Are you safe right now?

Call 911 now. If you can do it safely, get to a room with a lock, or outside.

If you are not safe, or you are not sure, call 911 now. If it is over and you are safe, call his doctor and the 24/7 helpline.

It's over and you're safe

• Call his doctor today. You can tell his doctor what happened, and ask for him to be seen soon for pain, infection or medicine changes. His doctor is treating him, not your injury. His doctor must report if he thinks HE is being abused or neglected. His doctor may share what you need for his care if he agrees, does not object, or cannot decide and the doctor judges sharing is in his best interest.
• Call the Alzheimer's Association 24/7 Helpline, 800-272-3900.
• You can also call a crisis team. Arizona's crisis line serves anyone, and mobile teams can come to you: 1-844-534-4673. Text HOPE to 44673. In Texas, reach a mobile crisis team through your local mental health authority or 2-1-1.
• If you need to leave to stay safe, go. As soon as you are safe, call a family member, friend or neighbor to go to him. If no one can, call the 24/7 helpline or, in Arizona, 1-844-534-4673. Call 911 if he is in danger or no one else can reach him soon.
• Get care for yourself first. Then tell the plain truth.
• In Arizona, a doctor or nurse who treats a material injury that may have come from an illegal act must tell police, even days later. Ask first what they must report. Never lie.
• Ask before you give details.Before I answer, do you have to report this, and to whom?If you report, will you tell me?
• Your answers do not change your right to emergency care. A report can still follow.

It keeps happening

• Home can be right when you can decide and it is safe. A hospital stay or a move can be right when it is not.
• Write what happened, what helped, and what the doctor changed. Lock up guns, knives, and car keys. Use the behavior log.

What an arrest takes

An arrest takes his freedom. A no-contact order can take his home, and your chance to care for him there.

• APS cannot take his rights or yours on its own. That takes a judge. In an emergency, police and EMS can act right away. In Arizona, an evaluation agency can admit him without a judge first when he is a danger because of a mental disorder and is likely to be seriously hurt or to hurt someone before a court can be asked. If it keeps him, it must ask a court the same day or the next court day. In Texas, dementia by itself is not mental illness under the emergency hold law. Ask the ER doctor what is possible.
• In Arizona, if he has no medical power of attorney and no guardian for health care decisions, his spouse makes his medical decisions first, unless the spouses are legally separated. A guardian appointed to make health care decisions, or an agent he named in a valid medical power of attorney, comes ahead of the spouse.
• In Texas and Arizona, guardianship needs clear and convincing proof that less restrictive help won't work.
• He has a right to a lawyer. If he cannot pay, ask the court to appoint one.
• After an arrest, a judge can keep him away from you and your home, even if you did not ask. In Arizona, every release order must include conditions to protect you. If the charge is a felony that caused physical harm, such as a broken bone, the judge must order no contact with you, and electronic monitoring where available. In Texas, after a family-violence arrest a judge may order him to stay away from you and your home. The judge must issue an emergency protection order if you had a serious bodily injury or he used or showed a deadly weapon during an assault. Serious bodily injury means a substantial risk of death, serious permanent disfigurement, or a long loss or impairment of a body part. That order lasts 61 to 91 days, or 91 to 121 days if a deadly weapon was used or shown. You cannot give him permission to break it; only a judge can change it. In Arizona you have the right to be heard when the court sets or changes his release conditions, and you can tell the court you are his caregiver. His lawyer can ask the judge to change the order. If he forgets the order and calls or comes home, he can be arrested again. Have a plan for where he will stay, and ask his lawyer and an elder-law attorney about release to a relative or a care setting.
• In Texas and Arizona, a protective order you file yourself is usually the wrong tool. He may not understand it, and a violation can mean jail, not care. Ask an elder-law attorney before you file. This is not the order a judge sets after an arrest.
• The harm usually comes before any trial: jail, holds and orders that keep him from home.
• You cannot drop the charges. The prosecutor decides. You can say you want care, not jail.
• A justified act of self-defense is not domestic violence in Arizona. Defensive measures to protect yourself are not family violence in Texas.

At the ER or clinic

• If police ask about your injury, the hospital usually needs your agreement to share more. Some reports do not need your OK: a report a state law requires, a court order or subpoena, an emergency when you can't agree, or a serious and imminent threat to someone's safety. In Texas, the police-report law covers gunshot wounds. In Arizona it is much wider; see the next point.
• In Arizona, a doctor, nurse or hospital attendant who treats a gunshot, a knife wound, or other material injury that may have come from an illegal act must tell police right away, with your name and what happened. A doctor or nurse must do this at urgent care or your own office, even days later. They do not need your OK. Ask whether police were told. When they report abuse, neglect or domestic violence about you to APS, they must tell you promptly, unless that would put you at risk of serious harm. This is not a reason to skip care or leave out what happened.
• If you want him home, say so. If home is safe with more help, say that, and ask for home health, respite and a follow-up visit. If you cannot care for him safely, say: "This is an unsafe discharge."

