How can I help this elderly woman and her dog?
February 6, 2017 1:03 PM   Subscribe

I am a property manager. One of my tenants is an elderly woman who lives alone. Over the weekend she fell and was taken to the hospital. This is the third time she fell in a four day period. I am concerned about her and about her dog who is alone in the apartment.

My tenant lives alone in an apartment building I manage. Lets call her Mary. Mary is in declining health and as far as I know, has no friends or family. She has not given us any emergency contact. I spoke to a nurse at the hospital where she’s been since yesterday and she said that Mary is awake and alert but they will be keeping her a few more days. Mary is not responding to my phone calls or emails.

I am heartbroken thinking about this poor woman all alone. I am concerned about her being sent back home and falling again, or worse. I am not a doctor but everyone on my staff (doormen, super, etc) think she is declining rapidly and should not be left alone. Should I… tell someone? She is Section 8 and I don’t want to get her in trouble or take away her choices, etc. She is normally a very feisty, independent woman.

Of most immediate concern is that she has a dog. A member of my staff gave the dog food and water last night but… A. we cant keep doing that and B. the dog needs to be walked/cared for! I spoke briefly to an animal rescue place today and they offered to come by once a day and feed/water the dog until Mary returns but I’m afraid that they will come by, decide the dog shouldn’t be there, and take him away. This dog is all this woman has in the world. I realize the dog’s safety is the most important thing but…. AHHHH I don’t know what to do!

So my immediate question is, what should I do about her dog, and then my second question is, should I alert someone about the woman herself? Presumably the hospital won’t discharge her if she’s really that bad, right? But then they discharged her last week after her first fall, and then she fell two more times. So maybe they're just pushing her through the system. There must be something I can do to help. We're in NYC if that matters.
posted by silverstatue to Human Relations (19 answers total) 4 users marked this as a favorite
 
To start: unless the dog is using a litter box or puppy pads, it needs to be taken out more than once a day. You need to either organize shifts of helpers (maybe a few neighbors each willing to do one walk a day) or look into a full-time rescue/fostering situation.

(Also: I took in a ten-year old cat although I previously had no desire to have a cat and it was one of the best decisions I've made in my adult life so far. She's almost 16 now and is the smartest, sweetest, funniest, prettiest cat I have ever known. So maybe there's another tenant in your building who is actually the perfect temporary or long-term owner for this dog. You won't know until you ask around!)
posted by kate blank at 1:16 PM on February 6, 2017 [11 favorites]


Most people who do animal rescue recognize that, to many people, animals are family. Generally, they aren't going to abscond with this lady's companion. The group I volunteer with has taken in animals until their owner is released from care, so that could be an option. We also re-home animals when their owner didn't make it home.

The hospital should have a social worker who is consulting with the woman about the things she'll need to return to her home. Sometimes the arrangements include home nursing care, but not always.
posted by answergrape at 1:23 PM on February 6, 2017 [3 favorites]


Before I say anything else, as one citizen to another, I want to thank you for your question, it's extremely caring.

Now, to attempt to answer it ... I am actually going through this with my parents at the moment, and although falling is not easy, it can be handled: There are safety devices that can be installed in apartments; there are security alarms that can alert hospitals and caregivers of falls and other emergencies; there is physical therapy, which can help strengthen muscles and ameliorate balance.

Falling is also a priority issue from the point of view of the State, as the cost of long-term injury from falling is so great, it's simply common sense to do all that you can to make prevent the situation, if at all possible. So many cities and states offer a lot of (often free) services, related to fall prevention.

To access and coordinate them, you could contact the resident social worker at the hospital and/or you could google "fall prevention" and "services for the elderly" along with the name of your city/state/county and see what's offered and who you might call for advice. But probably the simplest and most effective path, given your role as Property Manager, is to contact your most caring local representative, explain that you and she are both constituents, and ask if they can intervene to find a case manager to address quality of life and safety issues for a single elderly woman without family or resources in your building. A constituent outreach person should then investigate options and report back to you what can be done, as well as facilitate the process. If you've never reached out for constituent services from a government official before, it can be truly remarkable to see how situations can be ameliorated with a single official phone call.

Good luck to both of you, and thank you again.
posted by Violet Blue at 1:29 PM on February 6, 2017 [17 favorites]


My approach would be to do the legwork, find some local solutions and then present it to her as your obligation as the property manager to make sure her dog is not making messes and to make sure the property is not contributing to the issue. That sidesteps several problems, like her being embarrassed, her not wanting you butting in to her private life, etc. I would claim to be just doing my duty as the manager.

