How do you move 90 yr old homebound mom to assisted living? She has no intention of ever leaving her home.

I think ALF will not work for her without assets to pay. Most will not accept medicaid (tho some apparently do, and this a good thing to check out).
Currently you are enabling a Mom you describe as currently quite "with it". Meaning capable of understanding. I think the fact you ALL now recognize that your Mom needs 24/7 care means you should get together and speak about withdrawing what support is not absolutely crucial, and about ALL OF YOU going together to tell your Mom the facts.
If she will not agree then nature will take its course. We have a member named Elaine I hope will speak with you if she sees your post. Her own mother refused care over and over and over and eventually did end up having an incident, and dying in her own home. It can and it does happen. And it may happen in your Mom's case. I think otherwise, given your Mom is basically with it, you cannot force the issue. The time will come when something else will break and the issue will then be forced.
I sure wish you all luck with this. It is impossibly difficult to know how not to enable a senior you recognize does need more care, but who refuses said care.

It's a dilemma if no one is her PoA, thus can make a beneficial decision on her behalf. If no one has PoA, and no one in the family pursues guardianship, then you will need to report her to APS as a vulnerable adult to get her on their radar. They will eventually gain guardianship and make all her medical, financial and care decisions for her, if they find she is incapacitated.

If there is a "next time" she falls at home and is then taken to the ER, this is the opportunity to intercede and make sure she is not returned home. This would be an "unsafe discharge". No one in the family should go to retrieve her to take her back to her house. Sometimes the hospitals will work very hard at guilting family to come get her and even take her into their own home. Never do this. At the hospital arrangements might be able to be made for her in LTC. Your mom's reticence might be a sign of her cognitive impairment, as judgment often erodes first, along with short-term memory. It is like standing by and watching a train wreck in slow motion. I wish you success in getting her somewhere she will be safe and your family can breath a sigh of relief.

I predict that unless something drastic is done, that one by one your 5 sibs will back out of helping, and the "last sib standing" will be the one to take on fulltime care for your mother.

Do you think this is a possibility?

ALL the sibs need to tell the mother that they won't be providing care for her anymore, and then back out of the picture.

Do you think this could happen?

Lizrose, this is going to sound harsh, but ask your Mom which one of her children is she willing to sacrifice so that she can remain in her house? Tell her close to 40% of caregivers will die leaving behind the love one they were caring, and this is due to pure exhausting of caregiving. She could lose two children or more.

Very elderly parents still view us as still being in our 20's or 30's with a lot of energy, not realizing that their grown children are senior citizens themselves or close to being seniors. Even showing my parents my Medicare card and AARP membership didn't phase them.

Regarding assisted living.... your Mom is at the age where she probably remember that aged friends and loved ones went to the county home for care, most of these places were asylums at the time. Your Mom may have no idea that today's assisting living facilities are more like hotels. My Dad loved his senior facility because he was around people of his own generation. He never felt alone.

Lizrose, kudos to you and your siblings for taking care of your mom.  I think the answer to your Q. 1) is that you can't convince your mom who doesn't want to lose control that she should give up all control. Instead, given that she still has reasonable mental faculties, the best you can do is to let her discover that her current living arrangement is not as safe and comfortable for her (or you and your siblings) as an assisted living facility would be. You and your siblings can, gently as you can, offer to take her on tours of facilities and help her figure out all the complex details of how such a move could happen. I know first hand several times over that this answer is easier said than done, so good luck in getting that done.

The answer to your Q. 2), I think, is that the move would be better now, while she has her mental faculties, but obviously that will be up to her. If she's able to give someone her POA, then she can also take it away and you also won't be able to gain guardianship.

After my mom died and I could see that my dad living on his own wasn't going to last for too many years, even with several of us helping him, I began researching and taking him to assisted living facilities just to "look around," as I told him. I didn't pressure him at all to make any decisions and he seemed to enjoy the outings and once in awhile would actually make a comment about something he liked or didn't like. As it turned out, my wife and I first moved him into our home for a few years before I became completely exhausted and had to move him into a memory care facility.

This is a hard time for your mom, you and your siblings. As my wife's aunt used to say "Old age isn't for sissies." Like many or most of us, she was adamant about staying in her home, but my wife also had to eventually move her to a memory care facility. Best wishes for you and your mom.

You and your siblings were told that she cannot be left alone. Was SHE explicitly told by a doctor who knows her that she cannot remain in her home by herself, and that her children CANNOT take responsibility for staying with her? Do you have confidence that her doctor will be willing to be THE BAD GUY to tell her that family care is at an end and she CANNOT stay alone?

