Spend it now or hold off in case we need it?

You'll need it !!!

We had those same questions when both my parents needed extra care. We met with an elder lawyer who had several ways of conserving their money. They are expensive but worth it.

I missed how old your mom is and what her health issues are, but I strongly recommend hiring (a responsible and vetted) caregiver if it is a financial possibility. We've been 27/7 with my MIL for 5 1/2 years now (she's 93). If we'd had an inkling of the toll this kind of situation would take on our bodies and souls, we would have arranged for respite much, much sooner. Actually, I lobbied for it YEARS ago, but it wasn't until I changed jobs for one out of the house (thank the maker) and my husband was primary caregiver for his mom, that he really got on board with getting help. Quite simply, we waited too long. Relationships with my own parents, our friends, and our children have suffered. The personalities and dynamics in your family may be quite different, but for us too much "togetherness" hasn't fostered affection.