6 Steps for Preventing Falls Among Your Older Loved Ones

Guidelines for Preventing Falls

CDC: Older Adult Falls

Having fallen once, she is at greater risk of falling again. Go in and see if there are any environmental factors you can mitigate. Look into the possibility of getting her additional assistance if possible, but focus on doing those things that you can legally defend in a court of law as reasonably your responsibility should she react negatively. If she is happy to get your help, you may have more wiggle room. Until then, think about this like "What if we get sued, either for trying to help OR for doing nothing?" That should help you sort how much intervention and what kind of intervention you can justify in the name of duty under the law.
posted by Michele in California at 1:43 PM on February 6, 2017


I would start by contacting the NYC Department of Aging. They might be able to send out a social worker and determine what services are available to her.

My grandmother lived mostly independently in NYC until 101 and we relied on things like The Visiting Nurse Service and Jewish Family Services to help her stay in her home when she needed extra care (note Jewish Family Services serves everyone).
posted by brookeb at 1:43 PM on February 6, 2017 [2 favorites]


Unfortunately at the moment I have no way of contacting her. I have tried emailing, calling her cell, and asking the hospital to give a message. My doorman (who is not a doctor) suspects she had a stroke, so I dont even know when I DO have a chance to speak to her, how coherent she will be.

Right now, I have my staff feeding and giving water to the dog. According to them, she NEVER takes the dog for walks. He just... I guess does his business in the apartment. It's awful. This woman should not be living alone.

I'm going to give Mary 24 more hours to contact me, and then I will start investigating all the help numbers/websites shared here. Thank you everyone for your suggestions and your concern.
posted by silverstatue at 1:56 PM on February 6, 2017 [1 favorite]


I spoke briefly to an animal rescue place today and they offered to come by once a day and feed/water the dog until Mary returns but I’m afraid that they will come by, decide the dog shouldn’t be there, and take him away.

So, yeah. Dogs require a lot more than one visit per day. At a minimum I think you're looking at three visits per day. And frankly even that is far from ideal - dogs want and need human company. Being alone for 23 hours per day is not healthy for or fair to that dog.

I agree that a rescue org may decide to remove the dog for its safety. I like the idea of trying to find someone in the building to provide temporary care for the dog until its owner can resume care.

When the owner comes home, someone needs to have a Serious Talk with her about having a plan in place for her pet. Like, I live alone and have a verrry small network in my city (newly transplanted introvert) but I still have instructions for how to make sure my dog gets cared for if I'm suddenly sick or hurt. Making these plans is just part of being a responsible pet owner.
posted by schroedingersgirl at 1:57 PM on February 6, 2017


According to them, she NEVER takes the dog for walks. He just... I guess does his business in the apartment. It's awful. This woman should not be living alone.

Just saw this update. This is animal abuse. As painful as it may be, the dog should be rehomed to a person or family who can provide appropriate care.
posted by schroedingersgirl at 1:58 PM on February 6, 2017 [7 favorites]


So maybe there's another tenant in your building who is actually the perfect temporary or long-term owner for this dog. You won't know until you ask around!

This might have the added advantage of providing this woman with a friend in the building who will check in on her from time-to-time. (Actually, about anything you can do to foster a sense of community among the residents would be a good thing.)
posted by she's not there at 1:58 PM on February 6, 2017 [1 favorite]


Referral to NYC Adult Protective Services.

You are very kind to be worrying about this lady and her dog. A rescue cannot unilaterally take someone's dog away (that is their property!), though, if they are sufficiently concerned, they may report the situation to the city, which could in theory lead to the dog's being taken away. The current isolation is not good for the dog, but it is technically possible for the dog to usually relieve itself indoors with use of wee-wee pads and the like. I don't know if that's actually what's been happening, but I think you'd probably have heard from all your tenant's neighbors if the dog's waste was just accumulating, for obvious reasons.
posted by praemunire at 2:06 PM on February 6, 2017 [1 favorite]


An older woman on my floor in the 1st place I lived in NY had a companion come in daily after she forgot something burning on her stove. I'm not sure who paid for it, but some of the NY Times Neediest Cases articles have described charities arranging for homemakers for those incapable of handling the needs of their place.
posted by brujita at 2:16 PM on February 6, 2017


Hi! I had this happen (pretty much exactly, except that my resident spoke no English to begin with) a few years ago when I managed section 8 housing! I ended up with a porky Chihuahua for a few days, and then another resident "adopted" her. There was nothing formal, we just rehomed the dog until the resident came back. Unfortunately he didn't make it and we were unable to reach any family at all. So Blanche ended up with Patsy, and we made the best of it.