In a similar situation, my LO did rethink her situation, and after a fairly rocky start ultimately entered a very good Memory Care.

In her situation the assumption that she was cognitively intact was not the case and your description seems to suggest that your mother may be the same.

Bottom line, your ultimate goal MUST start with SAFETY. Will she accept challenges to her perception of herself if they are offered by people outside the family?

Would your sibling group attempt an intervention? Has she tantrumed through life to get her way?

You've been lucky that the entire family pulled together through this last year to keep your mom safe but these next few months are going to be even harder. This is where the "tough love" portion kicks in. Probably a family meeting, without mom, is needed to layout a plan of action including:

1. Review her paperwork or establish paperwork for Power of Attorney, Medical Power of Attorney (they aren't the same and don't need to be the same person). Also review her finances.
2. Start looking at Assisted Living facilities without her and determine what she can afford and if they will accept Medicaid once she qualifies (Medicare doesn't pay for assisted living).
3. Establish your boundaries - no overnights, one check-in or visit per day, someone will grocery shop for her but no meal prep, This is HARD but she has to understand that this is how living independently works, she has to be independent or she has to go to assisted living. EVERYONE in the family has to buy into this.
4. Wait for the disaster - another fall or hospital trip which will probably end with her needing a nursing home - or if you're lucky she'll soon realize that moving to assisted living is necessary.

Most of us have gone through this process. It's not easy and our mom/dad/love one is angry and spiteful, but just like with a toddler or a teenager they have to learn the natural consequences of their decisions. You say your mom is mentally sharp so she can see the results of her stubbornness and decide how she wants to live. I had to do this with my father. I cut off all help except grocery shopping and trips to the doctor. After years of asking him to move to assisted living he finally relented when he realized that I was out of town and he needed someone to apply an ointment to his itchy, itchy back and there was no one to do it. Not a life-threatening situation (it was an allergic reaction), but it was scary for him to realize that he was actually all alone with no help. He begrudgingly agreed to assisted living at age 97. Both of our lives are much better and he now says he should have moved earlier when he was more able to make friends and participate in activities.

Mom has 2 (actually 3) options.
1. Mom accepts that the family can not continue as is and a caregiver is necessary. And mom pays for the caregiver.
2. Mom goes into Assisted Living if she will not accept a caregiver.
And mom pays for AL.

the third option and one that no one would want is you all cut back the amount of time you are caring for mom and she WILL fall again then she would have no option but to enter rehab again and THEN you say that she is not safe at home.
The problem with this is her next fall may be fatal. She may not do well with rehab and maybe wheelchair bound after then next fall.

If she has not been declared incompetent you can not "make" her do what she does not want to do.
You can present options.
she can refuse options presented.,
If she has been diagnosed with dementia you can place her in Memory Care. AL is not a great place for persons with dementia. Does someone have POA?
If she has been diagnosed with dementia and no one has POA someone will have to become her Guardian.

Right now we are exactly where you are -except maybe one step worse because BIL and SIL live with FIL. He is cognitively perfectly able to make his own choices. Physically he is a mess, nearly completely immobile. The VA sends a bath aide 3 times a week and literally his only mobility at this point is when he gets out of the bed and uses the walker to go to the bathroom and recently he has made rumblings about a bedside toilet - which is a huge fall risk for reasons that would take forever to explain so we are right on the precipice. But his 'reason' is always that BIL and SIL live there - so there is no reason whatsoever to explore any other care solution. So they are looking at options to move out. He is over 300 pounds...once he is unable to get himself out of the bed on his own -and we are just literally almost there - we are beyond their ability to provide his care - they both have physical limitations themselves - and his falls require a call to the fire department and usually 2 crews/ambulances or at least 4-6 people to get him safely up....so not something they can do alone. So his only option is going to be a skilled nursing facility.

Deep down he knows it. He is fighting it. And he will fight it until he has no other option. So our only choice is to remove the other options. And that may be your only choice. By providing all of the round the clock extra help, that provides her with her 'independence'. In her mind, she is able to maintain her 'independence.' My FIL still thinks he is 'independent' too. When BIL and SIL moved in with him, SIL and I sat down and completed a ADL checklist. He was still in pretty good shape. He could still do pretty much everything on the list. Now, the only thing and I do mean the only thing left on the list that he can do for himself is get up with the walker and go to the bathroom. And even that is assisted with the walker and diapers. He has lost every single one except that. It is very hard for them, rightly so, to deal with the loss of their independence. But it is even more difficult when they are being propped up and not really seeing that they have lost it.

