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My relative has had several falls, fractures, EMS calls, rehab & hospital stays. Has been told ‘not to live alone.' My relative is not in agreement with that decision. They return to their environment & repeat the incidents. I live in another state. What, if anything, can I do?

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I would report this relative to his/her local APS for evaluation.
If they feel that the person is in danger to self for self neglect they may suggest state guardianship for examination and evaluation and for perhaps guardianship of the state court appointed fiduciary to manage and place.

I would not myself become overly involved. You are not (or do not say you are) the POA. That's to my mind at this point a GOOD THING because being POA for someone uncooperative and in denial is a nightmare that is a training going nowhere.
You seem to be the next of kin, and the one being called?
So next call refer to a Social Worker at the hospital, give the information you just gave us, tell the social worker that there's nothing you can do about this and suggest state guardianship.

Should APS and the state refuse guardianship then perhaps this elder will die at home after a fall and an inability to get help. At 81 myself and an ex retired RN I am here to tell you that's perhaps an option. We all will go. Your relative would perhaps go on his/her own, in his/her own home than face down dying slowly in care. I have come to the conclusion we live way too long, and at the end there is no quality whatsoever to those lives.

Best of luck to you.
I hope you will not take the responsibility for this.
You didn't cause it and can't fix it.
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ElizabethAR37 May 25, 2024
Agree. There are "super elders" out there, but at 87 I'm not one of them, and even they will make a final exit at some point.
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If your brother is of sound mind and you do not have POA for him, he's free to make his own poor decisions until he becomes seriously hurt. At that point, rehab will refuse to release him back home to live alone and he'll have no other choice but to go into a long term care facility.

It's difficult to witness these poor decisions made by loved ones, knowing there's a better answer out there: hire help. Wishing you the best of luck with a difficult situation.
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GAKD13675 May 25, 2024
Thank you.
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My 98 year old Father fell and was hospitalized with septic shock from a UTI. We were able to convince him to sign POAs for healthcare and finances. So when the rehab home was going to discharge him he insisted on returning home or going to a siblings. He’s incontinent, can’t walk and now has dementia. We were able to tell him neither of those options was feasible unless he wanted to pay $10-12 thousand a month. He does not have much income or assets. So we found a memory care facility. He fought at first but now seems to like the place. These have been the hardest two months I’ve lived through.
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From your profile:

"My brother had a fall & has been in either rehab or hospital for the past 3-4 months. He can no longer live alone,but has difficulty accepting that."

So is he currently in rehab/hospital? If so then you can contact a social worker in the facility where he's in and have a discussion about court-assigned guardianship and placement into LTC. He is an unsafe discharge and as long as no one goes to take him home, and he can't get himself home, he'll stay put. If you insert yourself more than this, he will get the idea that he can/will go home. The best thing is to refer him to social services and then step away until he is placed.
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GAKD13675 May 25, 2024
Yes, currently in hospital.

Thank you for the information. I’m so confused.
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The word, as Alva said is "unsafe discharge". Your brother is telling the SW he has help at home, I will bet. When he enters the hospital again and especially rehab, speak to the SWs and ask that he be evaluated for 24/7 care. If found he needs it, then inform the SW that he lives alone. That you do not plan on being his Caregiver nor will you pick him up. (He would then be ur responsibility) He needs to be placed in LTC with a State Guardian taking over his affairs.

Whoever is telling him he should not be living alone should be telling the SW that he cannot be discharged.
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waytomisery May 25, 2024
So true . My parents always lied and said that I didn’t work and/or lived with them in order to get discharged.
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Not Much you can do eventually she Might break a hip and will be forced into a rehab which usually leads to a nursing home .
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You can try to reason or plead with the relative. Then call protective services. Often it will do no good, especially if your relative is of "sound mind" when APS visits.

My uncle was the same way as your relative. The last fall he broke his back, had surgery, plateaued in rehab and is now in Long Term Care.

I feel for everyone involved because it is so stressful and no one wants to see a loved one unhappy. But, it is not you that can fix or change your relatives decision.

Good luck.
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TouchMatters May 30, 2024
Reasoning and logic do not compute.
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I believe, often times, it takes a fall or some medical situation in the home requiring hospitalization - to get the wheels rolling for the care that is actually needed.

What can you do?

* Depends on who has legal authority / decision making. One of the bottom lines may be "who has legal authority to make decisions for a person(s) when they do not have the cognitive abilities to care for themselves

and then

who is / will take this on this responsibility?

* Depends on if your relative is diagnosed with dementia - language from an MD indicating they are unable, cognitively, to care for themselves.

* They could be made a ward of the state - perhaps (check).

* If you / someone / family has legal authority, move them closer to that person.

Of course, they will not want to move - or change in most ways; they will dig their feet in the ground to maintain their position - due to fears of losing independence, and fears of the unknown, coupled with confusion due to cognitive brain changes.

* You might want to contact APS (Adult Protective Services) to make a home check and see what that reveals.

If I were you, I would check on the legal requirements of a hospital or rehab facility in allowing a person to leave their care if they do not have the care 'at home' or wherever they go upon leaving.

If they are legally allowed to return home wherein this behavior will likely repeat itself, there will come a time when they won't be able to return home. If no one is legally responsible for them / their welfare, then they will make their own decisions and suffer the consequences.

Gena / Touch Matters

You
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Someone has to refuse their next hospital discharge. If they fall and there is a fire, they won't be able to leave. An EMT had to convince my mom.
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The relative who has been living through these health event/crises/fall/hospitalisation has had choices. Sometimes not many.. but choices all the same.

Often the choices are things like;
- rehab vs home, or
- home alone vs home with help
(obtaining home services, meal deliveries, paid aides etc)

Change is hard.
Many people avoid it. Have denial.
Say "I'll manage" & "It will be fine".

Some have real reasons that prevent understanding change is required - they lack insight to their situation.

Is that suspected here? Does the relative have any brain injuries or brain changes effecting cognition?

My LO can say 'I don't need help' followed immediately by orders to 'I need xyz'. Had said 'I don't need an alarm for falls'. Yet frequently fell & couldn't get self up. Lack of insight the Doctor said.
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