My sister is divorced, kids in 30s aren't able/willing to help. Good logistics yet and remembers people but can't manage $, housework, organizing, cooking, even coffee pot. Uses cream rinse instead of shampoo, extreme hoarding and is very insulted if any deficiencies are addressed. She has dementia diagnosis and homecare coming in to give pills every a.m. but I think she needs so much more.

She probably does need more help. Medication management is just the tip of the iceberg. If she won't accept additional help now, many will not. It often is an emergency situation that triggers the necessity of having a thorough evaluation. The Area Agency on Aging will do the assessment, if they can get her to let them in the house.

You could try a call to Adult Protective Services to do a check on her. The person help with her meds may have a similar opinion. Have you chatted with the med manager?
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