To Linda in NY: Contact CaringKind in NYC. They have a 24/7 help line. They will find a way to help this dear lady. She is lucky to have you. 646 744 2900. (I think their website has recently changed.)
13
I cannot imagine that the elderly woman is not scared - aging completely alone in a large city while knowing that she is getting (at least) forgetful must be terrifying. It is also dangerous - she could leave something on the stove to burn or accidentally turn the gas on. Kudos to the writer for considering helping. I hope the coop can find a solution.
10
How about introducing the lady with the pigeon to the guy in the park; sounds as if they both need a friend.
10
I am getting to like writing a response before reading the expert's opinion, err, expert opinion.
I could hardly be more concerned with the protection for the lady who you describe in such terms as lovely and forgetful after learning that you are really concerned about keeping this woman from threatening you and your other bitties and use the herring that she may harm herself as placebo to get her held in mental hospital incarceration until the gestapo scientists decide she cannot be allowed out and should be confined as a ward of the state.
Your final tip-off is that you are frantic to learn whether there are laws requiring someone else to do your dirty work and let you go about walking your domestic animal undisturbed. Why don't you just voluntarily sign yourself into an old folks home?
12
Most - all? - States have a Guardianship protocol for people who cannot care for themselves and either have no family or are resistant to family caring for them. In NC it’s called Guardian Ad Litem. It’s risky to get deeply involved with a non family member because you are vulnerable to accusations of financial and emotional abuse whether or not you do anything wrong. Guardians appointed by the court are bonded and extensively trained and have regular oversight.
9
1. Alzheimer's can only be medically confirmed via autopsy. Many other illnesses/diseases can mimic MCI/Alzheimers/dementia.
Sandra Day O'Connor was a hale and hearty 75-76 year old when she resigned from the Supremes because her husband was diagnosed with Alzheimers. O'Connor resigned early in 2006. In October, 2018, O'Connor resigned from 'public life' as she was diagnosed with MCI - early stages of Alzheimer's.
In numerous public and private speeches, she regretted resigning to care for her husband (who fell in love with another woman @ his care facility) rather than the traditional old age or ill health. As tough a cookie as O'Connor was she was simply unable to care for her husband as his Alzheimer's/dementia progressed.
2. Homelessness is a worldwide problem because of the increasing income inequality. Once again, America leads the world in this particular manifestation of our economic system.
3. Ralph Nader was granted a full financial needs scholarship to Princeton. His Lebanese immigrant parents felt they could scrape the dollars together from their small, family owned restaurant, so that the needs based scholarship could go to someone with even less money than the Nader family.
Perhaps it is time to rotate the author of this column IMHO.
4
Another resource in NYC is NORC - Naturally Occurring Retirement Communities - which spring up in areas, particularly co-ops, where a large senior population exists. These are partially subsidized by the government. The one in my neighborhood includes a nurse and a social worker, and they make house calls to determine exactly what's going on and what kind of help is needed. They may also provide deeply discounted devices, from commodes to grab bars to Life Alert gadgets to house cleaning and home health aides. My mother made great use out of their services for years and I'm beginning to use them myself.
8
LW1: This woman has clearly reached out to you in a gesture of friendship, and expressing her fears that she’s no longer functioning as well as she used to. She also appears to be in some relatively early stage of dementia and you seem willing to be of help but understandably not to get enmeshed. I think involving the building management or board would be a big problem because in NY they can be very nasty.
Remember too, that dementia may remain stable for a while, but it never gets better, only worse. Also, she’s probably terrified. How about inviting her to go to coffee nearby someday, so you’d be in a safe public space, spend some time getting to know her, and either then or at a second meeting ask if she’d like you to accompany her on a visit to her doctor to ask about what kinds of services there are for older people who are having memory problems and might start needing help in their daily lives? All the NY hospitals have excellent elder services. If you were willing, you and perhaps some other people in your building could provide informal support to her of various kinds, but social services, not you, are the ones who should be doing things like contacting family, and her doctor is the place to get that going. If she doesn’t have a doctor, call 311 on her behalf to get started.
She may end up no longer able to live independently, and handling that kind of transition is a huge job even for family, which I know having done it for my mother.
15
@Mikki
It’s her brother, not son, who lives in Japan. He’s probably in similar shape as she is and might not be able to travel. It’s a difficult situation.
12
A common symptom of dementia is that the person is unable to recognize that they have it. This adds complexity to the ethics of the situation.
22
The answer to the first two situations is the same--gradually make friends with these people as equals, the same way you might make friends with others whom you see on a frequent basis. Once the questioners have done that, what help the people need or want will be more obvious, and help can be given the same way friends help each other, rather than in a condescending manner.
11
Am I missing something here?
Feeling guilty for 70 years is indeed a serious problem. The trigger for this guilt is inconsequential by comparison.
The answer treats the long-ago decision as the primary matter, which is actually trivial at this point, and has no chance of a remedy. The answer does not mention the enormity of 70 years of guilt, which seems to me to be the problem, not the symptom, and is amenable to treatment.
By discussing the ethics of this 70-year old decision as if they were relevant today, the answer does a disservice to someone who has a genuine disorder, a guilty obsession with that decision, encouraging more picking at the scab, more guilt. This is not helpful.