As for your resident - do you have anyone at all that you can call? References on her rental application? I wouldn't necessarily count on her coming back tbh.
posted by checkitnice at 2:31 PM on February 6, 2017


Seconding on alerting the Adult Protective Services APS.

Generally you want to get in touch with the hospital nurse care manager or social worker that's responsible for Mary's discharge from hospital. Convey to them your concerns. A decent hospital with competent care management team will work with the patient to ensure that she will discharge to a safe environment. They will alert APS if they felt that's appropriate. If you feel you are getting nowhere with the care management, you could also try to discuss the issue with the attending physician. Nowadays every hospitals wants to reduce their rate of "readmissions," i.e. patients that keeps bouncing back into the hospital, so they should be actively working to ensure a safe environment for her.
posted by Pantalaimon at 2:39 PM on February 6, 2017


According to them, she NEVER takes the dog for walks. He just... I guess does his business in the apartment. It's awful.

Unless you mean the dog is using a litter box, you should be aware that this alone might make the apartment borderline uninhabitable and will probably require a large amount of money to fix before a new tenant moves in.
posted by showbiz_liz at 2:49 PM on February 6, 2017 [10 favorites]


My doorman (who is not a doctor) suspects she had a stroke, so I dont even know when I DO have a chance to speak to her, how coherent she will be.
If she had a stroke, she may be mentally competent in important ways, but she may be unable to speak. It will depend a lot on what part of the brain was impacted. Sometimes, stroke victims can communicate in written form well before they can speak again.

I'm going to give Mary 24 more hours to contact me, and then I will start investigating all the help numbers/websites shared here.
I suggest you do the legwork/research today. That way, you will be ready to act promptly should the need arise.
posted by Michele in California at 3:40 PM on February 6, 2017


Can you go to the hospital during visiting hours and talk to her in person?
posted by bendy at 4:17 PM on February 6, 2017 [7 favorites]


While privacy rules generally prevent the doctor or hospital from telling you about the patient, the reverse is not true - you are free to tell the doctor anything you want about the patient and they can accept that info. I think in this case if you typed up a nice 1 page summary (how many falls in how many days, poor quality of apartment, lack of dog care, etc.) they would be happy to get that info. When I worked in a hospital getting reliable third-party info was very useful.
posted by soylent00FF00 at 5:58 PM on February 6, 2017 [4 favorites]


The priority in this case is certainly the dog, and it should be taken into the care of a rescue organisation for the time being (though, I suspect, for longer), or a compassionate foster family - or perhaps even a neighbour or somebody else in the building, since pets are apparently allowed there? It needs to be walked daily and needs to be let out at least three times a day, and cannot be left alone for hours on end.

As for Mary...she can no longer live independently and certainly not alone, and needs to go into a care facility. I suspect that there will be some kind of state procedure or process for that, as she isn't the first person in Brooklyn to be in this situation. I would get in touch with whoever New York's residential tenancy or old person authority is, and seek their advice.
posted by turbid dahlia at 9:31 PM on February 6, 2017


Definitely call Adult Protective Services (APS). Be aware that they are understaffed and (often) inadequately trained, so don't expect them to necessarily do anything promptly or well. They also don't have to provide services for people who are in the hospital, so they might not assess this woman until she has a discharge date set. Once you make the referral, the case will be assigned to someone for an initial assessment. You can find out that person's name and number by calling the borough office in the link provided by praemunire. Be politely persistent about what they are or are not doing. (She might be eligible for home health services, so she's not necessarily doomed to an institution. The hospital discharge team should explore support services for her if they plan to discharge her back home.)

As for the dog, you could try calling the Mayor's Alliance for NYC Animals to see if they have any suggestions. They used to have a program to help people keep their pets (for example short-term foster during a hospitalization) that was unfortunately de-funded. They might know if there is anyone else doing that kind of work in the city.
posted by Mavri at 8:26 AM on February 7, 2017 [1 favorite]


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