If you live in Arizona

• Police told: A gunshot, a knife wound, or other material injury that may have come from an illegal act, including from him, even days later.
• In Arizona, if you are injured or he used or showed a weapon, police must usually arrest him, even with dementia.
• If they take him in anyway. Arizona's must-arrest rule applies when a spouse is physically hurt, or when a deadly weapon or dangerous instrument is discharged or used, or shown in a threatening way, unless the officer believes she will be protected from further injury. An arrest under it means he is booked, not ticketed and released. 1. Give the officer his diagnosis papers and medicine list. 2. Ask where he is being taken. 3. Say he has severe dementia and needs his medicines. Jails must give the people they hold needed medical care, so ask that his papers go to the jail's medical staff. 4. He has a right to a lawyer. If he cannot pay, ask the court to appoint one. The next business day, call an elder-law attorney or legal aid about guardianship and his care.
• In Arizona, his hurting you does not by itself create a duty for you to report him.
• If you can decide, Arizona APS help is voluntary, and you can refuse it. For him, if he cannot decide, APS can ask a judge for a guardian. Ask the worker to note his diagnosis and that you are his caregiver.
• Reports can also be about his care. In Arizona, health workers must report if they think he is being abused or neglected, and that can include being left alone without supervision or being locked in. Telling the truth about what you did to stay safe is fine: stepping away, locking yourself in a room, or blocking a blow. Do not lock him in. If he got hurt too, say how plainly. Asking for help, respite or a different care setting is not neglect.
• Arizona has no no-fault label like Texas. A person found to have abused, neglected or exploited someone can go on a public registry for 25 years, after a chance for a hearing.
• If a child is there, the officer must check on the child's safety.
• Medicare discharge appeal, inpatient stay, the same day: Arizona, Commence Health (formerly Livanta) 1-877-588-1123.

On tribal land, call your own Nation's services first.

Arizona phones

• Arizona APS, (877) 767-2385 (1-877-SOS-ADULT), is not 24/7 by phone. It's open weekdays 7am to 7pm and weekends and holidays 10am to 6pm Arizona time; the online report is 24/7.
• Arizona crisis line 1-844-534-4673 (1-844-534-HOPE). Text HOPE to 44673.
• Mercy Care crisis line 1-800-631-1314 for Maricopa, Pinal, and Gila.
• Arizona Complete Health crisis line 1-866-495-6735 for Pima, Cochise, Yuma, Apache, Graham, Greenlee, La Paz, and Santa Cruz.
• Arizona Complete Health crisis line 1-877-756-4090 for Coconino, Mohave, Navajo, and Yavapai.
• Maricopa Senior HELP LINE 602-264-4357, 24 hours. Toll free 888-783-7500.
• Pima Council on Aging 520-790-7262.
• ALTCS 888-621-6880. AHCCCS 1-800-654-8713.
• Arizona Caregiver Coalition 888-737-7494, weekdays 9 to 4 Arizona time.
• Legal help: Community Legal Services (602) 258-3434 or 1-800-852-9075. Southern Arizona Legal Aid (520) 623-9461. DNA People's Legal Services 1-928-871-4151.
• Banner Phoenix Valley Help Line: 480-448-7511. (Can lead to a hospital stay. Ask how he comes home.)

If you live in Texas

• Police told: Gunshot wounds. If you are 65 or older or disabled, APS must be told, and APS must tell police if it thinks a crime happened.
• If you are 65 or older or disabled, you are the person Texas APS is checking on.
• Arrest: An officer may arrest. If a judge's protective order is broken in front of an officer, the officer must arrest.
• In Texas, after a family-violence arrest without a warrant, he can be held four hours after bond has been posted, and up to 48 more hours by a written order.
• In Texas, APS cannot move anyone out of the home against their will without a judge's order. If the court is closed, including after 5 p.m. or on a weekend or holiday, it can act first, but must get the order by 4 p.m. the next business day or bring the person back.
• If you can decide, you can refuse APS services in Texas. If he cannot decide, Texas APS can provide services without his consent only through a court order, and the court gives him a lawyer.
• Texas can mark a case valid but no-fault when the person could not understand because of dementia, or when a caregiver is physically unable to give care.
• Medicare discharge appeal, inpatient stay, the same day: Texas, Acentra 1-888-315-0636 (TTY 711).

Texas phones

• Texas APS 1-800-252-5400, day and night.
• Facility complaints 1-800-458-9858.
• Area Agency on Aging 1-800-252-9240.
• Eldercare Locator 1-800-677-1116, call or text.
• VA Caregiver Support Line 1-855-260-3274, weekdays.
• VictimConnect 1-855-484-2846.
• Legal Hotline for Texans 1-800-622-2520, option 3, weekdays 8:30 to 5. Free phone advice from Texas Legal Services Center on Medicaid, Medicare and long-term care, plus wills and powers of attorney for ages 60 and up. Advice only, no court help.
• Lone Star Legal Aid (800) 733-8394. Regional, for east and southeast Texas.
• Legal Aid of NorthWest Texas 1-888-529-5277. Regional.
• Find an elder-law attorney.

Insurance

• Medicare's Benefits Coordination and Recovery Center handles questions about "how did it happen" forms: 1-855-798-2627 (TTY 1-855-797-2627), Monday to Friday, 8am to 8pm Eastern.

Real stories

This is not a promise about your case.

Sources.

A note

For Texas and Arizona. Laws change, and police, APS and hospital practice varies by county. For your own situation, talk with legal aid or an elder-law attorney.