What can be done with an elder that has no idea that anything is wrong with them, although it is clear there is something wrong going on with their health? The next doctor visit isn't for another 5 months, and there is absolutely no family or friends around to help. There is no actual immediate harm to them or others, and except for possible self neglect they are taking care of most of their own ADLs. There is no discussing this, as attempting to do so usually ends with verbal abuse.
If you are local and can take them - could try some tips or tricks, "therapeutic fibs" if you are willing to take this strategy. Say that you are taking them to lunch (and you really can go to lunch after the doctors appointment). Schedule the doctor's appointment and just drive them there. There may be some yelling and verbal abuse when they realize its a doctors office. Then, treat them like a little kid and you could say "well you just have to see the doctor. If you go ahead and see the doctor, then don't forget, I'm taking you to your favorite place for lunch afterwards!". SOme may say harsh, but it can work.
If you are able to check in with some frequency then you will know if there needs to be medical care. After transport to medical would be a good time to discuss full diagnosistic workup with doctor and with social workers, and to work on placement from the hospital if necessary.
Placement will likely be the beginning of the end and will moreover be difficult to find in one who is acting out in anger, may mean medications, falls and etc.
We all go. More and more I am for someone being able to control their own world as long as possible. It's difficult to know how much you can participate here in monitoring, so in the end this must be your decision if the elder is unable to act rationally for him/herself.
You say it is time for another eval in 5 months. I would wait that long were it me. Can you tell me what the LAST eval came up with in terms of advice from the MD? If you are MPOA you may want to make a simple phone call now with this question.
Let the doctor know ahead of time what you are seeing .
If that doesn’t work , unfortunately the only thing is to let them fail and end up in the ER and then ask to speak to a social worker if you think they are unsafe at home.
If a trip to the ER does not happen , and things get worse , you could always call the County Area of Aging or APS to come out and evaluate . If one doesn’t get them placed , try the other.
If you are aware of family you can contact family and express your concerns.
If there is "self neglect" occurring you can contact APS or your State's Elder Abuse Hotline number and report the situation.
But here is the big thing.
If you are not related,
If you are not POA
There is not really much you can do.
If you are a friend, continue to be one so that if they do need help, if they do ask for help you will be there to support them.
They may or may not recognise illness in themselves.
If they do feel or see illness they may or may not want to treat it. May not want to take medication, undergo invasive or burdonsome treatments. Nor travel into a bigger town.
Would having a different conversation help?
Rather than I have concerns, I think you should see a Doctor.. what about;
Are you OK? Is there anything you need help with? Anything troubling you? If there is..
What do you want to do about that?
Be a trusted ear. A shoulder.
I often accuse my DH of being 'The Tradie' - stomping in, ready to get on the tools to FIX. Heck, I've done it too - ready to jump in boots first to fix before asking. Please don't take offence if I got this wrong. Anyway, wanting to fix showes you CARE.
Also some people just want to live and die the way they want to, and I think people try to take there rights away because we know better. And yes we do actually no what's best In many situations, but when or if I make it to 80+ yrs I don't want my rights to live the way I want to live to live taken from me. By family or doctors and be kept alive with machine just because the people around me think it's best for me. So I try to give my loved ones that respect, with certain limitations
But it is very hard to stand by and watch someone you care about, health failing and you can't get through to them
Is the elder unsafe or in immediate danger? Is this a relative or an acquaintance? It sounds like the person is functioning adequately in taking care of themselves but that you are suspecting there is a bigger health issue going on. Is it an issue that the person would want to address or might he or she want to leave well enough alone and not seek treatemtn?