Dad refuses live-in care. What options do I have?

I agree with the others . Stop doing anything for him etc.
I do want to add that you have in your profile that you don’t want him to go to a care home . A care home is exactly where he belongs. Who would be willing to be a live-in caregiver in the filthy house that you described?
I would be speaking with the social worker at the hospital , tell him/her that there is no one to provide care for him at home , and that you are not taking him home. Either he goes home on his own or hopefully it would be deemed unsafe discharge and social worker finds him a care home .
Either way you walk away from this . You don’t have to take care of him . He’s being stubborn .Don’t visit him in his house .
If he ends up in a care home you can visit him there if you like , but I question if that is wise either. He will be angry . He’s ruining your life with his stubbornness, as well as he’s a bully .
You said in your profile that you feel guilty that you should be doing more. There is nothing for you to do . The man refuses care. That’s on him .

Your option is to walk away. He isn't going to change and will never accept help until there is a disaster.

If walking away is too harsh than set strict boundaries and stick to them. Agree how often you will visit and don't help for any other reason. He will quickly discover he needs more help.

Go to the discharge planning department of the hospital first thing tomorrow.

Tell them dad lives alone and that you and your sister are mo longer able to assist due to health and safety issues.

Tell them it will be an unsafe discharge if they send him home.

Do not sign his discharge papers.

Do not provide transport.

He has capacity, right?

Then let him capably find himself home health care and pay for it.

You can't help him. He wants what he wants and d**n with everyone else. Next time he calls you for a health emergency, tell him ur calling 911. You now know what he is doing, stop reacting.

There is a reason he was not in your life. Old age does not erase that he wasn't a Dad to you. He should expect nothing from you. You either walk away or have strong boundaries like Mountain said. You do not owe him anything and you aren't responsible for him because he is your bio Dad.

Next time he is in the hospital do not pick him up. Tell them you cannot care for him and there is no one in his home who can. Its an unsafe discharge. Do not take on POA. Call APS, let them evaluate and take over his care. Explain that he did not raise u and you are not willing to be responsible for him. The State will take over his care. If APS evaluates and thinks he can live on his own, then u back off.

You and your sister need to stop what you are doing, no more supporting his bad decisions.

Don't pick him up from the hospital, don't do anything, back off, let the chips fall where they may.

Sounds like he has been the man in charge all his life, he always wants his way, the order giver.

You owe this man nothing. Move on.

To echo what a lot of people have said...
The best way to "care" for him at this point is to care enough to STOP doing all that you have been doing for him.
That may be the only way that he will realize that he has to accept help OR something will happen that will force him to accept.
Honestly what would happen to him if your sister went on vacation and you were sick at the same time? What would he do?
What you could do is next time he is in the hospital, of if he is still there tell the doctors, Social Worker, Discharge Planner that he can not be discharged to home as it is not safe. You can invite someone to come an assess the home if they wish. This might provide a brief spell in Rehab if that is needed.
But at this point if no one is willing to document that he is not cognizant there is not much you can do but back off and wait until something happens.

Tired--you don't sound like a whiner. You sound like someone who is being used and is finally tired of it. I saw comments suggesting that your dad didn't take care of you as a child (he wasn't a dad). I'd have a hard time doing anything for him under those circumstances, and especially if he isn't appreciative and kind to you now. He wants to call the shots, so I think you should let him, and stop riding to the rescue.

I read your profile and it sounds like your dad needs lots of help in many ways and just not with his daily care. Sounds like he may be a hoarder as well, and that is a mental issue on top of everything else.
He requires more care than you could possibly ever provide and the fact that he's not a very nice person and never has been, even to you, tells me that you should not be the one caring for him.
If he continues to refuse to hire help, then you must just walk away and call Adult Protective Services and report a vulnerable adult living by himself.
They will then come out and do an assessment and take things from there.
If you continue to do even the littlest of things for him, he will continue to believe that he doesn't need any help. So you must stop.
And realistically you already know that he belongs in a facility. 24/7 care will cost him much more than a facility will.
Your dad needs help. Please call APS.

You can't "fix" this one. I am sorry you are going through this. It isn't what you signed up for, is it? Walking away, quietly, is the right move. Live your life, and do the best you can to move forward. He doesn't seem to be willing to do anything to help himself, help you help him, or find any joy in whatever life is left in him. It will get better for you. Hang in there.

I just read ur reply to Alva. This is the opportunity u have been looking for. He needs to be evaluated for 24/7 care and if found he needs it, you tell the W that to send him home would be an unsafe discharge. You have tried to get him help. APS has been involved but because he is uncooperative they closed his case. You refuse to care for him. Tell them you were not raised by him and he had nothing to do with you until he needed u. The State will need to take over his care because u refuse to have POA, which he probably wouldn't give you, or guardianship.

If he is dying, best place for him now would be Longterm care. That way when Hospice is called in, he still has round the clock care. In home, family does most the work 24/7.

Please, do not have any guilt in this. He has made his bed and now he has to lie in it. You reap what u sow. He has brought this all on himself because he is stubborn.