My mom got diagnosed with Alzheimer's 4 years ago. She'll be 80 this year. My dad is 86. Both have refused any sort of outside assistance. My indigent brother is the only one they will let in the house. His home maintenance fixes are scary (fire and electric hazards). I reported to APS because my parents went without hot water for a month, preferring to wait until my brother could come from a couple towns over. My mom didn't bathe for over a month. They sent a social worker but my mom refused to talk to her or let her in. Will APS be able to help them or can my parents refuse service? I am on the other side of the country and only see them once a year. This feels so dehumanizing to my mom who hated being dirty when she was of sound mind.
APS will not immediately remove the elder from their residence either. They will offer multiple sources of help. If the elder declares they are being assisted by family this will hinder any real help if they are truly in decline (Been there and it is so frustrating)
Honestly, it will take a medical crisis for any real change to occur. Then you will need to deal with the hospital social worker and discharge nurse to declare an unsafe discharge. But if your brother delcares he is able to care for them it will override your request because he is local.
Sorry for your situation. It is very difficult when they are propped when less than satifactory aid is been met.
In most cases a real catastrophic event will occur for any change to happen.
In our family's situation, we basically had to meet up with APS to take them into our parents' house. They had tried to visit before by my parents would not open the door. So we met the agent outside and brought her in with us (we had a key). She was extremely nice but short of an emergency situation, they cannot do much other than offer resources. Since our parents had heat, water, electricity, and food and there was no real hazard in terms of hoarding (other than stacks of paper on the table), APS's hands were tied. They did sit down and explain that they could send home health aides and other services, but the parents resisted.
Unfortunately it took medical issues (minor fall, racing heart) to get them out of the house.
Is he able to properly and safely care for your mom?
If he also has dementia they should not be living alone.
If he is unable to safely care for her then APs should step in and follow up with an investigation.
The concern might also be if your brother can not manage their care he may be investigated for neglect.
You could also contact the local Senior Service Center near them and talk to a Social Worker and express your concerns.
If you can send a not to their doctor and let the doctor know of your concerns they may follow up as well with a call to APS.
And you could also make a call to the police asking for a Welfare check. You might want to mention potential hazardous problems with plumbing and electric work that may have been done without permits.
Is the hot water working now? How are they getting meals? If APS comes and finds water and power on and food in the fridge, they may not do anything.
Is there anyway you can come out for a visit to see what things look like for yourself? It seems a little unfair for your low-income brother who doesn’t live close by himself to have the responsibility for your parents solely on his shoulders.
I do have a geriatric care manager on retainer but my parents refused to meet her. It sounds like APS may not take action if they are not allowed in the house.
I will come in the summer but that's a long time from now. I promised myself I would not drop everything for emergencies based on my last several years of visits. It's not like my dad agrees to my housekeeping/caregiving suggestions when I'm there, though he will happily accept my labor. Since my brother is keeping them fed I don't think I have any leverage if I were to go now. I don't think I have it in me to go through the guardianship process, if that's even possible since my dad does not have dementia.
I can identify with your dilemma as I too live across country from my 101 year old mother. I can share what I did but it seems like your parents situation is more serious without your brother living there and no one else lives in the house, right? Are they any other siblings or relatives in the area who could help you out? Dialogue and negotiation is always the first and best way to work through these situations. But my older brother would not talk to me much less dialogue about our mother's care.
SUGGESTIONS TO CONSIDER:
First of all, what I haven't been able to do is get my older brother agree to visit with my Mom Aging and Disability Services in our hometown. They have always been helpful but emphasize it's up to your mother and father to want their services.
The second idea, is to see if you can get a geriatric manager too help out with a conversation between you, your brother and your parents. Not sure if there is one in your area.
Finally, you can always hire an Elderly Care Lawyer and go the legal way. It's expensive but may be the only way you can go.
If you want to take time and read my experience with APS and well care check by the local police, I'm writing it down here.
Last year in 2025, my older brother who is the primary caregiver gradually cut me off of any contact for the medical persons and took away the only source of daily contact with my mother. He also now is the primary shareholder of the house LLC so it means he completely owns the childhood house my mother is living in. He too wouldn't accept outside help but it's his decision not my mothers.
What I did last year with the help of a younger brother is to compose a 7 page document explaining our serious concerns. We then sent it to APS and they did investigate but there was not serious enough concerns for them to do something. It did make my older brother mad but the idea was our concern for our mother.
I also called a well care check with the local police. A wonderful police woman did visit my brother and mother. Even though my Mom expressed her wish to have contact with me through her special equipment, nothing was done. I'm not sure what the police force is like in your mother's area?
I visit my Mom twice a year to connect with her though my older brother is angry and verbally abusive towards me when I see him. I do NOT stay at the house but with a good friend in the same town.
So what now in 2026 is happening? My older brother developed gout so his daughter and my mother's granddaughter is living at the house and taking care of both of them. She is family so that is okay.
You need lots of thoughts and prayers as you seek wise, safe counsel on this important and seemingly impossible situation. JLE