12
@William Romp
Church teaching of 70 or more years back had as a primary goal the lifelong placing of guilt in people's minds. (See George Carlin for verification.) It seems to have worked very well in #3's case. 70 years of guilt over a scholarship to a Catholic high school awarded by a Catholic middle school to a kid the Church decided was totally deserving of that scholarship? Now that has to be Catholic Guilt writ large. I went to public school exclusively, with my Catholicism taken care of only at Sunday School, augmented by Wednesday afternoon Released Time Religious Instruction (older NYC school-goers will remember that concept). I ceased and desisted entirely by age 13. I once won $25 for a high school essay on the old New York City Center, and I have remained guilt-free about it all these years. It's really time #3 embraced his deserving talent and stopped writing to third parties in an attempt to expiate his sins (another olden times Catholic synonym for guilt). He might even try the Confessional if all else fails!
17
@William Romp If this is an ethics column rather than an advice column, then the long-ago decision seems to be the only thing that matters from which we readers can actually learn.
4
LW1's situation is only going to get more common in NYC. The population here seems to get older and older as the city became more popular and friendler to older people. Yet often close family members are not so geographically close.
9
@David Binko
Perhaps you would like to sign onto a concerned citizens group which will spear-head a government subsidized advisory committee to rid the "community" of older and older populations. Let's put a halt to this popular and friendlier living space for those who can be warehoused elsewhere. Crackpot.
1
That is way too simplistic a response. It sounds good on paper and in a hypothetical conversation, but when the time comes, it is not as easy to just "go to another state" as you suggest.
My comment was directed at Brigid for her euthanasia oriented response. My family have believed in it, too. But when the time comes, you can't just go to Vermont or Oregon to die. This isn't Solient Green. It isn't so simplistic an answer.
8
I am old. I look forward to the day when I can go to Vermont or Washington State and relieve my children of the burden of their infirm parent. Why do people think they have the right to live until 98? The vast majority of Medicare spending is wasted on the final six weeks of life. We old people should just die. as is our inevitable fate.
35
Perhaps the ultra-opinionated should jump first.
12
Oh Brigid, I couldn't agree more. Blessings on you.
4
"We old people should just die."
seriously?
10
Regarding the lady who may have Alzheimer’s. I would contact the son in Japan. He should return to the U.S., check on his mother and make arrangements for her care. Of course, the staff would help by providing referrals.
8
@Mikki A brother in Japan, not a son. And information can be provided to the brother without telling him what he should do.
8
@Mikki
Wasn't a son, was a brother, so he may be older and in worse condition than Sis.
7
I know that there are those who may find this comment offensive, but going to public school instead of one based in mythology is likely to have been the better education.
62
@Sue The schooling isn't based on mythology just the religious instruction. The rest of the curriculum may be as good, better or inferior than the local public schools, depending on lots of things besides the religious affiliation.
4
@Roger Catholic school teachers get paid lots less than public school teachers. Generally, the teachers are superior in public schools. You never hear of a public school teacher leaving to go to a Catholic school, but the reverse is absolutely true. My husband, who taught art in a Catholic school for ten years, easily agrees that Catholic schools just are not as good as good public school.
8
LW3 I couldn’t help but wonder what else you would have consistently thought about for 70 years if you hadn’t got the scholarship. Maybe it’s just time to grow up and move on to your next unmoral dilemma.
23
LW3: the unstated assumption seems to be that a Catholic education is better than a parochial one. Is it ?
14
Re the 8th grade scholarship recipient. “You are morally permitted to weigh your family’s interests and your own over the interests of others.” I have always acted on this principle but at 74yrs old I do not think I really believe it. It may not be too late to begin change at least is small ways
7
Dear LW #1,
There are many reasons why the woman in your building could be acting the way she does. Dementia is one of them. It is sad that this woman apparently has no close friends or relatives to look after her. If you wish to help her, it is possible that she may decline your help. It is within her rights to do so if she has not been declared legally incompetent. In that case the only thing you can do is contact adult protective services, as others have suggested. However, if she is willing to accept your help, I suggest you find out from her who her family doctor is and contact him or her to address your concerns, or get her an appointment and offer to take her. She may not have seen her doctor in a while. He or she may have the contact information for her brother or an emergency contact on file, would be able to assess her and diagnose the problem/start treatment and would be able to get her plugged into social services in the area. Her doctor would not be allowed to disclose any of her information to you, but you could feel free to tell him or her your concerns.
13
I received scholarships based on achievement a bit less that 70 years ago. It never occurred to me that I was taking the money from someone else, and it did allow me to have a great education without debt after I graduated. I realize that is a big deal. I'm quite comfortable with the situation. Grateful and comfortable. A "high performing" student is likely to contribute, I did.
17
@Daisy22 My history is the same; I received a merit-based scholarship 50 years ago, and I was and am grateful.
Assuming that LW#3 is financially comfortable, he or she could assuage their sense of guilt by making a generous donation to fund scholarships for others. If LW#3 feels that only the needy should receive such assistance, it's easy to direct such a gift toward a needs-based fund.
8
I notice that the elderly neighbor's brother is in Japan. If the neighbor herself is a Japanese citizen (or even if she previously worked in Japan and paid into the system), then she should be entitled to benefits under the Japanese national health insurance and pension programs. If she is a Japanese national, I would suggest contacting the Japanese consulate as well as the brother and other local authorities, as necessary. My husband and I moved to Japan in 2008 to help care for my father-in-law when he developed Alzheimer's. As his disease progressed, local government provided regular visits by a care manager, adult day care, home health care aides, physical therapy and later therapy to help him swallow. They even subsidized the cost of some minor home renovations to help us keep him at home longer. Even with the help, caring for him at home was physically and mentally exhausting, but he was able to stay home with only a short hospital stay at the end (he died of lymphoma). I was shocked to learn from the comments here that Medicare does not cover dementia care! If I were in the neighbor's situation and could still travel, I would choose Japan over the US any day. Oh, and I shouldn't neglect to mention how the neighbors up and down our block came to our aid many times, once even carrying my father-in-law through the street when he couldn't walk, just as we helped them in their time of need. Our natural human desire to help is nurtured in that kind of community.
