Goes to ER instead of following Dr orders. Should she be in assisted living?

We do not know enough about your 'old obese sister' to provide input (from my perspective). It may be up to a social worker or another medical professional to make this recommendation / determination.
* The question needs to be directed to your sister. It is up to her.
* What you do not address if how you respond to her seeking pity from you.
- What do you do?
- How do you handle these communications?
- How do you want to handle them?
* If me, and I see a pattern of self-pity / loneliness / depression - set your limits (10 minute calls, 5 minutes, 2-3-4 days/a week? Don't answer the phone? If she is obese, clearly she has a problem and this could be part of her reason(s) for going to the ER - perhaps medication(s) are part of the problem.
* Does she have a regular medical provider?
* Do not argue with her. If she needs a sounding board, set your limits. She won't change.
* She may be going to the ER for attention.
* Key here is how you want to be involved / how you expend your time and energy interacting with her / and her patterns of behavior.
Gena / Touch Matters

Tell her to ask her doctor for home health care. They can sent PT and OT folks in to get her up and moving with exercise. A nurse can come, probably weekly to see how she's doing. It might get her motivated and more stability in her walking ability to keep her safer. They might also recommend a walker to use in the house.

She needs to be evaluated and treated by a geriatric psychiatrist. She may be lonely or have a health obsession. Either way, she needs a little intervention.

This is a stubborn woman who needs more care and help but is not willing to do anything about it. Do NOT enable her by being there. Let her lie in the bed she makes until she is willing to take charge and fix the problem.

Dhe should be wherever she wants to be.

What she *should* do is listen to her doctor(s), but she doesn't. There really isn't anything you can do to change her situation. Assisted living won't change her issues, other than there might be someone available to help her up if she falls. Otherwise, AL isn't going to solve anything for her and it would be up to her whether she wanted to live there or not.

Attention seeking? Sounds like it. She goes to doc, gets advice, but ignores it. Until she decides to change her life circumstances, this will go on until she has a serious medical issue and then she may end up in a NH.

If you feel you can't really help her and don't want to be interrupted so much, let her calls go to voicemail. You can take her calls when you want to take them. You can call her back later, if you choose to after she leaves a message. Listen with half an ear, mumble some "comforting" or sympathizing words along the way, but find a way to cut the conversation short - ring your doorbell or set the oven or microwave timer and beg off the call.

You can make suggestions for ways she can improve herself, but she is the one who needs to make a decision to improve her life. It doesn't sound like she's willing to put in the effort and would prefer to get sympathy from others. Encourage her to consider taking her doc's advise and say you'd be willing to be more supportive IF she makes the effort to change.

Contrary to what others are saying AL might be beneficial to your sister. Many seniors are lacking social interaction, especially since Covid. If sis moves into AL she might make friends and get involved in some of the social activities and find something else to do other than eat. Of course it is up to the AL to assess her and decide if she is physically a fit for them. Mom's AL would send any resident who fell unattended to the ER, and if she is really obese the staff may not be able to help her and would call the EMS anyway.

NewUser22: Some individuals have health issues that should be addressed by their primary care physicians in conjunction with specialists. Calling 911/EMS should be reserved for true EMERGENCY care issues. If everyone called 911 for what is deemed a non emergency, the ERs would be overrun. An assisited living facility is not her answer. She has to be determined to lose weight with a qualified nutritionist without drawing you into her saga if she chooses to not change her life style.

Many people behave like your sister. It’s certainly frustrating. I don’t feel like you are fat shaming your sister at all. You are merely pointing out that her weight is contributing to her health issues.

Let’s face facts, obesity is a common situation and some people struggle to lose weight, others are plain uninterested in losing weight. You know your sister and her background story.

If you have repeatedly offered your sister feasible suggestions of ways to help her improve her life, and she has constantly ignored you, or disbelieves your ideas, then I wouldn’t even bother to suggest any possible solutions to her.

Yes, your sister may be seeking attention. She may want you to feel sorry for her. It may work on your nerves. Limit the amount of time that you listen to her. What else can you do?

As far as assisted living goes, I seriously doubt that she would change her habits if she isn’t interested in doing so. You can’t force her to change her ways. Maybe she is a food addict.

