My dad, 91, lives 1300 miles away. He recently fell with minor injuries. Should I insist he move closer to family?

I don't think that I would "push him" to do anything. Let him come to the decision to move back or not on his own, for now anyway. He has his life where he's at now, and just may not be ready to leave it all behind. There may come a day when he won't have a choice, but to move nearer to you, but for now, I would just let him be.

I think rather than pushing, you and your brothers should explain everything to him as carefully as you can, the dangers of staying alone in this environment and etc. Other than that there is little you can do with a competent adult, and things will progress as they will until there is real injury and you are contacted by Social Workers in hospital setting to ask who will take guardianship. You will be able then to act in your dad's behalf without his permission. Until then you can only advise. I wish you all the best of luck. This has to be so worrisome on a daily basis.

Maybe the OP's father figures he's rather live his life on his own terms as long as he can, and then doesn't care if he falls or something ends his life--as opposed to giving up what he enjoys because something might happen in the future. Of course this doesn't make life easier for the rest of the family, but that is his choice. Some people would rather live life to the fullest in spite of "danger". He might figure he'd rather just end up dead in his own place than potentially kept alive much longer in a nursing home or at least a restricted lifestyle. (Maybe in some sense there is too much of a mentality to "protect" old people at the cost of their freedom--although if he develops dementia or becomes physically incapacitated then the decision will have to be made for him.)

I had an uncle who lived in his own home until he was 98. A son who lived within a half-hour drive came over to bring groceries, etc. every week or so. Other family members who lived within a couple hours of him (including my father who was 13 years younger) would visit him when they could. (Although he hadn't bothered to renew his driver's license, he still drove the half-mile or so the post office to pick up his mail until he was about 97.) Finally, another son, living in another state, took him in, where he lived a month past his 100th birthday, needing more care the last few weeks. I was living some 400 miles away but I visited when I could, and he seemed content in his ranch-style home where he had lived over half a century, and he enjoyed sitting in his living room watching baseball games on TV. Other than being hard-of-hearing, he seemed okay mentally, and was able to walk without problems.

Katroy68, as others have advised, it's probably not a good idea to insist, or even "push," your dad to anything. But, at 91, it is imperative for you and your brothers to stay watchful, visit him as often as practicable, and encourage him to visit you, as well. Communicate frequently, let him know that all you care about him, would welcome him back to his home state, and would even help him figure out the logistics and help make the move if he wants to do that. It sounds like you and your brothers are already doing those things and kudos to each of you if you are. Best wishes.

My MIL with Alzheimer's dementia lives in Hawaii while we live in Florida and her other son lives in California. She wants to die in Hawaii. My BIL manages her affairs. She has 2 caregivers that take turns caring for her 24/7. Before she had her 2 caretakers, she was cared for by home health care aides 24/7. Her current situation is better for her since she has less caregivers coming and going.

There are lots of caregiving situations that can work for your dad:

You can have dad move in with you or another family member. This would be the least expensive option. If he has some dementia or mobility issues, then living alone is probably not a good idea any more. Just be aware that many dementia sufferers progress in their disease to requiring 24/7 care.

In-home help: home health aides can clean house, prepare meals, transport dad to appointments, bathe, dress.... is the next least expensive option. My MIL can afford her caretakers because all her assets have been liquidated and added to finances from her late husband's life insurance. Unfortunately, this option was not affordable when he was alive since it required too much money and Hawaii is expensive.

Lastly, residential facilities are available in most towns. They are more expensive than in-home care. However, there are some that will take Medicare and Medicaid.

My dad was just like your dad. At first he waffled between wanting to be with us and staying put. We even had a place chosen near my sister when he did a 180.. Finally he decided on his own that he needed to unload his house. He knew he was having cognitive issues. But he wanted to stay in his city so we moved him to an IL apartment. He hadn’t been there a month when he realized he should have moved near one of us!!! So we found him a place near me and moved him again. He was 93 and moved to IL and later AL and then LTC at the end. I was glad we chose a continuing care residence.
The moral to the story is you can’t force a move and yes it is better if they are nearby. Hopefully your dad will decide when it is time in a reasonable fashion. Do know your life will not be the same as you know it. But I can’t imagine handling all I had to with him 350 miles away. As hard as it was, I am glad he moved here.

Maybe you could highlight the "fun" aspects of him moving closer to you, (rather than the medical reasons why). You could say, "You can come over for lunch," or "You can come over and we'll watch a movie on TV), etc., or if he moves in with you, you could highlight the same things. If he likes dogs, maybe he could get a (calm) dog. They can be great for easing tension, anxiety, transitions, etc. My mom moved in with us when she had Alzheimer's, and just the presence of our dog helped her.

If he is still mentally capable, it will ultimately be his decision, but have a discussion with him about how he would like to live if he becomes less capable of caring for himself. His friends and life are where he lives now, but I've seen many people decline quickly after they reach their 90s. At some point he may no longer be able to drive. He may need to have aides come in to help with more things like shopping and cooking, and take him to doctor appointments, he may need to hire more help like a regular cleaner and someone to do little chores around the house like change light bulbs, etc. When "strangers" are coming into the house of a vulnerable senior the situation changes. You need to be sure that personal information like financial statements and valuables are locked up. The other option is to move to an assisted living facility at some point. If there comes a point where he needs a lot of assistance, it will be much easier for you to help him and visit him if he moves close to you, and this should be part of the discussion. Ask him if he'd like for you to take over his financial affairs, and if so, have all bills and statements sent to your address. Any move will be difficult for a 91 year old, and he will need lots of help. The very thought of it may be daunting. He may need your help selling the house. There are professional movers who specialize in helping people downsize. Make sure that all of his paperwork is in order: power of attorney (POA) for medical and financial decisions, a living will that explains his medical directives and wishes (and be sure that you know them too), will, and some banks have their own POA forms.

While you can continue to hint, legally you don't have the grounds to force him to move back to where his family is as long as he is considered competent. It is hard and discouraging to see a family member become injured or make decisions that you feel are wrong. The fact of the matter is if you were in the same shoes and you had someone pressing you to move, from where you had a life with your spouse would you be willing to do so? I would try to get him to accept outside help in his area such as people that can drive him to appointments etc. if you have an agency for the aging in his hometown area that is a good place to start. See if he will be willing for meals on wheels and just let him know that when and if he decides to move that you will be there for him and keep open communication with him.
He may come round and move, but he may not. He probably sees that he has issues, and isn't quite ready to accept them himself. It is all new to him too. If he was a care provider for his wife he may be all too familiar and doesn't want to put that burden on other family members.
Best of luck

One single fall is often the "game changer" and not for the better. At least get one of those devices he can push if he falls (if he does not lose consciousness). My neighbor down the road said his mom was a walkie-talkie but she fell in the bathroom and ended up fracturing her pelvis and ended up on hospice and died bedridden. Fractured pelvis is inoperable

Geriatric people living alone are often targets of home invaders, where they can get beaten up and killed. Hey this is the world we are living in now.