38
@CK.
This highlights some of the horrific gaps that our
first world nation has now, in caring for our citizens.
It will only get worse unless we unite.
19
You missed the mark with LW1, Professor Appiah. In fact, as LW1 describes the situation, there’s no ethical conundrum to be solved! Whether the neighbor has a diagnosed condition and is aware of it is not only NOT a big ethical question, it’s irrelevant. The only thing that matters is that she can’t find her way back home because she’s forgetful. And whenever a situation like this arises, there’s only one practical, straightforward step to take: call Adult Protective Services—just as a compassionate woman once did for my late father-in-law, who at the time was driving in circles in a strange neighborhood because he couldn’t find his way home from the market.
Fearful and confused, he eventually pulled over near a pair of large dumpsters, thinking—hoping—he couldn’t be seen by neighborhood residents. But in fact numerous sets of concerned eyes had been following him for some time. When several more minutes had passed without any movement from my father-in-law, our Good Samaritan approached (with two other neighbors behind her in support), spoke briefly and assuringly with my father-in-law, and promptly called Adult Protective Services.
This occurred before he was diagnosed with Alzheimer’s, but ended up being the episode that finally prompted him to accept his disease and get help. My wife’s family and I remain grateful for that kind woman’s intervention and her example to this very day.
67
My father died of alzheimer's/vascular dementia so I had many years experience with that downhill slope. He was unwilling to acknowledge his diagnosis.
I have known many other people in his situation and some were able and even eager to discuss the ramifications and others were not. I have always tried to respect their choices.
I have a very elderly close friend now who lives alone in an apartment. She forgets things, has had mini-strokes in my presence, has been hospitalized with urinary tract infections that have made her seem demented until treated, is sometimes taken advantage of by acquaintances, loses things. Her children are far away. She has told me nothing matters more to her than maintaining her independent life in her own space and since I have seen quite a lot of the alternative arrangements I sympathize with this and try to offer support and so do other friends. I have accompanied her to doctors' appointments and talked to her about her situation and attempted to sort out various disasters but I do not attempt to diagnose her myself or interfere in her arrangements even if I worry about her.
Maybe the situation is different in NY but while many people working in relevant agencies here are professional and kind it is awful to give up one's life to institutional priorities and I would not start on that path until it was urgently necessary nor would I interfere in the life of a neighbour I did not know well except to offer some companionship.
22
@pigeon
How very kind. Should it happen that any of us end up in the unfortunate situation of your friend, ill, with no family near by, a kind friend to keep an eye on us is the next best thing. I thank you Sir for your humanity and kindness. How encouraging to read this comment rather than "best to mind my own business " attitude found in modern society.
Those readers worried about illness and care with no family support need to make a plan now. Don't wait. In the West despite modern advances in science and medicine future support and care for ageing has been ignored. Why?
13
@pigeon-I was in a similar role with a friend of 20+ years. I took her to get diagnosed which was a devastating sentence for a lovely person in her 80s. Fortunately she appointed me as her Power of Attorney and Health Power of Attorney and later executor. I was able to hire companions, CVNs, home health caregivers, and others keeping her independent as long as possible and autonomous until I had to move her into a assisted care facility where she could get 24-hour monitoring. Fortunately, a friend of 45-years lived near enough to the long-term care facility to visit daily. I was grateful to pay her to acknowledge her time after our mutual friend passed.
12
LW 1
She needs to be evaluated by a professional.
https://www.agingcare.com/local/new-york-city-department-for-the-aging-new-york-area-agency-on-aging-ny
I am sure they will have appropriate references
12
In situation #1, a visit to the doctor is a must. It’s quite common for elderly woman to have urinary track infections and not even realize. An infection can cause confusion that mimics the symptoms of dementia.
31
@Born In The Bronx, UTIs in the elderly too often lead to SEPSIS.
13
RE: 'a danger to the neighbors' - if they have a gas stove, they can be a danger to the entire neighborhood. More elderly than you would think have lost their sense of smell and will never notice a gas leak or a pilot light that's gone out, which is more likely to happen if the stove isn't cleaned regularly by the forgetful...
12
Call the brother. Call the brother. Call the brother. And if she has a lawyer, call that person too. Have her doctor's name, call that person too. Actually, that should be worked through the co-op board who may want to call in a geriatric worker to make an assessment.
Kindness and care from neighbors and staff *sounds* good, but there are legal implications when she 'forgets' she gave something away and calls the cops. You can get involved in an elder abuse case fraught with legal charges if she develops paranoia.
If the brother refuses, yes, talk to the city, but even if she and the brother hate each other, keep him informed. And..keep contemporaneous records of every visit with her, and every incident she needs help with. If you end up dragged into court because of a greedy brother, you may need them.
15
The best thing to do if one suspects a neighbor has dementia is to contact his/her family. The liability of helping one with mental deficiency is endless. Having said that, if the neighbor is a danger to themselves or others the police authorities should be notified. This is a situation best left to authorities.
4
Be careful, is my advice. When I lived in San Francisco in a condo, the elderly woman across the hall was a renter and the owner of her unit was trying to kick her out. That being illegal, I asked a lawyer friend of mine to help her out, which he did, at no charge, and she was able to stay.
After that she became very dependent on me. She would watch for when I got home from work and come right over and knock on my door. It got so I dreaded coming home. I did small things for her, like addressing her Christmas cards, helping her pay her bills, helping her clean her kitchen, prepare a meal, just inviting her in for a while.
