To struggle to believe this person is being left routinely passing out and unconscious for hours?

Sorry if this has already been said, but what was their childhood like? You don't have to answer, especially if they are a sibling.

I'm thinking potentially personality disorder and self sabotaging due to low self worth along with on one level enjoying the attention and value they feel when looked after. Not believing, understanding or having faith that life could be better if they took the help on offer to improve their situation/worrying that if it worked everyone would disappear and they would be unloved.

I would prioritise mental health appointments, but not be surprised if traditional approaches fail. Maybe ask about DBT.

Whether they suffer anything they claim they do or not, it’s all a red herring. You can suffer from any or all of that, yet still need to be reasonable and make reasonable arrangements if requesting people do things for you, be it paid or unpaid. That’s the issue. If you believe you may be unconscious for a period of time (whether or not that’s valid), then you need to provide alternative forms of access for people who are doing things, pre-arranged at your request/agreement. If this is not facilitated then the person, illness or not, is being unreasonable and the consequence is that people don’t do things for them.

People certainly can be unconscious for a variety of reasons and for some people it does happen a number of times.

It would be unusual for the regular loss of consciousness to never result in an injury.

The thing is they might well have all these diagnoses. But, they have to have reasonable adjustments, not impossible ones. It's about them accepting practical solutions such as a key safe or a parcel box to accommodate and safeguard their life. So, if they collapse and need urgent medical help no one will know or be able to access them to check. The difference in urgent medical help being available to them when they need it may mean they're lying in a pool of blood dying a slow, painful death, at worst, or with a broken leg at best, for hours and days.

They have to be told and it's tough love based on risk assessment. Nothing less and nothing more. And you? You've got to draw boundaries and use some tough love on yourself. You've enabled them.

"There have been many crisis's. Letting them entirely fail means watching a frail disabled person free fall on to the streets, and go with whoever will take them home and look after them. You can imagine some of what happens next, and then when something awful enough happens, someone intervenes and the cycle starts over with them even more damaged, but not learning. This is the closest to 'magically getting it together' they have ever managed, sliding down further each time.
I have raised if they should be in assisted living, but they don't Yet qualify.
There are positive sides to them as well, but they're rarely seen these days.
What they are on the brink of, could be a basis for a new future if they can get over the line."

Perhaps then they will be forced into a facility though. Is there a version of adult protective services where you are?

You aren't qualified to deal with this to be able to help this person to a satisfactory outcome. Sounds as if they have mental health issues. I can't see what else you could do if they are not in a position to work with you. Don't let this drag you down, too.

No. It confirmed a diagnosis of FND. You brought up fibromyalgia, not me. You were suggesting that if FND is difficult to diagnose and treat it was similar to fibromyalgia, when in fact it’s nothing like it. It’s often misdiagnosed and was in my friends’ case until she was admitted to hospital after a seizure and referred to a neurologist who did the necessary tests.

My MIL was like this, she has a heart condition and has 'episodes' that result in her being taken to hospital. She refused to have a key safe and so wouldn't ring and ambulance but phone my DH to get him to race 15 mins up the road and phone an ambulance on the way. I'm sure she just liked being an inconvenience to her kids and having them at her beck and call. Refused to have grab rails after a hip replacement, didn't want carers and when they did come it wasn't early enough so one of her kids had to go round even hough they both work. Would phone up to complain about pain and then say she didn't want the kids to go up there... obviously she did, otherwise why call them. In my opinion it's attention seeking and control

I would not continue to help unless they did their part. There are professionals that can help them. I would give them my perimeters in which I'm willing to assist and if they don't like it then they can call someone else.
Perhaps whatever your version of social, services is....Call them and let them know.
What would they do if they didn't know you?
I have experienced this with a friend, and I had to do that. They were mad at me for a good while but we are still friends many years later when they realized I helped them by not enabling them anymore. People will magically get it together when they have no other choice.

And Sometimes it will take a crisis and letting them fail. Sadly. I know it's hard though, really I do. All you can really do is let them know what you can and will do and under what terms.

Both things can be true at once.
They may genuinely struggle as they say, AND they are an unreasonable diva who is very difficult to help.
I have dealt with a person or two like that; they had genuine problems but ended up alienating most people by being awkward and fussy for no good reason.
I imagine there is some psychology behind that behaviour, but that's not for me to diagnose!

Agree..with FullLondonEye also you could call the Duty Worker in Adult Social Care and explain your concerns then ask for a welfare visit. They will check their file but may not be able to tell you anything as you are not NOK or have POA. You don't need to have family's consent to make a call to them and could remain anonymous. Then step away a bit for your own sake. Just a thought have they got a carbon monoxide alarm in their home in case gas is leaking and knocking them out?

I think that it would have been helpful if you had included this in your original post

When I've been really hard hearted and read the riot act, that putting aside that this is the 'reason' they still have to let me make vital stuff happen around it, they end up so distraught and exhausted that I've eventually had to stop, as they are so emotionally distraught it becomes hysteria (but pulse is genuinely surprisingly low) and have cried to the point they can no longer make sense. This is definitely real and results in days of exhaustion and sleeping.

