Elderly man cannot care for himself but refuses nursing home. Wife/primary caretaker cannot care for him. Options?

Question

Background

A married couple I know have a large age difference - about 20 years. The husband has been "dying" for literally 6 or 7 years now - in and out of hospice a number of times, and then was in a nursing home for a while before convincing his wife to let him come back and live with her at home. The husband is not able to live independently. As just one reference point, I remember sitting at his table talking to him 5 or so years ago and he literally fell asleep mid sentence. I thought he died on me, but when I called his name a few seconds later he jerked awake and attempted to pick up the conversation where he had left off. He cannot drive nor does he live in a place that has public transportation (not that it matters - he is not very mobile).

Through most of this his wife (now in her late 50s) has been his primary caretaker. After a number of hospital stays she moved him into a nursing home for a while. After maybe a year or so he convinced her to check him out and let him stay with her again, once again becoming his primary caretaker. The problem is that as his health has declined he has become a more and more ornery person. I can tell that the stress of caring for him is very much wearing on his wife, and we recently learned that there was a brief period of time when she was even contemplating suicide.

Question

The situation seems fairly critical to me and the most obvious solution to me is having him move back into a nursing home. The wife has considered this but believes the husband will refuse. From my own reading he could possibly be forced against his will if the wife were to be legally declared his guardian, but from what I have read that is both expensive, time consuming, and doesn't have a high probability of success. Either way, I don't actually know much about this process or whether or not it is really an option anyway. I'm wondering what legal options might be available given that:

1. The person is clearly incapable of taking care of themselves
2. Their only caretaker is (mentally) incapable of taking care of them also
3. Real harm may happen to one or both parties if nothing changes

Attempting to force him into assisted living is the first option that comes to mind, but I'm happy to hear about any legal options that might help alleviate some of the stress from the wife. I'm guessing there isn't any serious hope of forcing him into assisted living, but I also don't see any great options otherwise so I figured I'd ask here. If relevant, I believe there is a nursing assistant who comes once or twice a week to help. They are very poor (I assume the nursing assistant is paid by medicare?) so anything involving any amount of money is more or less a non-starter.

Answer 1

From my own reading he could possibly be forced against his will if the wife were to be legally declared his guardian, but from what I have read that is both expensive, time consuming, and doesn't have a high probability of success.

A guardianship is pretty much the only option. It can be expensive and time consuming. The probability of success boils down to how clear the case is, and the more obvious it is that the would be ward can't care for himself and refuses to do anything about it, the more likely it is that a guardianship would be granted. It will also be faster and less expensive if the case is clear.