What powers do APS have over a senior who lives alone with no living relatives?

My only concern would be if social services (or any authority) determined she couldn't live by herself anymore. If they determine she's unsafe to live alone, they are mandated to interfere. You don't say anything about her getting rehab after her hip break. If she refused it and just went home, then she's already on their radar big time. If she refused home care after her hospital stay as well, that's another indication that she's maybe TOO weird. I understand eccentricities, but too eccentric will get her into trouble.

It's not unusual for paramedics to report unsafe living conditions to APS. That may be what happened.

I'd say she may be on thin ice by now. Her FUTURE conduct is probably more important than her past in this case; as it can be chalked up to the infection. I'd explain this to her and suggest that she allow home healthcare and be very cooperative with any suggestions they have for ongoing services in her home.

My inkling is that, if she refuses all assistance and is completely against their recommendations, she's going to have a difficult time of it. They will act in what they perceive to be her best interests.

Does it seem that she is returning to her old eccentric self? If so, and she is ambulatory (even if with a walker, cane or other item for assistance) and can by & large manage her ADL's (activities of daily life), she can leave the facility once she completes rehab. Since she didn't have you already as her DPOA or MPOA, everybody has their hands tied in ever telling you things. But she can ask ? about her care, her medications, etc and there is no reason why you cannot be in the room when this happens. She can say, "I want my friend here to take notes for me". They have to allow her to do this. If she is manageable on her ADL's she can sign herself out or the facility and if you can set up for a home health care service to provide "care" like 3 or 5 days a week (the minimum is usually a 4 hr day & they can bill it to her credit card), then that will offset any APS concerns on her return. When you go to visit her, try to take an activity for you to do with her, like playing a game, or putting together silk flowers in a vase, or doing a drawing. Something to establish at least for staff @ the rehab, that there is a preexisting relationship between you two.

I would also get the house all nice and clean looking and take pictures and a video of the home before she returns to it. Open the cabinets and take shots of how the bathroom shelves look with the supplies for daily care; ditto for shots of the open refrigerator, pantry shelves.

Now at some point in time, she will need to get all her legal together. So you may want to start to find an experienced elder law attorney for her. I would suggest you contact a couple in larger towns (like in Charlotte rather than one in the more remote area where you live) and you also want to mention to them that there could be a malpractice issue with her getting a hospital based MRSA infection.

There are some things you need to do for yourself in all this. Please carefully document to the penny everything you have paid for from the checks she gave you. Xerox all this and make sure to keep all the original receipts. Just to be extra careful, think about your own credit situation and if there could be any sticky issues for you (like you have a foreclosure or any police record or anything that APS or some long lost family could throw at you. If she is deemed unable to do for herself, in order for the state NOT to have her become a ward of the state with a state appointed guardian, the potential guardian (you) will need to have a pretty spotless record and have enough income so that there could be no incentive for financial impropriety. I don't know if all states do this, but for my mom the attorney did in addition to the DPOA, MPOA and codicils to her will, he also did a "Guardianship in case of Incapacity" statement - which names who she wants to be her guardian if that situation should arise. It gets around having to do the whole rather expensive several probate court hearings that go into establishing suitability for a guardian- if SC allows for that you want to get it as it helps solidify your standing as you are not a relative.

I would hope that she recovers enough so that she can do the DPOA, MPOA and get all the banking done so that you are a signature on the account and be able to get back to her old odd self!

It sounds as if there will be a court hearing before anything is determined, if I'm reading you correctly pamstegman? Kathy always assumed (as we all would like to do) that she was fine-would stay fine and that was the end of it. We have talked about the POA and she is kicking herself that she didn't do it before this happened. We have agreed that once she is through this, we will take care of it right away. I have documented every dime spent on her bills from her accounts and my own credit worthiness is A+ so I am not concerned in the least that I will be suspected of spending funds that are not my own. Truth be told-I've spent several hundred dollars of my own on various Kathy-related expenses. But I'm not looking for that back-she needed it and I was glad to be able to do it. If the situation were reversed, she would do the same for me. I will ask her to consider the "Guardianship in case of Incapacity" statement referenced above. In the event there is a court proceeding, I will be happy to appear as an advocate for Kathy. Do they allow us to have an attorney? I spoke with her tenant this morning who is collecting the rent on her property to deposit into her checking account, and he agrees with me that she is functional and capable of handling her own affairs, once her hip surgery is healed completely. I'm saying a prayer that all goes well from here on out as she is getting better every day. Thank you AgingCare for giving us a place to bounce these questions off of others!

That is excellent advice Maggiemarshall. I've already been urging her in that direction and can only hope she'll listen. She has been getting rehab now for the better part of a month and according to the facility where she's staying, is more cooperative following my last visit than she was prior. She recently had the local county attempt to take a piece of her property via the Eminent Domain method and she fought them with an attorney and won. So she is already suspicious of the local county government and their offers of "assistance".

For many people in her situation, the words, "I'm from the government, and I'm here to help you," strike mortal fear in their hearts. ;)

From everything you've said (and not said), I'd say she's being watched.

And I'd also say she's very fortunate to have such a good friend.

I agree with the being watched part. She'd do the same for me if the shoe were on the other foot. My life is richer for having her in it. Guaranteed to be NEVER a dull moment!

You have a lot of insightful and accurate comments here but I wanted to clear one thing up.

MRSA is staph. It's a strain of the staph bacteria that is resistant to antibiotics.

(You can learn all kinds of stuff here!)

You say you went and cleaned her house and it is now spotless. Was it actually dirty and cluttered? It may have been seen that way if her weirdness did not include housekeeping. Was there adequate food in the house? Was the fridge a lab experienment. Some people who are passionate about things spend their money on their interests and not what others feel are essentials for healthy living. Growing a garden and storing the potatoes in the bath tub would come under this heading. No dishwasher or hot water? You know she waits till all the dishes are dirty then boils up a big pan of water and washes the whole lot spotlessly does she go out and forage for wild food, shoot her dinner or set traps for rabbits. That is probably how the majority of her neigbors live but to a new MSW with the ink barely dry on her certificate from the big city college it will look as though she is incapable. I hope things work out for Kathy she will be miserable if she is confined

If you are not POA or Health Care Proxy, obviously she does not want you to know anything more or control anything more. APS can petition the court to have a Guardian appointed for her IF the MD's have determined she cannot handle things on her own. Much hinges on her ability to pass a competency test and her PT goals. The power lies with the Judge to decide, based on the facts presented in court.