Others have also done this. Both short, sharp no emotion and and walk away, and long drawn out 'you have to make it possible' no one can help if you don't.

It does sound as if the disbelief and questioning you brought here is something they may have picked up on and is very upsetting to them. They may be very sensitive and picked it up from your behaviour. Trust may be a big issue in their life.

The use of the word hysteria is very revealing in your post. If they read this how would they feel? Having days of sleeping and exhaustion after you have "read the riot act" to them sounds like you are inadvertently triggering something very deep and hurtful.

There's obviously more to this. It could be a form of post traumatic stress caused by the lack of medical care and being disbelieved.

It sounds as if the priority for this person is to be able to talk about the passing out and for you to listen to them and believe them before you get on to the practical stuff.

You know from previous posts that yes, medical problems can be missed and that the medical system can let people down. There may be no simple solution and sometimes just being a listener is what is needed. Show them you believe them.

Then you can move onto the practical things like the shed with the trust that you will hear them and understand and listen and in their own timeframe.

I haven’t read the full thread but I fully agree with some previous posts - there are 2 issues here. It is sadly very possible that they are that unwell and being left with no help. But not accepting simple accommodations such as giving up a shed key seems unreasonable. It does depend on the reasons though, and there may be something more behind that ‘no’ - a previous incident that’s scared them?

"Confirmed" what diagnosis? An mri and ct scan confirmed a fibro diagnosis? 🤔

I think all you can do is give ultimatums. As in 'if you don't give me the key to the shed then I can't ensure your package is delivered', and then you have to stick to it, regardless of their apparent distress. While it may not be all their fault a certain amount of personal responsibility is required where possible, but while others enable this person to get out of helping herself then she won't. I know it's not that easy - I have a situation where I've declared I'm going to stop enabling someone close to me, and that they'll have to sink until they're forced to swim. Ultimately I do still help them though, on the basis that the lower they fall, the more work it'll be for me when I inevitably have to pick up the pieces! 😥

Everyone reaches their point of critical mass though. You have to work out where yours is and not pass it. I think the fact that this person has admitted they are partly at fault during the tougher conversations means you know it's not all on the health services. You know they themselves are a significant part of the problem, no matter how much help and support you do or don't get. You can't let them drag you down with you so you're just going to have to hold the line more firmly when it's something you know they can and should do.

Honestly it's impossible to know what's going on here because any of the things you fear could be true - she could be falling through the cracks in care or she could equally be a complete piss-taker who wants the world to revolve around her.

I work in a medical capacity and have seen cases where a patient has had serious diagnoses missed and been horrified - but on getting to know them better I can completely understand how this has happened because they are so incredibly difficult to work with and the doctors just can't get straight answers to any questions.

Equally a relative by marriage was disabled due to an accident and got an awful lot of support and sympathy for that but genuinely didn't deserve it. This was someone objectively awful who not only made zero effort to help himself but actually actively made his own situation worse and lied endlessly to anyone around him - and yet because 'oh poor Dickhead is in a wheelchair', no-one was allowed to question any of it.

Of course you also have the fact that two opposing concepts can be true at the same time and there's a chance what's going on with your relative is a mixture of all the things you fear. Are you not able to have an honest conversation with this person where you point out that 'because unconscious' isn't the answer to every question and that actually there are things they can do to help themself? Have you pointed out that you and others have finite capacity for practical help and indeed for compassion when that person seems set on self-sabotage?

It is about capacity as was said
Have tgey had a mental capacity asessment?

if she’s deemed to have mental capacity, she can’t be forced to do anything against her will.

In any case op. Report your concerns to their gp.
Set your boundaries. Do not take on more than you can manage. If they wont put a shed key in a locksafe then stop deliveries.

Then the answers will not be very useful without knowing the nature of the obligation. If it’s a neighbour, friend, husband or brother the answer will vary.

If she’s had carers in the past that does mean that a care assessment has been carried out at some point, unless she has the means to employ private care. But the rest is really odd because if care services were involved then all of the things you’ve mentioned here are safeguarding issues and should/would have been reported. Care doesn’t just stop without recourse to the authorities providing it.

It sounds very difficult, but maybe the best thing you can do is report the situation to social services as a safeguarding issue and let them investigate. Problem is, if she has capacity and refuses to engage with support services nobody can force her, even it’s to her own detriment. In my experience these cases usually end up the same way - with hospitalisation after a fall or accident, which results in a major rethink on support.

A social worker would be the one to carry out a care assessment l agree, but the outcome of that wouldn’t be to ‘allocate’ a social worker, it would be to arrange a care package. OP hasn’t confirmed that. But l agree, if this lady has capacity then she can’t be forced to engage with support services and the whole thing becomes much more difficult. If there hasn’t been a care assessment so far, OP could make a request herself if she feels there’s a safeguarding issue. Either that, or if she knows the persons’ GP she could maybe alert them to what’s going on. At some point l think OP is going to have to step away as the person seems too difficult.