Here's a story:
I lived in a house over in the Waldo area for quite a few years. There was an older woman living by herself in the house across the street. She was a very smart lady, and had all of her senses about her. But she could barely get around at all. She had a walker she used, but even then she wasn't the least bit mobile. I enjoyed chatting with her, cause she was a very rambunctious lady who cursed like a drunk sailor on occasion. And she had a fascinating outlook on life. I would shovel her driveway when it snowed, and helped her carry groceries in and such. She had kids, but they were complete shitheads who cared nothing for her and lived across the country. They tried a few times to get her into an assisted facility, but she outright refused. Her kids didn't care enough to push the matter. I ended up moving, as did the other nearby neighbor that had often helped out the lady as well. I found out later that Jan ended up dying in her home shortly after. It happened in February during very cold weather. Nobody checked up on her until 2 months or so after she'd died. By then, it was spring, but her heater had been set to 80° for months. Her cats ran out of food, and started feasting on her decomposing body. The coroner had to enter the house in a hazmat suit.
Sometimes the hard decision of requiring assisted living for someone who needs it must come from an outside party, or it might not otherwise come at all.