Best wishes to you.

Don’t let this stress you out. Unless you are her POA - focus your energy elsewhere. You live far away, have different lives and you don’t need to get involved.

At some point, if she continues to call paramedics to help her with normal activities of daily living (getting up), she will probably wind up in some type of nursing care whether she likes it or not.

I understand you are concerned about your sister’s health but honing in on her obesity as the focal point of her problems is doing her an injustice.

I understand you are concerned about your sister’s health but honing in on her obesity as the focal point of her problems is doing her an injustice.

She doesn’t belong in an assisted living facility. No amount of coaxing by you, by staff or even a doctor will make her participate in activities offered there. She is obese and probable unable to physically participate. Yes, she will get more nutritious meals but other than that if she is not willing to do for herself, this is not the solution. Can you become more involved with her? Can you start a once or twice a week walk in her neighborhood. Maybe that will encourage her to walk a bit by herself once she sees she can do it. Obesity is demoralizing and this could be a big factor in her mental problem. Would she keep a diary of what she eats so you can see. Make suggestions.

sounds like she should be somewhere where she can get extra help but IF she is of sound mind and doesn't want to go, not much you can do. There will be a time when she gets hurt bad enough that they will send her directly to a NH for rehab or whatever. do you have POA? if not, then its a waiting game, unless you can talk her into going someplace where she can have better help. wishing you luck.

Assisted living will only "help" with household help. She needs medical and psychological evaluation and treatment. Talk to her about seeing a psychiatrist to start dealing with her mental health concerns.

A couple things pop to mind. True she has attention seeking behaviors. She is getting a lot of secondary gain by not adhering to a treatment plan, enlisting friends to take her to the ER (dangerous liability by the way), and the sympathy of an ER visit. EMS may start charging for these visits if they become too frequent.

Not to make light of it, but I had a senior who used to be 'found' on the floor and be taken to the ER, get a hot meal, warm bed for the day shift. His dentist daughter worked all day and refused to come get him. We discovered he put himself on the floor and never once actually fell!

I'd start with asking PCP for a home health evaluation including PT. Let them assess her and the home for safety and her mobility and strength. A plan could be made after that.

Good luck

My sister, who was 85 when she died this last January, was very much like your sister. She, too, would go to the doctor, but not follow his advice. She has fallen once, and called on neighbors to get her up. They couldn't, she had the chain across her door and couldn't get in. EMS broke down her door and got her up; she had a sprained wrist. Strangely, the sprained wrist turned into her sitting for MONTHS, except to go to bed or bathroom, until she basically could not walk anymore except with a walker. She ate cookies and deli sandwiches that neighbors would shop and get her. As far as I know, that was her diet. (I am not exaggerating; I saw her kitchen.) My brother and I tried very hard to talk her into improving her entire situation by going to AL, but she NEVER have agreed to AL, She knew she couldn't live her life like she wanted, which evidently was sitting on the couch eating cookies, watching TV and manipulating her neighbors to get her food and drive her to doctors' appointments and the hairdresser. Brother and I live in different towns and are aged ourselves. I think we both felt like we had to do something, but she just ignored our concerns. Finally, her sacrum broke. Dr. said it was from osteoperosis or old age. She didn't fall, it just broke. That led from one thing to another, and we had to go to her, call an ambulance, and she ended up dying in a skilled nursing facility a few months later. This is a long story, but my point is, there is not much you can do unless she is cooperative. I think my sister craved attention and pity, and if she did something for her well-being, that type of attention might end. Hate to say that because I loved my sister, of course, but she put up barriers to any kind of help we offered or suggested. You have to refuse to be made to feel guilty. Do what you can, and then let her live as she is choosing to.

She sounds like she needs to see a psychiatrist for mental-health evaluation and treatment if deemed necessary.

Ask her if she feels like harming herself, or wishes she were dead. If she threatens to do self-harm or is suicidal, you need to call 911 and get her hospitalized for a psychiatric evaluation.

Otherwise you cannot tell her what to do or how to live.

Has your sister expressed any interest in moving to Assisted Living?

