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He refuses to go to personal care. He has fallen several times and is not safe. He lives in a boarding room and access to kitchen and laundry is on the other side of the house and you must go outside. He doesn't clean his room and do laundry unless I come over. He can't get food unless I come over. I live over an hour away. He tells me he can do this but he has shown that he cannot. I am lost as to what to do. I have called Office of Aging and also he was just in emergency room for dehydration. He has also lost considerable weight of 20 pounds in 5 months. Both tell me there is nothing they can do if he is of "sound mind". I use that term loosely.

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You step away until he gets taken to the hospital.

That is the reality of trying to help a vulnerable adult who is still competent.
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There's really not much you can do, but wait for the next catastrophe to happen. Then you will hopefully be able to make some decisions on his behalf. At this point, it is what it is, and if dad feels he's fine on his own, then let him be on his own. Quit enabling him by going over and cleaning, doing his laundry and getting him groceries. As long as you keep doing that for him, he will continue to believe that he's fine to live on his own.
If you stop doing those things, he will soon realize that in fact he does need more help then he first thought, and hopefully be more open to discuss his long term care. I wish you well.
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Nanulinda1 Jun 2021
Not necessarily true . If he has dementia or Alzheimer’s there is a thing called Anosagnosia . It is not the same as denial. In their altered reality they might TRULY believe they are fine ..,
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If he ever goes to rehab, have him evaluated for 24/7 care. If its felt he needs 24/7 care you need to tell them you cannot care for him and sending him to his home would not be a "safe discharge". There is no one to care for him. The rehab can not discharge him unless its safe. He would be transferred to a LTC facility. Since it sounds like he has no money, he will need to apply for Medicaid and his SS will go towards his care.

You can try this at a hospital too but my RN daughter says they aren't under the same rules as Rehabs are.
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As others have said, there is really nothing you can do to make this happen. But I do have a couple of suggestions. As a result of reading "Being Mortal" by Atul Gawande. I took a different approach with my father in law than I had previously done.
Instead of telling him that he should move as my MIL had significant dementia and was difficult to live with, I started asking him questions about what he envisioned for the future, how he saw the next few years etc. Turns out he understood he needed to move but he was stuck by all the stuff he had at his house. It was not that he was totally attached to it, he just could not figure out how to move and where to start. They had been in their home since 1957. He had the beginnings of vascular dementia and could not really problem solve. So maybe ask him how he sees his life going, especially if you stop coming over and enabling him. That may lead to a breakthru.
And then, on your own, start researching options for him that would be near you. His financial status is going to be important here but once you know how much he has, (or does not have), you can research options just so you are aware. If there are viable options for him other than emergency placement, you can possible show him and get him to agree. If not, you will have to wait for an emergency, and there will be one. But at least you will be prepared with some knowledge ahead of time.
Good luck; such a difficult journey.
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Stop enabling him. He’ll see that without your help he can’t live independently. If he has trouble “getting around” it’s only a matter of time until he falls and ends up in an ER. If he has no one to help him return to his apartment/room he won’t have any choice but to go into a facility. Without your help this will all end quickly.
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I disagree that you should stop enabling him. He needs help and the fact that he has lost 20 lbs means he needs MUCH more help. Hire someone to get meals for him twice daily and to watch him eat. In the meantime, start looking to move him into his new home near you. You need to be around the care homes to make sure they are caring for him. Meals on Wheels will provide food and serve as a wellness check. But honestly, he needs placement into a care home.
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If your dad is already living in a boarding house, perhaps you might be able to get him into a family-style group home where there are a small number of residents, live-in staff, personal care assistance, meals prepared, etc. He might prefer this over a larger more "institutional" setting. You don't mention your dad's finances, and these kinds of places are not cheap but are less than large assisted living places or nursing homes. I don't know whether they would be covered by Medicaid in most states, but might be worth looking into.
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If he is a veteran he would probably qualify for a VA pension and “Aide and Assistance”. You are the aide and/ or you can use the pension for outside aid. Your local VA office would be the place to start and get questions answered. It’s been a God-send for my dad and allows me to care for him now full time. There was paperwork at the beginning that seemed a little daunting but I got through it with no problems and now working well. God Bless you both.
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One thing bad about this forum is bad advice. Ignoring him is very bad advice. It could kill him.

I do not like "ignore him" advice because that much weight loss means something is drastically wrong and he really needs to be in the hospital--from there he needs to get a medical and a psychiatric evaluation, and social workers can do safer placement.

TALK TO HIM FIRST and get him to the emergency room. IF HE REFUSES, you MUST fight for him. It is time to take action and call 911.

DO NOT ASSUME IS HE IS COMPETENT.

IF that were my parent and under those conditions, I would call 911 and tell them you feel your dad is a danger to himself and has something drastically wrong.

If you feel he is a danger to himself you may want to get a psychiatric evaluation after ruling out medical reasons for the weight loss. In Florida this is known as a "Baker Act".

THINK SAFETY FIRST.
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AnnReid Jun 2021
Would SHE be “better off”?
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First thing if he's lost 20 lbs in one month is a big concern and he should be checked out by his Dr,, blood and urine to make sure his weight loss isn't due to something worse than just not eating much.

He may be waiting to see if you'll offer to let him live with you.

You can't blame him for not wanting to go live at a Senior place,
they are understaffed and not a fun place to live, as you loose all your rights and are told what to do and when to do it.

He wojld be happier staying where he is if he doesn't have family he could move in with.

While he's staying where he is, You could install a camera in his room that he can be watched 24 7 by your cell or computer, in case he falls, ect in side his room.

He could also wear a fall necklace in case he falls outside going to the kitchen or bathroom.

He should have a small refrigerator and a microwave in his room.

He needs plenty of easy stuff to eat in his room.

You can basically cook and warm up anything in a microwave.

They have easy microwaveable meals for breakfast, lunch or Dinner.

He should have easy snacks to eat like Breakfast Bars, Cheese Crackers, Peanut Butter Crackers, Nuts, Bananas, Apple Sauce, Yogurt, Breakfast Drinks like Ensure. Easy Soups to heat up that you don't have to mix with water, Juice, Milk.

You may try to get him on Meals on Wheels and have a meal delivered to him once a day.

Prayers
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