What to do first?

Tbw777, below you asked, "How do I get someone in to assess her mental state?" Here is what I did with my MIL: you are allowed to tell a "therapeutic fib" in order to help her. Tell her that Medicare (or Social Security) now requires an annual physical in order to continue to receive benefits. If she buys this, make the appointment for her and plan to go with her. Have a pre-written note with you, asking the doc to perform a cognitive exam and test for UTI. They will be happy to do this. If she has a UTI, they can give her antibiotics to clear it up, and her behavior may improve. Most likely the cognitive exam will indicate a level of decline. BUT even if you know this information, if your mom is still totally resistant to other forms of help and she has not assigned anyone as her PoA, then you are stuck unless you wish to pursue guardianship. So, this is a decision you need to make. Otherwise, as other commenters suggested, you will need to contact social services/APS and get her on their radar. I went through this with my resistant step-FIL. The county will eventually pursue guardianship which means they will call all her medical and financial shots. You will no longer be privy to any of her financial info. When she passes, they will cremate her and contact you to find out where you want her remains sent. Then they will ask if there was a Last Will, find the executor if there is a will, and it will move forward from there.

If the county takes guardianship, you will certainly be allowed to carry on your relationship with her, but the county decides what NH and makes medical decisions on her behalf, with which you may not agree or may be inconveniently located (FYI they will put her in a county facility). They may seek your input but they are not there to make the family happy. If your mom has a lot of financial assets, I'm not sure they are obligated to tell anyone how they are spending it and what might be left when she passes.

So, you need to decide your participation level in your mom's care. For some problems there are not perfect solutions. I wish you peace in your heart as you decide.

Your mom has been through a lot and it sounds like you have been too. The treatment she has had could be affecting her mentally. Perhaps she is depressed. Call your local Area Agency on Aging. There is one that covers every county. Ask for a social worker to come give her an assessment for you to determine the level of care she needs and what help is available. You may need a certified elder attorney to help you place her with the help of Medicaid if she is not going to be able to private pay. She has to be medically and financially qualified for LTC if medicaid is required.

Its not "abandonment". You have to earn a living to pay your bills. Who told you that? It sounds like your Mom needs a state social worker involved to find a solution for her. Call APS of local social services, have them do welfare checks and find possibly alternate living arrangements for her.

Tbw777, many on this forum have been (and currently are) in your shoes with resistant LOs. Some more info would be helpful: are you her legal durable PoA? Has she ever been given a cognitive exam by a doctor (in your presence)? If no the PoA, this is a must in order to more easily help her. If she won't assign you, this is a big problem which can be addressed when you clarify it for us.

If she has never had a cognitive exam, it means that she very well could have dementia, as the behavior that you describe is in line with it. Even if "she was always like that"...it would amplify these traits. Let us know if she's ever been tested.

FYI it is important that she assign the PoA FIRST before having a cognitive exam. This is because she legally cannot create a PoA if she is "incapacitated" with dementia. And someone could contest the PoA, if this is a possible issue.

At this point in her care, it is really no longer about what only she wants. You don't want to be her caregiver. She doesn't want to be alone. The perfect answer is LTC (because I think she is medically beyond AL), whether she likes it or not. But a lot hinges on your having PoA and her having (or not having) dementia. Please provide that info so that the forum participants can help you more fully.

Wow, you've got your hands full. AL has to be paid for with your mom's money. But given the description of her capabilities, I don't think AL is the answer since she is not ambulatory and the answer would have to be a skilled nursing home. Some nursing homes accept gov't funding to pay for patients that run out of money.

People want a lot of things but that does not mean they are always reasonable wishes in the hard cold reality of the real world of elder care. So, your mom does not want to be alone yet no one can/will stay with her. Except the paid care that she does not want. Very common but hiring care without her approval is the way to go since she is obviously not making good choices at this time.

She won't try to get better? Won't walk? You have to wonder what in the world she is thinking. You say no signs of dementia but given her age and this inability to make reasonable decisions, maybe there is something going on in that department? Worth looking into?