My 81 year old mother who lives independently and has COPD agrees she needs help with housework, but has not taken the initiative to do so. She does not want strangers in her home, yet she has talked about a neighbor who would be willing to help for a reasonable fee. She is financially stable and can well afford the cost. I cannot force her, she is competent to make her own decisions. Why is she procrastinating when she knows she needs the help?

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Maybe your mom is afraid of the unknown, like having somebody new come into her house to do what she's always done. Then what if she doesn't like them or their work. I'm just guessing here. If she doesn't make a decision soon I guess you'll have to guide her, just short of doing it for her. Even if she's independent she may appreciate your input. At 81 my independent mother stalled and balked at making decisions. My now 83 yr old aunt on the other hand is a ball of fire who can still handle all that comes her way. So knows what drives elders?
My mom had a maid. Credit cards, SS card came up missing. She fired her. I was stunned, didn't think the maid capable of it. Several months later mom found the stuff buried in her sock drawer where she herself put it. Poor maid. In the meantime mom said she could no longer afford a maid and being on oxygen, wasn't able to clean. My son and I agreed to clean because mom strongly hinted it was our duty. Then we found out the money she couldn't afford for a maid was being used on lunches and gifts for the part-time paid caregiver/new bestie/the "new" daughter who took my place. My mom is the only person on the planet who could justify in her mind that it was ok to take advantage of her family's kindness. I know your mom wouldn't do anything like this, like I said only my mom could think it was ok. I can laugh about it now but it wasn't funny at the time.
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Debralee, I've been through this now with both of my parents, together and now separately. First of all, you mother may not want to emotionally accept that she needs help. It's 'in her head' but not yet 'in her heart' as acceptance. To 'need help' means to the elderly that they are 'going downhill' and that means they will 'lose control' and/or that they are moving towards end of life too. Also, sometimes, at least true with my 'depression era' parents, they do not want to spend any extra money. My mother will accept...and abusive try to get....any kind of help from anyone if it is 'free' to her, and even though there is plenty of money in their trust to cover most of what they will need the rest of their lives!

Some ideas to help her 'decide'....try to communicate with her physician that handles her COPD and have the doctor 'write an order' on prescription pad and give it to her, while discussing how not taking care of her breathing, via rest and conserving her energy will make her breathing worsen over time. And then stress how, if she doesn't accept help in the home, she will get worse and the day will come that she is unable to stay in her home. So if her goal is to keep as much independence as possible and stay in her home as long as possible, she needs to create a plan and accept help now, before it is 'too late' for that choice to be. Ask if you can sit with her and come up with several places she can call and set up interviews...and start the process for her with a list....but be sure she helps create the list and sanctions the particular choices of whom to call. That way, all will be started except for HER making the calls. Maybe get her to agree, with like a week's leeway, when she will make the calls, and then another deadline, as to when she will interview the agencies and work up to when she will make a final decision. Sometimes, it is 'baby steps' to get the process started. But I believe SHE should make as many of the decisions as she can, WITH the final choice is HERS. That way, she won't 'blame you or anyone else' for 'doing this to her'!
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