimes expect from one another. Best of luck to you.