What do you do about vomiting and dehydration?

I think you did the right thing Harry...next, like said above, call APS, and as soon as they show up WALK..real fast! But then I'd worry about my ol friend...
Anyway, I hope your friend gets some loving care like you've done....I doubt that will be from his "kids". I'm glad APS is there to help elders like this cuz sometimes kids can't do it for many reasons. I have loved and TRIED for years to help my dad but he'd "kindly" or stubbornly refused.
OR just didn't give a crap about his health!

Every family situation is different and usually isn't what it appears to nonfamily...in my little town, everyone thinks my dad is the "best" old man etc. Lotsa times I can see that "best" thing they talk about but I'm the only one who deals with the "unbest".

Wow what an awful family they are to have guilted you about making a sound decision to assure their 90 year old received the proper care. I can't believe they asked if you would pay for the ER evaluation if Medicare didn't pay. You can't take chances with a frail 90 y/o who was vomiting and pale for three hours. I would have made the same call, as would many here.
Apparently the family has no clue about caregiving and you have become their scapegoat.
What a shame the 90 y/o is the one who will suffer the most.
It's a tough decision but the family's actions put you in a potentially bad situation as you will get the blame if you are around the 90 y/o and make the wrong call b/o their cluelessness.
If you decide to stay and continue to watch over her I wouldn't hesitate to call 911 again if her symptoms warranted it, heck it's better to be safe than sorry with the elderly- I would call EMS if I thought it was best and to heck with the family. They can't "make you pay" for the ER visit.
If you decide to leave and feel the 90 y/o is vulnerable and unsafe, call APS.
Terrible that you are in this situation.
You absolutely did the right thing. Did I read that you drove her there? Next time call an ambulance, notify the family, and leave it be. Call the family & let them go to the hospital
& make decisions for her. Stay out of it after the ambulance comes.
That family is so out of touch it's time they have a dose of reality.
Glad that you were there for your neighbor.

Harry, you did the right thing. Don't feel guilty. You can't win with people like that. Imagine if you had "let it go" and something bad happened - then they'd be blaming you for that. He probably felt so much better after they helped him at the ER -- you should feel good about that!

Harry
Is the elder on hospice ? I understand that can complicate Medicare payment

97 year old mom, thank you. Now I don't feel like the RN or I didn't overreact.

You did the right thing.

No, they didn't ask me to do all this. But, when I first moved here, I did nothing except clean the house 1x a week.  After a TIA and a 1 month stay in hopital and the return home, I was the only one around to do everything.  But the work just keeps adding up.
I should add that I gave a 30 day notice. I have no problem with, and enjoy taking care of, older people - always have since I was 15. But no matter how well you get along with the person you are caring for, if their family members don't speak to each other, if there's old fights unresolved, and there's bad communication -- run. Because I feel emotionally hi-jacked by these people. And now the guilt is setting in. I'm too young for this.

thank you for your reply. They did give an IV. Then set us home. But they were more concerned that IF Medicare doesn't pay for that ER visit, they'll get stuck with the bill. And since they didn't get a call and approve of it, how would I feel about paying the bill. I didn't answer. I just thought, If someone was caring for my 90 mother and she was that sick and worried, I'd tell the carer - it's your call because you know what's going on. At any rate, they did not want her going and used the ER doc as a reason to tell me I was wrong, because the ER doc said no overnight admission was necessary. I just thought... THIS time. You never know with older people. They just go downhill so fast.

"I help a neighbor by cleaning for the 90 yo and doing yard work, taking out for groceries, to lunch, the doctor appointments. but today they cornered me, had an intervention, told me they didn't approve that I took the elder to the ER (on advice from the RN who comes once a week). They decided I shouldn't have done that, and they will decide - even though they come over one time a week, for 20-30 minutes, empty handed, and leave. Does anyone else do live-in 24 care for free, or am I a sucker?"

Harry,
I saw where you posted this on another persons question. I had read your question here earlier. This comment makes it easier to understand what happened. I'm so sorry that happened to you. First of all the home health aid and RN should have called whoever is their first level of contact for the 90 year old and told them he needed to go to the ER. No, Harry you aren't a sucker but a very nice man who helped out a neighbor. Did your neighbor want to go to the ER? Is he capable of making decisions for himself?
Did one of the family ask you to take your neighbor to the store and dr appointments?
This is an unfair situation for you and your neighbor.
To answer your question. Most people get paid an hourly wage to do what you do for your neighbor unless they offer to do it because they are also going or are friends. The very idea that they had the nerve to complain that you took him to the ER is very annoying to say the least. What happened at the ER? Did they give him an IV for dehydration ? I wonder what his family would have done if they had been asked by the RN?!

Thank you. I did, on the advice from the aide who was here and called the RN explaining the current situation. In the end, the RN and aide were going to get them to the ER one way or another, so I was the driver. Today, the family had an intervention, cornered me, told me off... etc etc. Feel very unappreciated. Oh, by the way, I live here, I pay rent and they pay me nothing for the 24 hr help.

Take him to ER.