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My husband and I have been care givers for our widowed neighbor who has no family. This morning we received a call form LifeAlert that she had fallen and not responded. An ambulance was dispatched. We do not know if she passed out or had lost her balance and fell and was knocked out. I rode with her in the ambulance because she was very agitated and did not know what was happening to her. At the hospital her alcohol level was .245. How do we go about helping her? How do you send an 86 year old to detox?

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This is really a question for the docs and the discharge department. Since she will have no access to alcohol in the hospital, and they were aware of her status on admission, I assume that is being addressed. So, she will be alcohol free when they are ready to discharge. Are you and your family able to care for her in her home? Probably not. The discharge planners at the hospital will find an appropriate placement for her.
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Ba8alou, I completely agree. .245 is in the death zone for someone her age. She's more than caring neighbors can handle.

Get Social Services at the hospital involved immediately. Like tomorrow morning. They'll take it from there.

Just for your information, here are the effects of .245 alcohol concentration on a healthy person:

Increased pain threshold
Urinating on one’s self
Impaired consciousness
Slurred speech
Disorientation
Exaggerated emotional states
Decreased muscular coordination
Cannot talk or move
Loss of motor functions
Depressed or abolished reflexes
Impairment of circulation and respiration
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Make sure they are saying .45 and not .0245. Either way? not great.
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You saved her life. It's probably time of the next phase of her life, and it is very possible she may not return to living alone. If you can visit and talk informally with anyone at the hospital, letting them know just how much help you have been providing, they may appreciate the information. They won't be able to share information back with you unless you have HIPAA releases and all, but that might be about all you can do at the moment.
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You can bet the hospital will watch for withdrawal symptoms as well as doing some brain imaging. Let the Social Worker work on protective custody if it is needed.
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Thank you for all the answers. Unfortunately being Labor Day there was not any social workers at the hospital. They discharged her. She is back in her home. It is not possible to care for her in our home. We only became involved with our neighbor in Dec. of 2013. Up to then we really knew nothing about her and her husband (who passed away in Oct. 2013) and her life. They were extremely private people and did not welcome anyone into their lives. She has no financial means to go to assisted living or nursing home. We applied to Medicaid for her and she was turned down because they said she it was not that she could not take care of herself she did not want to take care of herself. Her mobility is limited due to two very bad knees. Replacements done over 15 years ago. ba8alou in respond to your comment the ER doc just said her blood alcohol level was 245. I wished I had asked him to repeat or explain.
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That's crappy care, and in the near future, hospitals will wise up if they want to stay in business because a readmission is pretty well inevitable and they will be dinged for them by the powers that be. Medicaid denials can be appealed, BTW. And you are awesome for trying to help her.

So - you either get to wait for the next bad thing to happen, or if you have not been able to do such a good job propping her up that it would look like everything is just hunky dory when they come out to have a look, you can speak to Adult Protective Services in the AM.
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I would also call the Hospital social work department this AM and try to raise some H#ll about her being discharged back to live on her own.
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You and your husband are very kindhearted, Christian people to be watching out for your neighbor. But she will self-destruct with the alcohol and take you along with her. This won't be the only night you spend in the hospital with her. Maybe you can find a way to be of service to her but at arms length. Create some boundaries. I'd hate for you to stumble into becoming 100% responsible for this lady.
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