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My friend's grandmother lives at home and is 86 and suffers from Alzheimer's and Dementia. She has good and bad days but does not have any sort of actual nursing care or medical care except for her grandson. He just has the basic things because she still gets around, feeds the dogs, some days are worse than others. Here recently it's gotten very bad. She was found sitting in her bed that was covered in urine and she refuses to eat almost everything, lost a lot of weight. She refuses to see a doctor as far as finances and things like that her business partner takes care of all that, he comes and takes her to lunch and grocery store etc. But in the last few days she suddenly went down hill, and is completely almost unaware of what's going on, she needs immediate attention and has the means to receive it, question is. How and where do you go to get something like this done? And quickly? She's needing in home care nurse around the clock at this point.

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This is your friend's grandma. I don't see that you have standing to do anything whatsoever, and am really sorry to have to tell you that. There are apparently already two people involved in her care, one for financial, and a family member for living in care.
I understand that you feel that things are bad to the point of neglect. If this is the case it is reportable as far as a "safety in home check" for her, and that would be through whatever state or local authorities are responsible for that. Adult Protective Services is the place to report what is thought to be neglect in some areas. In others I think you and your friend are going to have to do some research as to who to report to in your vicinity. I am uncertain how to tell you where to begin to ask the question as to HOW to report where you are. I myself would start with calling any listed Licensed Social Workers I could find in your area. I might try my own local doctor for the question. I might stop by an Assisted Living Facility. SOMEONE somewhere out there knows how you can report suspected inadequate care and an inhome visit.
I am hoping someone on the forum will have better information for you as to how to get a "check" done. Other than that, you have really no power to help if your friend's grandma has not got other family who cares. I hope this gives you and your friend a place to start sleuthing out a way to get an in-home check. If the authorities, after a check, believe there is real danger there can be a court appointed guardian who will assist with getting her Grandma placed in safe care. But do remember, with all the things you are seeing, she is still getting food when she wants it, is home, and is with her animals. Sometimes less than ideal is best for some people. Not seeing what is going on I can't honestly imagine what is being seen.
I surely do wish you the best and admire your caring hearts so much; often youth do not care, and clearly you both do. Good luck. Hope you will update us. Hope others will have numbers, entities for you to call.
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has any one checked her medication? That could be causing some of her symptoms. hospice had someone one I cared for, on about 20 meds. of which her husband gave her double dose's of a few, he just decided he was going to start giving her, her meds. he couldn't read them. I was the one that was supposed to give her, her meds but he just decided one day he was going to start giving her meds to her. I told the hospice nurses about him not being able to read, he even told them himself that he couldn't read but they still thought it was ok for him to start giving her, her meds. even after they saw him give her double doses of her (heart meds and others) right in front of them.


some might get mad about what I' am about to say but what ever you do don't let any one put her in hospice against her will.
someone I cared for was put into hospice against her will without her or her primary doctor knowing and without ever seeing the hospice doctor In person.
her husband forged her name, how you might ask if he can't read, well he got people to help him.
people at his job know people in hospice and the hospice doctor. In small towns like this the one where I live, you can get away with anything as long as you have money. you can do bad things right out in the open, In front of everyone and cops won't do a thing
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The only person with power to do anything is the one who has her durable Power of Attorney. The thing with her "business partner" sounds very sketchy...there may be financial abuse going on there. This partner is not actually caring for her, and this is what leads me to suspect this.

The grandma's mental seems too sketchy for her to give Power of Attorney now, as she is not of sound mind. If no one has PoA for the grandma, then the grandson should call social services and report her as a vulnerable adult. This will probably cause the state to start to pursue guardianship over her, and then no one will have any say in her care except them, but this is not bad and she will be cared for in a facility.
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Dawn, your friend needs to take her Grandmother to see her primary doctor to see if she has an Urinary Tract Infection. I know Grandmother refuses to see a doctor. Such an infection in an older person can spark a whole variety of symptoms such as what is happening now. This cannot be cleared without antibiotics.

If the issue isn't an Urinary Tract Infection, then Grandmother is at a stage where she needs a village to take care of her, one caregiver at home cannot do everything that is needed. My Dad has 3-shifts of caregivers and that was costing him $20k per month in my area. Hiring a Nurse would cost even more per hour, and wouldn't work 3-shifts per day.

I don't know if your friend's Grandmother would be able to get into Assisted Living/Memory Care, or if she now needs a skilled Nursing Home. This is something that seriously needs to be investigated. Believe me, the cost would be far less expensive then 3-shifts of caregivers.
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Take her to the ER to get checked for a UTI, or a 24 hour emergency center, as FF said. While you don't have POA, you can certainly help her without it.

If grandma will not agree, call Adult Protective Services.
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Call 911 and tell them she’s unresponsive and needs medical attention.
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Police can also do a welfare check.   I was shocked when they came to do one for me - a friend hadn't heard from me in awhile and was concerned.    It suddenly made me feel about 20 years older!

I also second the recommendation to check her medicine.   That would be a big concern for me, especially if she'd accidentally taken too much.  UTI is also a good possibility.

I note that you indicated she lost a lot of weight.  That doesn't usually happen overnight.  Something else may be going on.

And EMS are the best way to get someone to go to a hospital, especially a woman.  Those young men sometimes spark an alertness that hadn't existed before, and EMS personnel know how to deal with a very, very wide range of people.
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I’m not certain adult protective services is in order, if the grandson is doing all he can then wouldn’t he catch a case for neglect?, not everyone is skilled in caring for elderly so unless he’s hurting her or being negligent I don’t see the purpose . I think 911 should be called whether she likes it or not, grandson fcan just tell her he got scared seeing her current situation and thinks she needs a dr. She should be checked for medical and mental issues immediately. It may be time for hospice to come in and keep her comfortable if she’s deteriorating rapidly and the discharge planner at the hospital will help the family with those resources. If not... this very website has plenty of help in finding her some additional care at home if she’s ok to be home. Everything will depend on what the ER dr suggests, so get her there, it’s just a phone call and her inability to use the restroom or eat/rapid weight loss is sufficient reason to call. You are entitled to do that, you don’t have to be family.
Confused why the business partner is immediately suspect either? If he’s handling things his family can simply ask for a glance at the records he’s keeping for the purpose of establishing what’s Available to pay for in home care. Also... in home care and In home health care are 2 different things with a substantial difference in fees!
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Dawn, it’s been a few days...how is your friends GM now? To the hospital I hope?
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