It got progressively harder. She had only one relative, a daughter-in-law who lived in Texas. I got a hold of her phone number, but had to beg for her to come out. She did eventually, after several months of pleading. Since I was looking out for her mother-in-law, she hadn't seen any reason to come. She did eventually when my neighbor's doctor intervened and my neighbor moved to Texas.
I liked my neighbor and wanted to help her, but it was not my job to help her and I had no authority to do so. I remember her fondly, but I just could not do any more.
42
Coop and condo buildings often are occupied by people of approximately the same age. This is especially true if the building was built, say, 40 years ago and sold primarily to people of the same age at that time - say 35 to 45 years. A majority of the building can suddenly be old people needing increasing support amd servoces to age in place.
Denmark and Sweden have cooperative apartments - places where residents can, if they wish, cook and eat together. In other words, the apartments are designed to stimulate social interaction if desired while still providing privacy when desired. In one example, initial residents were deliberately selected to provide a range of ages, so there was/is always a programmed mix of 20's to old age. Everyone was expected to contribute some volunteer effort to the joint meals - but the younger more able folks took on the harder tasks like cooking and washing up afterward, while those less able were assigned things they could still do - like setting the tables. This system would be disparaged in America as "socialism." The Scandinavian government provides additional services for the aged in the building at no cost to the younger residents.
Decency and common sense have come to be seen as "socialism." Our culture promotes capitalism (private services) over sharing. But the humanity of sharing work and meals makes everyone feel better - and keeps elderly people from being increasingly socially isolated as their ability to do things deteriorates.
42
One very cold winter, a building staff member of my hi-rise told me about an elderly neighbor who was not turning on her heat or lights. Neighbors were bringing food and I brought oatmeal twice, but after finding an excuse to come in, I saw how she was living and became alarmed. I informed the Super and Management and was told that she had a right to her privacy, period. I asked them if they really wanted her to starve or freeze to death in her apartment, but they didn't budge. Without disclosing any of her information, I called Adult Protective Services. I discovered that they don't barge in and haul someone off as I had feared. They send a case worker to talk to the client and determine if help is needed. After speaking with the area case worker and asking many questions, I gave her the resident's info. The woman at first wouldn't open the door, but finally did.and the worker quickly determined the need for assessment for dehydration and mental stability. The resident agreed to go with her to the nearby hospital. After 2 more of such hospitalizations, her relatives were contacted by the caseworker. The grateful family spoke with the building Management, and took charge. They took her home with them, and she was placed in good supervised senior housing close by. They expressed sincere gratitude to me for my not allowing this situation to continue. I know I did the right thing, but it took time for me to get back the good relationship I'd had with the Super!
80
@EFdiamond
This is a great answer, the answer. My father did this with my grandmother in Minnesota and they determined she was a danger to self and others. No one should have to live with a woman so forgetful she might leave the stove on. I would call an agency immediately for an unbiased, professional opinion.
19
@EFdiamond
"Good" supervised housing costs a lot in this country.
It's available if the senior has lots of assets.
I've seen plenty of what is basically warehousing at
a profit.
12
@EFdiamond-Good action/plan. Seniors can feel embarrassed and ashamed to admit that they are forgetting things. Hearing loss often goes hand in hand with dementia. Following radio, TV, or even a phone conversation then becomes harder. Seniors struggling with these challenges can grow more isolated. It's good you were able to intervene on your neighbors behalf and call in local resources equipped to help -- as well as the family.
2
I can understand the Catholic school student's concerns. I owe my success to my mother's decision to use my father's SS death benefits (he died long before I entered school) to fund my education from grade school on. Once a jewel, the Midwestern city's public school system was in a death spiral by the time I hit kindergarten and after a year she decided the reputation of the school that provided her and my grandmother with superb educations was no longer able of meeting even acceptable standards. (The state decided the same thing and it was un- or probationaly- accredited for decades). Her sacrifice ensured me a solid foundation for college and a wonderful career, and led her to go into business where she was successful. I wish it were safe to assume that only certain megalopolis public schools are a disaster; far too many in the heartland are just as bad if not worse. So the lady's concern for her fellow student may be valid, her care for others is an exemplary chrachter trait far too rare today, and the examination of comparative outcomes should focus not just on that second-place student but on all students who left the parochial school for public high schools.
6
@John M. WYyie II You're looking at this scenario from a fairly contemporary perspective. The inquirer noted this was 70 years ago. That s/he is still pondering the question of whether the right thing was done is kind of fantastic since s/he'd have to be 83-84 at this time. That in itself raises questions for me!
11
My parents lived to 87 and 95. both ended up in the Reminiscence Room.
It was dreadful for all involved.
Not wealthy, I live solely on SS.
I am 68 and moved rural so I could afford to rot in place. Far from old city friends and standoffish neighbors.
So far so good. I feel it coming, yet can still figure out my 10 pills and 2 eyes drops a day.
I often think of Dustin Hoffman in 'Little Big Man'.
We may never know, 'when'...
14
@Why worry: Love your phrase "rot in place." Better to get out of this realm before it's too late, in my considered opinion.
9
Our aunt lived alone in an apartment 2500 miles from all relatives. I happened to be traveling for work to her town, and visited with her several times over a couple of years. It became evident that she was ill, and she reluctantly confirmed that she had terminal cancer. Yet she refused all assistance, wouldn’t even cash checks we sent her for food. Moving to a care facility was out of the question, she simply refused to consider it. Not even “meals on wheels.” (I’m sure other readers have similar stubbornly independent relatives.) When she became nearly helpless and still refused help, I enlisted the building manager. The manager and his wife were kind and caring, but were limited by what they could legally do in terms of entering her apartment. They called us when she was taken by ambulance to her last hospital stay. So, as a distant relative of an aged aunt, I hope that the coop neighbor gets in touch with the brother of her ailing neighbor. He may know nothing of the situation, and it is likely that he is the neighbor’s closest relative.
