Dear Prudence

Help! My Friend Wants Me to Care for Her Disabled Niece When She Dies.

In We’re Prudence, Prudence asks readers for their thoughts on a question that has her stumped. The answer is available only for Slate Plus members.

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Photo illustration by Slate. Photo by imtmphoto/iStock/Getty Images Plus.

Every week on Twitter @jdesmondharris, Dear Prudence asks readers for their thoughts on a question that has her stumped. She’ll post her final thoughts on the matter on Fridays. Here’s this week’s dilemma and answer:

Dear Prudence

I, my husband, and my childhood friend “Mia” are all in our early forties. Mia lives with and supports her niece “Hope,” who is in her mid-twenties. Hope has an IQ just slightly too high to qualify for disability, but for various reasons is unable to live independently. Hope was mostly raised by Mia’s parents (her grandparents), who are now dead. Her mother, Mia’s sister and only sibling, is also dead and her father’s whereabouts are unknown.

Their family tends to have very poor health, and Mia already has the health and mobility of an elderly person. She’s worried what will happen to Hope when she dies, since they have no other relatives they’re in touch with. Nor does Mia expect to leave much money. She earns less than $30,000 a year and Hope less than $10,000. They rent, have minimal savings, and just barely cover their present needs. So as Mia’s closest remaining friend, she has asked me if I and my husband will take Hope in upon her death.

Should I agree to this? We own a three-bedroom house and could provide Hope with a room and food, but I’m concerned about our responsibility for anything beyond that, since we’re far from well-off either (which ironically is the main reason we decided not to have kids). We’re not related to Hope and would have no formal guardianship, since she has never been declared incompetent. If we had to take her for needed health care or call an ambulance for her, would those bills be on her, as an adult (even with no money, insurance or credit history), or on us? If she developed mobility issues such that we couldn’t care for her at home, where else could we take her, and could they come after us for payment? We’d appreciate any and all advice you can give.

— Hesitant Helper

Dear Hesitant Helper,

I promise I’m not trying to avoid taking responsibility for responding to this difficult letter, but I’m really hopeful that if you ask an attorney the questions in the last paragraph, the answer will be, “No, she’s an adult, you’ll never be sent a bill for services she receives.” So talk to someone with expertise. Many people who responded suggested this as a first step:

These people need to talk to a lawyer!!!! — @schills

Your answer to this person should be: 1. If they are inclined to do this, seek legal counsel. 2. If they are not inclined to do this, be clear in their no and say it right away. — @terrychristiani

Not to kick the can down the road, but a lot of those questions about who would pay for what seem like they would be better suited for an attorney or social worker. also, LW, do you LIKE Hope? bc if youre going take her in out of obligation and then resent her for it… well don’t — @corvidcall

I think they need to speak to an attorney. — @KathMSchmidt

If you’re satisfied by the response and it makes you feel comfortable that taking responsibility for Hope won’t leave you with a mountain of debt, your problem is solved.

But if you’re still hesitating, I get it. This isn’t, after all, just about money. To agree to be a caregiver to an adult means taking responsibility for more than just a room and food. You would be her family. She would be your family. Your day-to-day life would look completely different. It would be emotionally intense. I’m wondering whether you’re focused on the potential ambulance bills because this other stuff is harder to grapple with.

I think it would be reasonable to tell Mia that you are willing to step in as a last resort and will not let Hope struggle with no support, but would first like to partner with her to try to expand the list of options.

I’m no expert but simply agreeing to take Hope in & take over her care is a huge ask/responsibility. Maybe LW can help Mia with some due diligence to exhaust other options before committing to this. — @KathMSchmidt

A social worker would be a good place to start here. And some suggested that Hope may in fact qualify for disability. So that’s worth looking into again.

Not a disability expert by any means, but IQ is not the only criterion for SS disability, and I hear first applications are routinely rejected. A social worker and disability rights attorney sound like the crucial next steps for Hope and Mia, never mind Helper’s intentions. — @Patryce_Blue

Echoing other responses to work with Hope and Mia to connect with social service agencies for help navigating. Their county’s Department of Human Services would be a place to start and could ask for a re-eval and additional support. — @muluacp

Mia needs to talk to a social worker about what options exist for Hope. If Hope has only been evaluated/treated by a single care team, it may be worth getting a second opinion to see if she qualifies for more than they realize. — @thenopesquirrel

If Hope is genuinely unable to care for herself, then her family should continue to pursue having that legally recognized rather than trying to set friends up as safety nets for worst-case scenarios. — @carollykasenumi

I know this is still going to be hard, but it would be great it, with your help, Mia could find a better option for Hope. And if you do decide to offer her a place to live, you’ll do it with an understanding of the full picture of what it entails, feeling certain that there was no other way to give her the life she deserves.

Classic Prudie

I know it sounds unbelievable, but a formerly close friend who is mentally ill pretended to have killed herself. She went on a string of unstable-sounding rants to me on her Facebook, through her messaging app, and finally in an email a couple of months ago, accusing me of terrible things that supposedly happened 20 years earlier. “Friends” of hers, who I suspect were really just her, took up the cause, contacting me through her accounts. Nothing I said appeased her/them. It ended after two days of frenzy, with an email from one “friend” saying that she had killed herself. Except … she hadn’t…