What principles guide you in determining the amount of support you need to provide to a declining mother (88)?

Liz, my MIL avoided having to take the road test by simply not reporting accidents. If she backed into something or sideswiped a parked car, she just drove away. All four corners of her vehicle were damaged, but she denied any incidents. We finally took the car away. Boy was she pixelated!!

Army Retired is right, Mass does not routinely test older drivers.
Lizdevine, if she had to take a road test, someone reported her or she had a history of infractions or accidents that triggered a retest. Here in NY if you have 3 reportables in 18 months, you get a road test, no matter what your age is.

I misspoke, I meant to say 12 yrs ago BEFORE my mother passed. Mass RMV site quote: THE RMV REEXAMINATION
A RMV reexamination is when a person's driving skills must be reevaluated based on one or more factors, including the driver's physical or mental condition, or driving record. A RMV reexamination may be recommended by a family member, physical or emergency medical technician, or peace officer. Other times, information in your license renewal application or on your driving record may prompt a reexamination. If you feel a driver is unsafe or incompetent, you may report the same to the RMV by filling out a Request for Medical Evaluation form. You can either fax this to (617) 351-9223 or mail to:
Massachusetts Registry of Motor Vehicles
Medical Affairs Branch
P.O. Box 55889
Boston, MA 02205

Not true about the road test in Massachusetts. My 82 year old mother was able to renew her drivers license and all was required was to pass a vision test. Massachusetts is a self reporting state when it comes to medical issues and driving.
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Gosh, scary. In Mass, the DMV requires elderly people to take a road test in order to keeep their drivers licenses. I remember how happy my mom was 12 years ago when she passed. She had never been in a fender bender tho. Judy, somebody could get hurt. I think you know what you have to do.

Absolutely start shopping around for an ALF with or without her. Probably best to do some of the preliminary sorting on your own to save her from the high pressure sales pitches and keep her from being overwhelmed by choices.
Until then, is is possible to hire some part-time help? Someone (NOT you) who can come in for a few hours in the middle of the day to clean, take out the dog, etc?
BTW, Many elders are resistant to moving, so some of the smarter ALFs will have a "try before you buy" apt that lets elders stay for a few weeks/month to see how they would feel about living there.
It is important to step in when appropriate -- I had relatives who almost respected their parents to death -- both parents were stubborn. Wife was pretty much blind, and husband almost bled to death internally & unaware of it (don't know who spotted the blood, but it was ICU & rehab, then no more living alone -- WAY overdue). 2 of the kids were docs, but lived out of town & parents showboated when the kids visited.

I agree about the driving. I would let my parents be furious with me, not speak, whatever, if I have to, to keep them off the road, if need be. Avoiding hurt feelings is not something that can be avoided when you have dangerous driving, a declining driver and no insight on their part as to the risks. I can deal with their anger and resentment, more than I could injuries and fatalities.

Wow--what if she hits a child next? Or causes a major accident? Mother was blissfully unaware of all the "little things" she'd dinged until her car keys were taken away. It was sad, but she made choices that made the decision to lose her license all on her own.
We always tell Mother "You CAN do what you want, but you cannot choose the outcome". This makes her mad, but it's true.
Please get your mom off the road---now! And I bet she would LOVE an ALF where all she has to do is get dressed and join in whatever activities she wants! I am afraid my mom is going to be too frail by the time we get her in an ALF to do anything but lie in bed and complain.
Most drs can help her to see the decision for assisted living to be a good one for her. My mother thinks Drs are right there next to God and whatever they say, goes.

Oh, I agree with those above about assisted living. I would try to get her doctor on board. It would take a lot of responsibility off of her and let her enjoy her time, rather than being overwhelmed.

When the decline reaches a certain level, the old notions of not interfering don't apply anymore. It's difficult, due to the way we were raised, but when their mind is not able to recognize the deficiencies and their judgment is no longer serving them well, the old ways of doing things may not work.

Being subtle, often doesn't work. Often being direct, firm and polite is the better approach, because just hinting and begging, won't cut it. I try to explain and show reason, behind my suggestions, but they don't have to like it. I know that I annoy my parents with certain things, but that's okay. I don't mind being the bad guy if its saves lives. I realize that keeping them safe as they age may become more difficult. They don't have dementia yet, but can still use some poor judgment.

I will remain respectful, but I will protect them. I have no guilt about that.

My principles are: If it's not hurting someone else, it's okay.
If it's hurting someone else, we have to prevent it from happening. "I'm sorry mom, the doctor says that your reflexes are fast enough right now to drive; we're going to get you some Occuptional Therapy and maybe in 6months they'll be better. meanwhile, I have the keys safe"

If it's hurting mom (brushing her teeth with hand lotion (for my mom, it was deodorant), then you have to make sure she's someplace safe where there is enough supervision, prevention, that she doesn't get hurt.

If your parent made you their POA, I suspect it's because she trusted you and that she knew that when the time came, you would respect and love her enough to protect her from herself.

Judy, has your Mom said she was overwhelmed by all the chores, or is that is what you are witnessing with your Mom? If Mom doesn't realize it is too much for her to do, then chances are your Mom could have the start of memory issues.

One thing I had to learn that back when my parents were first in their decline but had a clear mind, that any decisions they made they had to take full responsibility of whatever happened with those decisions. Such has deciding to stay in a house with a lot of stairs, so if they regularly would be tumbling down the stairs, that was the side effect of their decision as terrifying as it was.

And I had to learn not to keep enabling my parents to keep living there by dropping what I was doing to help them. Yes, I would run if it was a 911 situation, but I would dig in my heels whenever my Dad wanted me to haul over some mulch for the yard... "Dad, call Home Depot, they will delivery", but he didn't want to pay the delivery charges. Or if they wanted to go shopping... "maybe next week as I have a full week right now".

If it were as simple as all that, I expect JS wouldn't have felt the need to post.

So Judy what is it that you're wrestling with?

A recalcitrant elder?
Other family members telling you not to interfere?
Your own reservations about stepping in and getting too closely involved in your mother's life?

Principles? Respect? Are you kidding? How about fender benders, bad eyesight, overwhelmed.....
This lady needs help now and she needs to quit driving now. If you can intervene with some sort of principles and respect that's great, but intervene. She may not like it but she won't be dead in a wreck or kill someone else. Sorry to be so snarky but look at your post. It's alarming.

Does she live alone in her own home? It really sounds like she is a prime candidate for assisted living if she can afford it and can find one that will allow a pet. There they will help with many of the tasks that have become overwhelming. They also provide transportation to the stores and doctors. I recently had a 82-year old friend who moved into an assisted living facility. She had been living in her large, beautiful home for 65 years. The house had gotten to be too much for her. She is having a blast in her new community and enjoys having someone else cook for her and help a bit with the cleaning.

Common Sense. Now get her off the road.