21
@Gaston Buhunny ... assuming the LW can get hold of the brother's contact details. Even if the building management has those, they may not share them without the tenant's consent...
2
In a way all of the sections this week are about our understanding of community; altho' the last one is less compelling( the writer WON a scholarhship; the number 2 student simply attended a public high school. He wasn't deprived of an education.
Letters one and two are about whether we dare to risk making connections. The Ethicist rightly warns to be aware of your own boundaries, and to tread carefully. We do not have sufficient services in this country for individuals who are alone and aging, or alone in other ways and facing some physical or mental limitations.
For LW1 - the management or board has to be notified. If you are fortunate, the brother might want to be involved, or might have other relatives who can serve, or at least know more of her background . Perhaps she even has a legal representative who doesn't know she's having problems. If not, and say, Adult Protective Services is ultimately called in because the woman is deteriorating, and has no one to manage her affairs, the response can be of great help or greatly frustrating - in part because they may not be well staffed, and in part because there are often no simple interventions.
A friend who lives in a coop says her building has become a "Naturally Occurring Retirement Community" - many aging residents together in one place. In some communities there has been NORC organization to cooperatively provide shared services to help people remain at home.
5
The answer should be YES. If we are ever going to evolve into a caring and intelligent society, caring about our neighbors is paramount. Get involved. The payback of knowing you did the right thing for another human being will fill you with gratitude and grace. Helping another in a compromised state is always the right thing to do. Period.
20
Regarding the lady in the co-op building:
Staff needs to be the contact point to provide this woman with the suggestion that she should contact city or state aging assistance resources. They also more than likely already have the contact information for the brother in Japan. If they are concerned about her state, they should contact the brother. At some point a person with dementia or Alzheimer’s can become a safety risk for herself and others.
14
what is profoundly sad this is a clarion call for all of us urban singletons who have independently lived their lives free of spouses and family connections not by choice really but the way it played out and now years later you are still alone and your are losing your faculties leaving you vulnerable to realtors rent control takeover freaks and may thieves. To me, having cared for a brilliant intellectual Mom who suddenly entered into Dementia zone, and I was there to help her navigate to the next chapters including full time private at home care, which I paid for myself knowing that although she was low income and could have gotten into a nursing home, I just could not do it. I knew her, I knew that I'd be at the home daily anyway monitoring their "neglect," I just took it old school and did it myself. No regrets, but that realization that you are dealing with someone in decline is heartbreaking. Sad to me that there are no family members or former colleagues looking out for her. Just so sad so sad.
29
LW#3: You’ve been worrying about this for 70 years? I think there are many more important things you could worry about now and perhaps help with.
28
@Irene
Wouldn't it be wonderful to arange a fund for a needs based scholarship at a similar school! ( Very Catholic response to guilt.)
10
My father wen to a coed Catholic High School instead of the far more prestigious all boys Catholic School in the area. Although he had been accepted into the competitive boys high school, his twin had not, and so his parents sent them both to the local Catholic school. From the outside, it may have looked like he got a bad deal, and was held back by this. In reality, he made lifelong friendships with women and men in his school and loves going to the reunions some sixty years later. You never know what is going to turn out for the better.
33
LW#3. Gee i am trying not to be harsh, but to feel guilty for more than 80 years for accepting a well deserved scholarship is a bit, well, sad, for lack of a better word. I hope the LW hasn't obsessed over this for 8 decades, especially since he/she has no idea what happened to the classmate who went to (gasp) public school. Maybe that student excelled beyond his/her wildest dreams and the LW's accepting of the scholarship was a lucky break for student #2.
23
You have left out some important points re LW1. A staff person owes a duty to the building to inform them, so you were contacted for a go around. Perhaps to preserve tips if they are wrong. If you call in the social workers it is too possible that this neighbor will be declared incompetent and her funds will be eroded by the named guardian for providing no actual benefit. Also, a common cause of these symptoms in the elderly is being overmedicated. More likely than the dementia that it resembles. Now you will find yourself in the deep end immediately as you are not authorized to discuss her medical care to evaluate her condition. You are in fact not empowered in any sense to act on her behalf. The brother must be contacted. He can name someone a health care proxy in tandem with himself. Try to catch her in the morning and inquire about where her brother lives. If she can't remember and the building does not know, you could accompany her to her apartment to look in an address book. That is the limit of what you can do for her. You know already what to look for as signs of dementia but one experience does not a doctor make you. If all else fails notify management
10
If the forgetful neighbor owns an apartment in New York, she may be vulnerable to serious financial fraud. Both services for the elderly and her brother need to be contacted to ensure that this asset is protected, in case she needs care in a dedicated medical facility down the road. Dementia care is not covered by Medicaid or Medicare, and it is not cheap in the New York area. If she has clinical dementia a neighbor, however well meaning, probably won’t be able to provide the care she will need.
20
@Kate-Ideally her finances will be secured and the brother will understand that a Power of Attorney for Finances and Health Power of Attorney plus other legal documents are needed with people appointed.
1
LW1 - You recognise this elderly lady's need. I don't know what kind of 'staff' you have in your coop building, but don't think any of them are equipped to cope with the cognitive decline of a resident.
You are worried for her, and that shows your empathy. You have a couple of choices, which are not mutually exclusive.
