Worried Neighbors, Solitary Elders, Good Samaritans

I’m so glad to be back at the blogger’s desk and writing about an important issue.  It first came up when a woman approached me at a local street fair here in Salt Lake City. She came to the office a few weeks later with a particularly difficult and perplexing situation—one that has taken me some time to research.

Gratefully, I work with several mental health professionals who represent many decades of experience working with older adults. I went to our weekly meeting and was offered many helpful responses that I would like to share over the next few posts.

The Situation

The woman who came to our office said she lived in a neighborhood where she knew of a woman living alone. The older woman was eighty years old and very isolated from the normal social engagements that occupy many of us in middle age.  This woman was clearly in desperate need of help.  I’ll call her Mrs. Smith.

It was reported that Mrs. Smith has lived alone for many years in a home she apparently owns.  She has no family in the area—in fact, it appears that her only living family member is a brother who lives in a distant country. It is not clear whether this brother has contact with his sister here in the States—but if he does, it appears that he is unaware of his sister’s situation and needs.

Mrs. Smith is described as very suspicious—maybe even paranoid. She refuses to allow visitors into her home except in the direst emergency.  She has fallen ill on several occasions following incidents where she has ingested spoiled food.  The neighbors have made many efforts to help this woman but they have been rebuffed.  Only when Mrs. Smith has been too ill to respond to her door have the neighbors felt obliged to enter the home and have Mrs. Smith transported to the nearest emergency room.  Once Mrs. Smith is well again, she returns to her home and to her reclusive life.

As I described this situation with professionals who work with older adults I learned that this situation is sadly not uncommon.  The neighbors’ efforts to help and resulting frustration is also familiar.  The questions nagging at those in the neighborhood include:

•    When does our concern for our neighbor’s safety override her right to privacy and self-determination?
•    If we know this woman is at risk of self-harm, what state agencies, if any, can provide us with counsel and help? 
•    Is this a case for Adult Protective Services? 
•    Does our county Aging Services have outreach workers that can help us help her? 

These are the questions I have pondered over the last few weeks.  They are questions that are actually being asked by many thoughtful, concerned neighbors as well as by family members who may be estranged from an aging parent, aunt or uncle or even a more distant relative with limited resources.
I will attempt to offer some answers to these questions in the next few blog posts. I’m keenly aware that as I attempt to answer these questions, more questions will be posed than I have answers to.  I encourage your comments and suggestions throughout this process.

My next post: A Few Definitions