What advice for friends who are childless, he is depressed and suicidal, she is in poor physical condition. Doctors are not pro-active.

Your profile is confusing.

Are u caring for an 84 yr old or are u 84? Who has ALZ/Dementia?

I am assuming ur daughter gets SS and is on Medicaid. Does she go to daycare? Medicaid may pay fully for that. Have you considered finding her a group home? I realize that considering LTC is not something u want to do. But, you are not going to be here forever. Better that ur daughter adjusts now then everything being thrown at her when u pass. Mom gone, in a strange place, strange people. Now, u can help her transition.

I may eventually have to make this decision with my nephew. He is on his own now but his neurological condition will cause Dementia sooner than later. My daughters will not be able to care for him. So if I pass, he will become a ward of the state. I am trying now to set up things.

We notified APS for a similar situation after schizophrenic bil fell and broke his hip and sister was unable to care for him. I was doing 24/7 total care for our brother and caring for my feeble post stroke husband.
They were not able to provide physical assistance, but the lady was so supportive and I believe her involvement prevented premature discharge of bil back to the home.
Also the home health was so much more helpful than was our usual experience.
Our APS lady kept in frequent contact until my sister ( after a visit to ICU herself) were able to cope with their situation.
I was so impressed.

Husband is now in psych hospital undergoing evaluation after suicide attempt, hopefully they will get some help thru hospital. Thanks for your advice. After past hospitalization husband refused any follow-up advice. Wife relying heavily on friends for transportation, meals, etc.

The doctors can't legally do anything if they don't have Power of Attorney or guardianship. I agree with Countrymouse...call APS and get them on their radar. No individual will be able to help people who are in denial and resistant, no less depressed, suicidal and dangerous. The county will get guardianship and the couple will be placed in care and be safe and receive medical attention. If the wife is only frail but cognitively "all there", you can try to help her to bring about change for her husband. Ask her if they have any younger relatives at all to notify. But if she's also in mental decline, they both will need APS.

When you say the husband is a danger to his wife - in what way?

But in any case, I can't see how a call to APS could possibly be the wrong thing to do. If you don't report the situation, APS can't possibly intervene. If you do, and they think it appropriate, they will.

When you say the doctors and psychiatric hospital have made no long-term plans, how do you know? Is this what the husband has said, or do you have other sources of information?