Mom won't get help or go into assisted living. Is there anything we can do?

You haven’t said what you are actually doing for mother at the moment. One alternative to waiting for an emergency, is to stop providing support for a couple of days. No food, no visit, no clean-up for incontinence, no hot drinks - none of it will kill her. It will make her very uncomfortable and probably angry, but it may also very quickly make her understand just how much she relies on the support and how much work it is for others. Then you can with luck have a sensible conversation with her about the best way to proceed. 'If you want to stay at home, we need these changes....'.

For this to work, you need to get the rest of your helpful family members on side. Many elders believe that they are genuinely independent, and that is at the back of their refusal to accept help on anyone else’s terms. If it’s family, they just discount what it takes.

If you and your family understand that the alternative to this is to wait for falls and broken bones, you may all be able to work out how to play this. Ask the out-of-state sister if she has other suggestions, to undercut the criticism that so often comes. Good luck!

No doubt, you describe a very hard situation.

Since her decline was rapid, might be worth getting her to the doctor for an evaluation, some blood work, urinalysis. Could be something going on. My MIL is 95 also and she was living independently until about 6 months ago. Then a bad fall, then a broken ankle, and she didn't want to go back to her apartment. Now she wants to know what she's doing at this place (a nice nursing home). Her decline has been gradual and her doc at the nursing home has enacted my husband's POA for her due to her condition warranting it.

Anyhow, do you have to do a lot of things for your mom or is she really independent? If you are doing a lot, you can back off and bring in help for her whether she likes it or not. Someone to clean for her. Cook. Errands. Don't run yourself ragged.

Sorry that your sister won't help, but that is very common. One child is often the only one handling things. While it stinks, please accept it and don't be angry with her. It's her choice. You can make new choices too.

I imagine she has some dementia. If so, don't take her unkindness too personally. With dementia, they are really not in control of their behavior anymore.

I worry a bit about her being in a 2 story living situation. Can she live on one level? Seems much too dangerous for my liking.

When she has some kind of an event, that is often how loved ones like you are able to make some major changes. If she ends up in the hospital, for example, you can demand that she go to rehab afterwards to make sure she has the skills needed to live alone. Make sure they totally understand that she lives alone and that her discharge to living alone would be an unsafe discharge.

Good luck.

My relative falls frequently, eats badly but is able to cope alone only because the aides are let in to help. That took much time! Mostly for the reality to sink in - accept home help or move into AL. Each step equally painful. Accept MORE help or AL.. Accept bath aide or stay dirty.. Accept driving help or stay home. Accept grocery help or starve..

Your Mother may face a similar situation soon. UTIs, dehydration, falls do happen.

That's her best chance of understanding her reality & the best time to effect change.

Keep your message to all medical staff clear "I am concerned - she is home alone. She lacks insight to her needs".

Keep you message to Mother also clear "You need a little help. I will arrange it for you. It will help you stay home longer".

Then *more eyes* ie welfare calls & visits from you & others. Some Doctors will keep an eye too with refquent reviews.

No-one wants to get old or lose their independance. Some clutch on with an iron-like grip (to their demise). Some can be gently persuaded it's ok to let go a bit - to share meals with other elders, get a little help getting dressed, even have some fun at the sing-a-longs.

Best of luck!

Newheart15, are you her PoA? Is anyone her PoA?

Thank you so very much. Super helpful.

Newheart15, yes, I had that issue with my Mom [but not with my Dad, he was ready to pack and move to senior living]. Both were in their 90's.

Many on here on the forum had to wait for an accident/illness to happen. My Mom had several falls, the last one caused head trauma. Thus, 911, hospital, rehab, nursing home. She never came home.

We must remember, a person in their 90's remember family members who were elderly and being placed in county hospital [mainly asylums] back in the day. And they still view today's "homes" as being the same. I couldn't even get my Mom to tour a senior housing so she could see what it was like today. The chance to be around people from her era, and having medical staff on duty around the clock, if needed, even restaurant style dining in the main dining room included in the monthly rent.

you wait for a trip to the ER then tell them she lives alone and would be an unsafe discharge. Prior to that, you can't really force her to go to AL.

I think that you may be correct, that it may take an accident. You can consider reporting your Mom to APS, but the truth is that she would have to be found in a condition dangerous to herself and only then would she be transported to medical, whether against her will or not, where she would be diagnosed.
I would ask you to consider carefully whether or not you would THEN, after all that, want to apply for guardianship. If you do, then a Social Worker at the hospital could help you do so. But this would leave you responsible for all her affairs, for her placement against her will, for the disposal of her property and possible referral for medicaid funds, and that is a HUGE, a MASSIVE job, one that would be thankless and fought every step of the way. Were your Mom to fight diagnosis and guardianship in court she may well win, while disposing of any liquid assets she may have.
Not everything has a good answer. I was Trustee of Trust and POA for a very kind and cooperative brother who was so well organized, who ASKED me to take over his finances. Who never gave me a second of trouble. Who accepted his diagnosis of early probable Lewy's Dementia and wanted only to make things easier for himself and for me. And STILL it was a tremendous amount of work. There are legal ramifications for taking on guardianship and you must keep meticulous records.
Newheart, I am being as kind as I can to you when I suggest that there may not be a lot you can do for an uncooperative and failing senior. You can periodically check, enlist the cooperation of her nearby neighbors, attempt to call and check in daily, but I doubt that overall there is a lot you can do without COMPLETELY giving up your own life to it.
You might consider checking in with APS for a wellness check and advice. I surely do wish you good luck and I hope you will update us.

The most important info needed from you is whether you are her PoA, as this will change what advice and guidance is given to you.

Then, does she have a medical diagnosis of cognitive/memory impairment in her medical records? Has anyone taken her to have the test given by her primary care doctor?

If you are her PoA please read the document to see how the authority is activated. See if one or more medical diagnosis of incapacity is required.

One more thing to consider is that she may have a UTI, which would explain her "rapid" change in cognition. This would warrant a trip to the Urgent Care (or ER).