Mom recently hit an office mgr in the doctor's office but changes her story and says she only 'pushed' her. Any advice on her mental health?

She is very angry about changes in health care because of ACA. She's depressed, cries a lot, is losing her vision, control of bladder, is very fearful (thinks someone is going to come to her home and shoot her),etc. She will not see a counselor. She makes life very hard for my step-dad and half-brother who live with her in their own home - they often leave her alone because she is so cantankerous. I am concerned about her mental health and safety.