Elder Neglect Is Not a Grey Area

 

I read a post in a dementia family caregiver support group, and I just can't not say what I have to say. Others might be in similar situations, or variances of it, and it is to them that I am writing my thoughts on this matter. In this type of situation there are no grey areas — there is only black and white. There are no mitigating factors. And, as I tend to be, I will say it very directly.

The original poster described a father with vascular dementia, diabetes, and cognitive decline. His wife — who endured decades of abuse — refuses to care for him, works long hours to avoid being home, and won’t allow him to be placed in a facility. Instead, she moved her own relatives — her brother and his wife — into the house to care for him, despite the fact that he and they have always hated each other. The uncle’s adult daughter also lives in the house, but she is described as having the mentality of a teenager and doesn’t appear to contribute to the caregiving. The sister holds POA but does not live in the home, and she defers to the mother. The poster feels helpless, visits only when the others aren’t around, and is heartbroken by the neglect. And notably, the poster suggests that the family is financially well off — able to afford 24/7 care, but choosing not to.

Now, here’s what I see:

This is not just a sad situation. It’s criminal neglect — wrapped in emotional choreography and inheritance positioning. The father, whatever his past, is now vulnerable. And the people around him — who have the legal and financial means to intervene — are choosing not to.

I want to say something about abuse. It’s a catch-all term these days, and while it can be valid, it can also flatten decades of complexity. The father in this story may have been a monster. Or perhaps he was a man of his times — rigid, controlling, emotionally absent, physically punitive, shaped by norms that no longer hold. But he is not a convicted criminal. He is not in prison. Some in this might feel he should have been, but his punishment is not up to them to decide on their own. That’s not how justice works. And what’s happening to him now — this abandonment, this neglect, this strategic humiliation — is criminal. Not metaphorically. Legally.

The mother’s refusal to act is emotionally legible. She endured abuse. She wants separation and distance. But her refusal to leave the house, paired with her control over spending, suggests the money is co-mingled. She may see it as reparations. She may be preserving her own financial future. But she’s also using proximity as punishment — installing hated relatives as caregivers. That’s not just an unfortunate arrangement. That’s strategic degradation.

The sister, holding POA or DPOA, has a fiduciary duty to act in the father’s best interest. Her deference to the mother is not just passivity — it’s a breach. If the POA is durable and active, she could intervene. She chooses not to. That silence is complicity. It is elder abuse.

And then there’s the CNA. A certified nursing assistant is mentioned as being involved. That means a licensed professional is witnessing this neglect. And if they are not reporting it, they are violating their own legal and ethical obligations. Mandated reporting isn’t optional — it’s a duty.

And the insulin situation is telling. He is not refusing injections — he is self-administering. And how is someone with dementia and memory issues allowed to control that? He isn’t being supervised. The CNA isn’t administering. The doctor and sister aren’t intervening. Everyone is capitulating. That’s not just unfortunate. That’s another level of neglect. He is not being medically managed. His diabetes is being left to chance, emotion, and avoidance. Him being found alone, foaming at the mouth, rushed to the hospital — says it all. He cannot be allowed to control this.

The poster feels bad. They visit when it’s safe. They avoid conflict. But feeling isn’t doing. And while their grief is real, their restraint may be shaped by emotional allegiance — or fear of alienating the mother, who controls the purse and the future.

And that’s the axis everything spins around: mother’s money. Not just as currency, but as control, legacy, and leverage. Everyone is performing. The mother performs detachment. The sister performs helplessness. The uncle and aunt perform unskilled care — care that isn’t care at all. It’s ancillary. It’s not caregiving. The poster performs heartbreak. But beneath it all is a quiet war over who gets what, when, and how — and everyone seems to be benefiting in some way, except the father, the one that needs to be cared for.

If you’re in a similar situation, ask yourself:

• Who holds legal authority — and are they using it?
• Who controls the money — and how is that shaping silence?
• Who is being punished — and who is benefiting?
• Who is professionally obligated to report — and are they?
• And most of all: what are you doing, not just feeling?

Because eldercare and dementia care isn’t just about compassion. It’s about clarity, accountability, and the courage to act. The responsibility to act.

And yes, the responsibility to report — to the hospital, to social workers, to the CNA and her employers, to Adult Protective Services. To the police, too, if need be.

And if the person at the center of it all is still expressing distress, still asking to leave, still recognizing neglect — even if he’s confused or meek — that may mean he still has legal capacity. He may be able to revoke his POA, hire a lawyer, or request a social worker. But he likely can’t do it alone. He may feel trapped. He may need someone to step in — not just emotionally, but legally.

Feeling bad is not enough. If you see it and do nothing, you are complicit. You are enabling. You forfeit the right to call it empathy.

This is my opinion, and it is a considered opinion — backed by legality, and grounded in my sense of morality. If someone doesn’t want to care for another, they should leave it to those who do, or can, or hire the right people to do it. If they do not want to, others must intercede. It is not easy, I know. Relationships are fractured or destroyed over this kind of thing. It all comes down to who you really are inside.

I know who I am.