ere’s a nightmare situation, not uncommon in Elder Law practice.

A parent lives in squalor, without proper nutrition, refuses to see a doctor, doesn’t bathe, doesn’t take medications that were prescribed years ago after the last contact with a doctor, refuses help, won’t move to assisted living, the house needs repair, and so on. Or, to make things even worse, there are two parents in this situation. Either way, the adult child is desperate for a solution.

It is commonly believed that establishing a Conservatorship, through a costly and stressful Court-supervised process, will force the parent(s) to cooperate, but this is often not the case. Many people in this condition don’t care what piece of paper someone has from what Court; they will not, or cannot, live a safer or more appropriate life, and will refuse to cooperate with all efforts to improve the situation. Conservatorship is not a magic wand, and comes with no method to enforce a Conservator’s decision that the parent(s) live elsewhere, eat, take pills, see a doctor, or fix the house. It may be that waiting for an acute medical condition to occur, forcing hospitalization and possibly nursing home placement of someone who is too sick to fight back, is the only solution.

This interim is a good time to ask a care manager to take a look, even though the parent adamantly refuses to consider having help in the home. When there appear to be untreated medical problems, a care manager who is an RN, or has one on staff, may be preferable. If the care manager can get into the house, options for obtaining some measure of cooperation may be apparent.

The care manager’s assessment may also help determine whether or not, if the child is considering petitioning for Conservatorship, a Conservatorship of the Person would be workable. It is not advisable to request authority to manage food, clothing, shelter, and physical health if there is no way to perform those duties. Care managers, however, often know very skillful and experienced caregivers who can be effective in the most difficult situation.

The child must be prepared to sign a contract for the assessment, and be financially responsible for it. This usually amounts to a few hundred dollars and is almost always a good investment.

Even if a solution does not immediately result, the child will have a relationship with someone who can be called in if things change, and will feel better for having done whatever is possible under the current circumstances.

A version of this article originally appeared in the Bulletin of the Alameda County Bar Association.