If she asks for your opinion or your advice, you can be as frank as you like; but unless she does the kind thing to do is try to curb your (very understandable, if you ask me) irritation and frustration and voice what you know what she wants to hear - ideally without undermining any authoritative advice she has been given.

E.g, "oh dear, poor you. Didn't your PCP recommend you join that weight loss program to help relieve the knee pain? Do you think that might be a good idea? Maybe Marcia would take you and you could try it together." [Cue: 101 reasons why this would be much too difficult]. "Oh dear, poor you. Well, you be sure to good care of yourself now you're home again."

If you find her as irritating as I find my similar very much loved one at times, my tip would be to time your phone calls and cut them short - just make any unrelated excuse - when you've had as much as you can take. Otherwise you might become reluctant to talk to her at all and that would be a pity.

How kindly you feel towards her of course I don't know! But absolve yourself of any responsibility. You have no moral obligation to guide her choices.

I wonder if she would talk to a Counsellor/Therapist? You could suggest many people do for all sorts of reasons. (Getting older & having health issues being one). She may have anxiety, depression or be lonely, lack motivation, lack joy in life.

She may benefit from exploring what she wants from her next decade. What brongs her joy? Maybe for things to be a bit easier? Meals provided, activities & people close by? If so, yes AL may be a good choice ;

(Although if the answers have any hints of moving in with you 😳 stamp out that notion pronto!)

She goes to the ER for attention, then calls you when they're done giving it.

That's a mental/loneliness issue (and not necessarily related to dementia).

Frankly, she'd probably be a good candidate for something like assisted living, because she'd have more interaction with people each day and might find other things to be interested in other than hypochondria.

You can't make her go, though.

What she 'should' do & what she 'will' do are two entirely different matters, as you've witnessed with your sister, since she is not following doctor's orders. It's also easy for a doctor to say, "lose weight & exercise" to an obese elder when they've been eating a certain way & living a sedentary lifestyle for decades. Then it all catches up with them but it's not so easy to make the required 'lifestyle changes'. Your sister likely needs support more than anything else. Maybe that's what she's looking for when she calls you seeking 'pity'.......it may be understanding she's looking for more than anything else. Have you asked her what you can do to help her? There may be nothing you CAN do but listen to her, which also gets old if she refuses to help herself.

My sister in law is 64. She's been heavy her whole life and then became diabetic as a result. She did change her lifestyle, lost about 100 lbs and it still wasn't enough; she had her foot amputated to the knee a few months ago from a persistent infection in the bone and is now trying to walk with a prosthetic. Fortunately, her upbeat attitude is what helps her immensely. It blows my mind that she never complains or feels sorry for herself!

Anyway, if your sister moves into Assisted Living, nobody there is going to 'make' her eat right or exercise or do anything else to improve her health, either. That is something that she herself must want to do. When my mother lived in AL, she fell 40x because the staff can't prevent falls either! It's really a big fat mess when elders lose coordination and start down the 'falling' path, it really is.

Wishing you the best of luck.

It only matters if she will go to assisted living, and if she meets the very low bar of having a sound mind, the choice is hers. The good news is that you can choose what you do and don’t listen to, so essentially retrain her that you’ll have positive conversation and not the endless list of miseries. Wishing you peace

Next time she calls wanting pity make assisted living a suggestion. I have a feeling that she is trying to guilt you into assuming care for her. If you suggest assisted living or home health care etc. you might find yourself in a conversation about you moving to be with your sister...... If she balks then suggest going with that weight loss plan. Odds are if you let her know that you won't be manipulated into moving to her the calls for a "pity party" will stop. If you feed an animal it will come back looking for food.

If your sister is of sound mind, then it doesn't matter where you think she should live, as she will and can do whatever she darn well pleases. Unfortunately it will probably take a crisis or catastrophe before she will allow any changes in her life.
Thankfully you live in a different state, so you have the option of not answering your phone when she calls, and letting her calls go to your voicemail. It will then be up to you whether or not you want to return her call.
Have you tried telling her that you're tired of her calls for pity, and until she makes some changes you really don't want to hear about her woes? If not, you may need to do just that. Good luck.