1) You can become directly involved in making sure that she is safe and has the help she needs. You would need permission from either her or her family to do that, and perhaps some sort of legal authority. That will be a lot.
2) You can contact everyone you can think of in the city and health helping agencies to alert them to this woman's increasing need. Contact her children to tell them you are doing so. If she is not able to find her way back to her apartment from the lobby, she is not doing well at all. How is she shopping and eating. She may be doing neither.
If you do (2), those agencies will likely lean on you as a resource.
You can do this too:
(3) Nothing. You can walk past her in the lobby, nod nicely and I think you know the drill I am talking about.
You need help with helping this person. Ask whatever agencies there are that help elderly persons in NYC to send a social worker around to advise you what help is available for her and you.
Best wishes and thank you for being concerned.
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LW2 - I understand that you don't want to bite off more than you can chew, but you have already put yourself in the shoes of this man. You are imagining his situation if it gets cold and wet.
Good for you, and I mean it, a lot of people cannot get to that place.
He seems to have struck a cord with you. He is, so far physically OK, more or less well dressed and doesn't ask for money; mentally OK, he reads a paper and behaves as others expect him to,... but he might be 'covering' very well.
But he is sleeping on the bench.
This could be his choice
You have a couple of choices.
(1) Continue saying good morning and nothing else
(2) Sit down some time and try to strike up a conversation
(3) Tell him flat out that you are worried about him, particularly as the weather gets worse (he may have a fall back plan), and ask him if there is anything you can do to help him.
(4) Give him a hot coffee or hot chocolate and a sandwich when it works out and be the person who sees and greets him as a person instead of dumping on him as a homeless bum.
Thanks for worrying about him and thinking about how you can help.
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@Jean Sorry, 'struck a chord'.
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You know it is great to be empathetic but the bottom line on #1 and #2 is that these individuals are not your legal responsibility so how much you actually can help is probably limited.
#1 her brother needs to be notified by building management before dragging in the calvary; if he is unhelpful or uninterested then adult protective services need to be contacted
#2 you can talk to the gentleman, but I bet if you try and get too close he will either A) find a park where noone bothers him or B) you will wish you never opened that door. Does he even answer when you say hello?
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My mother is far along the Alzheimer spectrum. Fortunately we found a great facility for her. My father who had ample resources (hence we can afford the facility) insisted on taking care of her at home in their three story townhouse until he broke his hip and died less than a year later from congestive heart failure. I tell this story because of this remark " But at some point, she’s likely to require regular support and perhaps a move into an assisted-living facility".
There is no LIKELY about it. If she has Alzheimer's one day she will forget how to open her apartment door. I agree with everyone who said the best thing the one, as a stranger, to do when you have serious concerns is to call the equivalent of the Area Agency on Aging, contact social services and explain your concerns. You are NOT equipped to deal with this. It is the absolute worst thing that can happen to the elderly. My mother has been in the facility for five years, now on a thick liquid diet due to swallowing problems, The only things she responds to are her name and music. I have a new appreciation for the big band era.
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@CBW
Not to be too morbid, but there is the possibility the neighbor with Alzheimer's just won't live long enough to need the advanced care. Hence "likely"
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Response to Dementia:
I think what you're trying to do is a great way example of being a good Samaritan. Looking out for someone is always the right thing to do; however, someone with this condition is a little more delicate. You should consider the amount of work and think back on the way you helped your husband and how dedicated you will have to be, but if you're up for the challenge then GO FOR IT!
- Another thing I would consider is actually contacting her family member in Japan and letting him know what's going on.
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@eve It seems a few commenters are jumping the gun. Other than the writer's opinion, there is no CLEAR indication that this woman has dementia. There are many reversible reasons older people may seem to have dementia: dehydration, infection, low vitamin B, major depression, alcohol, etc. I would hate to have others throw me to the curb of incompetence the first or third time I forgot something.
My family was ready to throw my mother in a nursing home the minute she seemed a bit forgetful. It turned out she had a urinary infection. When cleared, the forgetfulness left as well. She lived another 8 years before any concerning symptoms became problematic.
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@P Green The woman's behavior is troubling. Something is wrong. The question is who is to do what. There have been some good suggestions.
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@justme I'm afraid we forget the context of the letter and remember the question is, actually, "what is the ethical thing to do". Not really an advice column, originally.
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@Roger No, I haven't forgotten. Perhaps you and I are interpreting things differently.
Re: Neighbor w/dementia
Just make her a big key chain tag with floor and apt # on it.
Be friendly and otherwise stop interfering.
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@Ivy
With dementia, nothing is as simple as you might expect. The neighbor could very well misplace the big key chain and forget where she put it.
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@Kate It could end up in the freezer. That seems to be a favorite forgotten hiding place for people with dementia.
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@Ivy clearly, you do not have the slightest experience with dementia.
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I'm surprised Israel doesn't have facilities for homeless, seniors. It's a small country one would hope they would care for their citizens in a kind way.
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Regarding forgetful neighbor: big miss of the first step. Find out how to contact her brother before anything else.
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We just went through the first situation with an elderly man in my building. Trust me, if you don't get involved sooner rather than later the situation can become very bad, very quickly. To the person who wrote in, please please please contact the Office for Aging, call the police for a welfare check, reach out to social workers.
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Whoa. Ethicist. Get out the correct information. What any person should do who encounters someone who cannot fond their home because they forgot the address. They need help. Call Adult Protective Services or if a case of dangerous behavior, the police. No ethical quandary. Those professionals will assess and refer.
