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What Can I Do if a Caregiver Is Isolating or Neglecting a Vulnerable Adult?

Read this in: Español

Author: Emily Hardy

If someone you care about is being isolated, neglected, or is refusing help they clearly need, it can feel helpless. There are legal steps and practical options, but the right path depends on the specific situation.

This page covers caregiving problems at home, including isolation, self-neglect, and questions about capacity.

What is the difference between neglect and self-neglect? 

Neglect by a caregiver means someone who is responsible for the vulnerable adult's care is failing to provide basic needs. This means they are not providing enough food, medical attention, shelter, or supervision.

Self-neglect means the person is not able to care for themselves due to a physical or mental condition. No caregiver is at fault. The person might be refusing to feed themselves, take medication, or do daily tasks.

In Virginia, both types are handled by Adult Protective Services (CPS). Self-neglect is a subset of neglect for APS purposes. The investigation process is the same.

if the adult has the ability to make decisions, then they have the right to refuse services, even if those choices put their health at risk. APS operates on a model of offering help, not forcing it.

If the adult does not have the ability to make their own decisions, then APS might take the situation to court. A court can order services to be provided even if the incapacitated adult objects.

What if a caregiver is isolating someone from family and friends? 

Social isolation is a serious concern. It can be a sign of abuse, neglect, or exploitation. But it is not always intentional. 

Sometimes a caregiver who once provided good care develops their own health problems, dementia, or other challenges that affect their ability to help. For example, a spouse who was the main caregiver may suddenly become ill or begin experiencing dementia or Alzheimer’s disease, changing the caregiving relationship. In situations like these, a person who was once independent may resist help, but family support may still be possible without involving the legal system.

You may want to try simple, lower-conflict steps first:

  • Call, write, or send a card to the older adult
  • Visit if it is safe to do so
  • If you are not welcome inside, ask whether you can visit outdoors, such as on a porch or deck
  • Pay attention to how the caregiver and older adult respond before deciding what to do next

If the isolation does appear to be intentional or harmful, you can:

  • Request a wellness or welfare check from local law enforcement
  • Contact APS to make a report

Read more: How to Report Abuse or Neglect of a Vulnerable Adult in Virginia

If the person has a guardian, the guardian usually cannot block visits except in limited situations, such as preventing physical, mental, or emotional harm or financial exploitation. In most cases, the guardian must notify the restricted person about the limitation, and the restricted person has the right to object. You may want to speak with an attorney if this applies to your situation.

A health care advance directive can give someone authority to limit visitation, but only if the document clearly says so. If the directive does not explicitly give that authority, it does not allow the person to restrict visits.

Can someone with dementia or Alzheimer's refuse help? 

This is a complicated question. The short answer is: it depends on the person's capacity, not just their diagnosis. It also can depend on the type of care they are refusing. This section focuses on the individual’s capacity not on the types of care they can refuse.

A diagnosis of dementia or Alzheimer’s does not automatically mean a person cannot make decisions. People with these conditions have very different abilities. Some can still make important decisions about their lives.

Also, many people set up legal documents before they lose the ability to decide, such as a medical or healthcare power of attorney, which is called an advance directive in Virginia. These documents describe what the person wants if they can no longer speak for themselves. They generally stay in effect once made. If a document was valid in the state it was made in, it should also be valid in Virginia. 

This area of the law is very situation-specific. If you are concerned about someone's capacity to make safe decisions, talk to a lawyer or a health care provider. What's possible depends a lot on the circumstances.

What if someone without capacity refuses to leave an unsafe situation? 

If a vulnerable adult lacks the capacity to make safe decisions, there are legal options:

  • If the adult previously signed a health care directive or power of attorney, the person named in that document may be able to act without going to court.
  • In Virginia, the Health Care Decisions Act allows certain people to make medical decisions where someone lacks capacity. Learn more about what the circumstances are and who can make decisions.
  • APS can ask a court to order that services be provided, even over the adult’s objection.
  • A family member or other person can file for guardianship, which gives legal authority to make decisions on the adult’s behalf, including where they live.

These are serious legal steps. Talk to a lawyer before moving forward:

What about removing an abusive family member from the home? 

Removing someone from a vulnerable adult's home depends on that person's legal right to be there.

Protective order

If there is evidence that the person poses a physical safety threat, the person being abused can ask the court for a protective order. A protective order can require the abuser to leave the home, even if they are a tenant or co-owner.

Read more: Protective Orders in Virginia: What They Are and How to Get One

Adult Protective Services (APS) Protective Order

If the vulnerable adult cannot seek a protective order on their own because they lack capacity, Adult Protective Services (APS) may be able to file one on their behalf. You can contact APS through your local DSS office. For this type of protective order only, financial abuse counts as a reason. 

Eviction

If the person is a tenant and there is not enough evidence for a protective order, the homeowner may need to use the regular eviction process to remove them from the home. Eviction rules can be complicated, so it is a good idea to talk with a lawyer before taking action.

Co-owners

If the person is a co-owner of the property, the situation is more complicated. Talk to a lawyer about your options.