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My friend needs help. He needs assisted living, something before he gets worse.  No one will be around and I'm concerned. He has family and a few friends, I hate to say it, but his own family won't come see him. It's bad.

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Bella90, I read your profile. My sympathy to you for the passing of your husband and your brother.

Your friend, who are caring for, refuses to get medical help plus will not clean himself up and that is his choice since he has no memory issues.

He will keep being stubborn until there is a medical emergency and 911 needs to come out. Once at the hospital, and when he is discharged you can refuse to pick him up, tell the hospital he is on his own. They will help him figure out what is the best thing for him to do.
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Are you being paid, if not I would walk away. Call APS and tell them there is a vulnerable adult that needs more help than you can give. They will investigate. Either offer him some resources or take over his care and place him.

There is a reason he has no one. He probably needs you more than you need him. I would put him in his place. You want me to help you then treat me with respect. Call his bluff.
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Your options are:

- call APS and report him as a vulnerable adult. Step away from providing care 100% if you aren't getting paid on a weekly basis for all your hours.

- call the nearest member of his family to inform them that APS is about to step in because you are no longer willing too provide care for a 400lb man and at that point he will most likely become a ward of the county. This may or may not incentivize them to help him, but at least you gave it a try.

- if you think he doesn't have cognitive impairment (and stubbornness is often the very first symptoms of dementia) then leave him the phone number of social services for his county or his local area's Agency on Aging so he can talk to them and find his own solution, if he wants one. Then resign if this is what you wish.
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