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@Elizabeth Landsverk MD, 100% correct and The Ethicist and others should take heed. This situation only poses an ethical quandary because the neighbor didn't know what to do--and neither does The Ethicist. I found my former brother-in-law living in his deceased mother's house without heat, electricity, or running water. The temperature the day I found him didn't reach twenty degrees and he was wearing oven mitts to keep his hands warm. I called Adult Protective Services and their representatives took over. He despised me for doing it but I'm comforted by the fact that he's alive enough to hate me.
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A Catholic does not become any less by attending a secular school. LW3's concern stems not from the quality of public education, but the lack of religious instruction for the No. 2 student. If this is all that the 84-year-old LW has to be guilt-ridden about, s/he must have lived a good life.
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States will have listings for an office for aging or some similar title. You can contact them and get referrals for all kinds of help. Better get this started now before she hurts herself or gets lost and injured. You cannot do all of this for her and as it gets worse which is what you will be looking at going forward.
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I'm surprised that people believe a lit burner on the stove is so dangerous (as opposed to a gas-leak) - haven't you let something simmering for hours w/o disaster? Even burning a meal in a pot or pan is unlikely to start on fire, just scorch the food and pan.
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@Roger
I boiled a teapot dry, the plastic handle started on fire....(freak accident, I know, my insurance company tried to go after the manufacturer.)
I don't have dementia but I was very distracted at the time. I caught the fire and was able to put it out with an extingusher. The damage could have been much worse. So, yes cooking with any source of power is dangerous for someone with dementia.
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@Roger — until the person in an apartment below, above, or adjacent to yours has actually caused smoke to enter your own apartment, you may not believe that this is an issue. Often enough, flammable materials are left near or on a stove. Grease fires happen, as well. I wouldn’t even have considered this, had it not happened in an apartment below mine. When the firefighters arrived, the resident didn’t want to open her door. Fortunately, relatives stepped in and moved the poor woman out.
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@Roger
You're kidding, no? When your apartment fills up with smoke from the scorched pan, the fire alarm (assuming you have one, as you should) will go off, and your neighbours will smell the smoke and call the fire department. My former landlady in our Chelsea brownstone was constantly burning food, and when we knocked anxiously on her door to see whether she was alright, she would appear in her ratty nightgown and say, "Oh, honey, that's O.K., I was just cooking a chicken." The smell would linger in the hallway for days. (Since she also smoked nonstop we were always concerned that she would burn the house down.) Also, there have been a number of instances in which children have started fires by playing with the gas burners, so yes, a lit burner is dangerous.
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First step regarding the elderly neighbor: call her brother in Japan. As her relative, it’s his right/responsibility to help his sister.
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If a staff member told you about the tenant who spends time in the lobby, there must be others in the building who know.
Imho, the ethical thing to do would be to talk to the management. It's more important to save everyone from fire than to save the woman from embarrassment. (And from financial exploitation.) She should be placed in care.
4
Does the final LW have any reason to believe that the other student would have wanted to attend a Catholic high school in any event? If not, then s/he is simply projecting his/her preferences onto others. (Then again, I suppose that if one went down the list to No. 3, No. 4, etc., a willing recipient of the scholarship would have been identified.)
8
Excellent answer to the final question. In the California town where I grew up fifty years ago, the Catholic school was easily inferior to the public system. Banishment to it was the ultimate threat that my parents hung over us if we failed to achieve or misbehaved. The smart kids who moved over to the public system for high school were behind, but caught up. Kids are resilient.
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Ah, another installment of 'why everyone else's life and happiness should matter more than mine'.
I'll abstain from LW#1, except to note that there are many nonprofits to provide visiting, meals on wheels, etc. Share the burden of monitoring her deterioration with them.
LW#2: Under no circumstances take this person into your home. My former boyfriend, and dear friend for 35 years, took in a homeless woman. She destroyed his finances, his belongings, and ultimately his life. That your homeless person is 'presentable' and well behaved (admittedly unlike my friend's pity adoption) is not necessarily an indication of sanity. Do not volunteer for martyrdom that will ruin you and ultimately not help him.
LW#3: In high school, I declined to pursue two scholarships for which I was eminently eligible, for altruistic reasons: our family was middle class, thus comparatively affluent, and I felt that scholarships should be for the disadvantaged and poor. Only when it came time to pay for college did I realise that though by comparison we were affluent, objectively we were not. Take the money!
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Be careful about lending diagnosis to persons you don't know, never met, or know only through second or third person telling.
When my youngest daughter became 21 she decided I had early onset dementia. This young woman never finished high school and made that decision on her own. Her reasoning was I had lost weight, rode a bike to work, and had a rented apartment without furnishings except for a small table and small computer. That was 20 years ago. She worked very hard to convince my other children I was entering dementia and was addicted to the online computer. The fact was I didn't want or need anything but basic furniture and worked only one mile from work in a hospital pharmacy making patient IVs. It was perfect for me at the time, no long commute or cleaning. She called a family confrontation and then the public health. It was a huge problem for me. Luckily nobody but her and her then husband insisted.
Since then, I married again. Moved. Recently came into some money and she has begun again. I am 69 years old. I seldom see anyone but that is by choice. I like my privacy and using my time doing as please. I'm an artist and don't require the constant input of others. I take care of my husband, home, pets and extended family. But still she continues to gaslight me. Why? The only reason I can think of is that she wants the money I have for my retirement and she wants it before it is 'wasted' on years of retirement. It is too easy to disenfranchise a person like myself.
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@ Susannah Allanic France
I am deeply sympathetic with you for having to put up with the boorish behavior of your daughter. Perhaps the only way to prevent it is to seek a court order preventing her to approach you and discuss your health, which is slander by a medically unqualified family relation.
