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I live in AZ she has a house in NJ she wants to go back to that is unsafe,
she has mental and cognitive problems.
What can I do to help her?

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"She doesn’t want to be in an assisted living but needs help".

Doesn't WANT to be in assisted living. OK.

But is not sufficiently independent to live alone. OK.
So therefore NEEDS some form of assisted living.

Can she understand that wanting something & needing are different?

Some after repeated conversations will get it. Say well I don't WANT to... but I guess I will HAVE to..

Others are stubborn & will fight til the very end (often their own demise of misadventure).

Setting up a professional, eg Doctor, Councillor, Social Worker to go over the options with can really help.

What have you tried so far?
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Do you have POA? Does she have Dementia. You may just need to be very honest. Mom, you cannot live on your own. You need surgery and it will be awhile before you can get around. You cannot live on your own anymore.

I live in NJ. Taxes are outrageous. The cost of upkeep is expensive. She needs to understand that she just can't afford to live here anymore. If my DH passes before me, I will not stay in my home. It will be sold and I will move to a nice apartment.
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Welcome, Paula.

Are your mom's mental health issues being managed by a geriatric psychiatrist? That might be a good place to start getting her some help.

You most likely won't get her to agree to go to AL. What many here have done is get their elder to the hospital after a fall or illness. Once there, you talk to the social workers about the fact that she cannot return to your home because there isn't anyone to provide adequate care for her.

Have you tried hiring home health aides (with her funds, of course) to give you some time off?
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Paula, when your Mom says she "wants to go home" she is referring to her childhood home back in the days when she was a child and life was simple. That way of thinking is very common for someone who has dementia.

Your Mom probably would need a Memory Care facility as she wouldn't be accepted for Independent Living. If your Mom sells her house [she could sell it "as is"] and use the equity to pay for such a living arrangement. My Dad was paying around $7k per month for Memory Care and he was quite happy there.

If your Mom cannot budget for Memory Care, then she could apply for Medicaid [which is different than Medicare] and Medicaid would pay for her to live in a Nursing Home.

I couldn't get my own Mom to downsize and move into a senior facility. As many of us here on the forum, we had to wait for a medical emergency where 911 is called, and from the hospital Mom would be placed in a Nursing Home. The main problem would be that she would be placed in a facility that had an open bed, there would be no picking of what facility.

It might be better for your Mom to move into a facility in her area in New Jersey, where she is familiar with everything around her. Example, when she watches the TV news, street names will be familiar, along with the News Anchors. Any abrupt changes only makes the dementia worse. Just food for thought.
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NightHeron Dec 2021
"Your Mom probably would need a Memory Care facility as she wouldn't be accepted for Independent Living."

This is not always true. I know a high functioning senior with a fully documented, court documented case of dementia plus personality disorders. She moves around well on her own and can carry a conversation, and she had no trouble being accepted to 5 different assisted living facilities (not that she has lived in all 5. She was accepted in a few that were not chosen). We were told that most residents of assisted living have some level of dementia. They only move them to memory care when it progresses to the point of needing constant supervision.

If your senior is high functioning even despite dementia, and many are as dementia can take years to progress, don't believe that your only option is memory care. Definitely look for facilities that have memory care in addition to assisted living, but talk to the individual facilities. Some here say memory care is best, regardless, and I'm not arguing that. But know that this is not one size fits all.
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You are saying that the issue is mental illness. By cognitive problems do you mean dementia? Has she had any testing? Do you have POA, and more importantly, do you WANT it, because I cannot imagine that task from another state. You may need to have wellness checks done by APS in your area. There may come a point when state needs to assume guardianship if you don't want to assume it; I certainly cannot imagine trying to do it.
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There is no way, unless Mom has family in NJ, that you can care for Mom long distance. Where I live, I put my Mom in the best of the 3 NHs. It was nice, but not great. My Mom was taken good care of but...I was there every other day to check on her. They need someone to advocate for them. The facility needs to know someone is watching.
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