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To Mr Appiah:
have you dealt much with dementia patients? My mother and my uncle both had it.....horrendous.
You seem to assume the affected can DECIDE to get herself tested and diagnosed with it; that she can go onto a website and read, understand and follow "advice on how to make life safer" and all the rest. SHE CAN'T, or what she can still do now, will be soon be gone.
Someone, given that her only known family member is in Japan, must step in to help her, or make the calls that will get her help and follow through to see it happens.
Otherwise you may well have a tragedy unfold in this situation.
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@RLiss I think he is saying that the law (and, probably ethics) gives the woman some rights, at least until she is diagnosed and has a hearing and is deemed unable to make her own health and safety decisions. You would want the same for yourself?
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@RLiss I think the suggestion of the website was for the letter writer's benefit, not the neighbor.
My mother has Alzheimer’s. Dealing with all the consequences for years now, I would say that no matter how well intentioned a neighbor is, it is not her place to get involved. There are medical and financial implications that only family should deal with. She could easily get suspected of wanting to take advantage.
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@MALINA:
her only known family member is in Japan.
6
So what? They have phones and internet in Japan. I don't live in the same country as my mother who has Alzheimer's but since I found a good place for her to stay, I have been able to deal with everything over Internet. It might not be easy for her brother to visit her but maybe he cares and would be able to either do something for his sister or at least mandate somebody he trusts.
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@MALINA, The fact that the brother does not seem to be very involved is the reason that there is a chance that there should be a Plan B if he is unwilling or unable to become the woman's protector.
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LW1 - This elder needs medical help/diagnosis, which should not be left to someone who's experience is as a caregiver. The OFA might be a fair start, as it can get that medical help. Bringing in family to take on that task is another way.
15
My wife and I found ourselves confronting a similar situation with a neighbor whose dementia was increasingly debilitating. Over the first few months, as her condition deteriorated, our tight-knit neighborhood stepped in to help - but it wasn't too long before it became readily apparent that possible self-harm was inevitable - her gas stove had been left burning for several hours and a neighbor helped turn it off.
In the end, this became a terrible balancing act, teetering between compassion and caution. As much as we tried to help, all solutions we could come up with ended in tears.
There are a number of terrible ways to leave this planet, but without a doubt, dementia is among the worst.
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I live in Florida in a 55 plus community. In our building, we have seen it all - scam artist taking advantage of fragile elders, home health care givers taking advantage of elders unable to realize that they are co-signing car loans and giving away credit cards, family that are unavailable to help their parents, elders living only on social security and not able to manage their financial situation, elders falling and requiring ambulances, and more. Please call on the board, local elder community support groups, and if you are close enough to know the elder’s family, call their family and give them factual updates and if the family does not respond, tell them you will call local authorities. Be bold, but firm in protecting your property from being used as an unofficial assisted living facility with neighbors as the ‘helpers’. On the other hand, community friends can be supports if that is accepted practice. Just be careful of taking on responsibility that has legal ramifications.
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The woman with dementia can become a danger to the building if, for example, she forgets to turn off her stove. She needs professional assistance. My mother was like that, and she became very reliant on neighbors, who, at first, were willing to help her with small things, and then she did exactly as you described - she became more and more demanding of them, until it was impossible, and yet my mother was convinced she didn’t need any kind of help because she manages fine and her neighbors help her when she needs. She had no comprehension of what a burden she became to her neighbors, knocking on their doors and demanding things. I had to force full-time home assistance, and when that became too difficult, I had to trick her into a home, which is basically a steep downhill situation, but unavoidable at some point, when you can’t leave someone alone for even ten minutes. So it is best not to let someone become dependent upon you in such a situation.
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I met my neighbour for the first time while taking my dog for a walk. She explained that she'd recently undergone a hip-replacement, and I encouraged her to walk every day along her driveway. She complained that her children and grandchildren never visited. I told her that I would come back to check on her progress, but I never did.
I worried that her children (who he she claimed never visited her) might view me as someone who wanted to rip off an old lady.
I feel very bad for having broken my promise to her, but was too worried about how the children might interpret it.
So sad when a community lacks trust.
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Eddie, you have great insight. I've been in your situation, but Women are less likely to seem " suspicious ". Next time, enlist a female friend or neighbor to help you, with a person that needs assistance. Thanks.
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So sad when a person breaks a promise, especially to someone in need!
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For the aging neighbor, well done for caring. She is in danger, from predators. Be a hero, by becoming her friend and getting her help. It's the right thing to do and she IS alone.
For the homeless guy: Do what you feel comfortable doing, and what he is comfortable receiving. In other words: become a friend. Well done.
Scholarship Student : Can you contribute to a similar program, Now ?
That would be helpful, and honor what you earned.
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Well done on the first answer.
Many people have no idea that an Office for the Aging (or something with a name like it) exists in every county in New York state, and that many larger cities (Yonkers is one) have aging-services divisions as well.
People can get the mistaken impression of an Office for the Aging, that "oh, you're going to put me in a nursing home."
Honestly, they'd rather not, given that Medicaid eventually winds up picking up nursing home costs for all but those who can pay full freight - and at $12K+ a month, that's not many of us.
What an OFA (full disclosure: I work for one, but not in the city) is designed to do is help keep seniors independent and happy for as long as is safely possible. It could be that a senior is eligible for services that'll help keep them in their home, and they have no idea.
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@knockatize In Wisconsin, the Office for the Aging is called the ADRC (Aging and Disability Resources Center). Every county has one, and it's a good resource for learning what's available for elderly, infirm, or disabled residents.
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