At the end of the day though, at some point the other shoe will drop at some point and then the decisions will have to be made.

Call Elder Services and report an Elder at Risk. A social worker will investigate while maintaining confidentiality as to who made the report. Enlist her physician in this as well.

OMG.....so identical to our situation with our 90 year old mom. She's been living alone since dad died 4 years ago....has had various home care assistance, plus few family helping out. But now, she insists on staying in her home, even though she can hardly walk, use her hands, bathe on her own, basically can't do anything on her own. She refuses to wear Depends, nor wear her alert necklace. The EMTs were there last week, and she needed to go to the hospital, but they said they weren't allowed to take her since she insisted on not going. My sister is trying to get paperwork, doctor, social services to get her into a nursing home, and it's going to be a struggle. Of course Medicaid will have to cover the expense, but the real struggle is mom giving everyone so much trouble, we fear that she will get kicked out of the nursing home, that's how vindictive she can be. Anyway, try to get a social service worker into the home and she will have the authority to rule your mom incompetent of living alone. That's what we're working on now. My two sisters and I are both unhealthy ourselves to take care of her, plus living one hour away. Mom's part time caregiver is also using a walker, so we can't count on her help much longer. In home care is almost impossible these days!! Can't trust hardly anyone in your home, plus many are inexperienced.
Best of luck.....sometimes ya gotta hurt'em to help'em. Sad.

I've read and re-read - why can't mother be left alone?

She has a falls alert which (glory be!) she is now wearing reliably. She can't walk without a walker, but I take it she has then been supplied with a walker? - so she can walk. She remains a falls risk, no doubt, but she won't be any less at risk of falling for another person's being in the house.

So..? Why the 24 hour supervision?

Oh you could be telling my story exactly. Only difference is that I am the only one that helps our parents. I travel 45 min to reach my 90 year old parents with dementia. My mom says NO to EVERYTHING!!!
Yes, I'm exhausted. Frustrated a lot. But I learned, also based on articles I've read, that you cannot reason with, argue or convince someone with dementia to do something they don't want to do. My mom now doesn't want to get up and walk to the bathroom or take a shower. I am beyond burnt out and feel like I have anxiety going anywhere with covid still out there and as much as I have tried and tried, I still can't get an appointment for a vaccine shot!
I don't know that I am helping you at all as I spout off my own problems but if nothing else, I feel less alone knowing that I'm not the only one dealing with a hard to deal with mom that refuses any outside care...ever. Unfortunately it's going to take an accident or some other bad situation for them to realize that they can't go on without more help!!!
My heart and prayers are with you and your family!! I KNOW exactly what you are going through!!!!

Move her when she has her faculties, that way she can get used to everything get involved in the activities and make friends. And be settled.
I saw Mum was getting dementia but OB didn’t acknowledge it so Mum was moved to IL. It didn’t last long and staff noticed she wasn’t taking her pills, I noticed food buildup, she wasn’t eating properly even though I took her grocery shopping, she couldn’t figure out the laundry machine even with written instructions so she was moved to AL and a month later to memory care , each move taking more out of her. I believe if Mum had gone straight to AL she would most likely still be there.

I would ask yourself what is your end goal here . What is it that your truly trying to accomplish and what does she truly need . We are in almost identical situations except with my father . He is 94. He developed mild memory problems a d vision loss 1 year prior . He started to suddenly hallucinate and wandered 1 year ago , my parents had been living in isolation due to Covid . This went on for a few weeks , he got mean suddenly ( dementia ) and wouldn’t take care from us when we tried to go back in . He became very bossy including to my mom and was impossible . He wandered 3 times in 10 days and ended up in hospital 1 years ago and is still there . There is almost nothing is left of him . He didn’t accept care well because he wanted to be in his home . They medicated him severely as a result and he became a fall risk from the meds . He wasn’t allowed to walk on his own even with a walker because fall risks can’t do that in hospital . He would try to get out the wheel chair to walk and they said he couldn’t so they locked him to the chair which caused severe agitation. He has wasted away and lost 40 pounds as a result of muscle mass loss because they simply didn’t have the staff to walk him . He has caught mrsa 2 times while there . This time he has cellulitis with it snd we may be in trouble . He is usually unaccepting of care from the nurses because they often don’t que him and tell him what they are going to do ( vision loss) so he swatts . Then they don’t want to approach him cause he swatts . They insist he uses a diaper despite being able to use the washroom . We have had meeting over it . But now because he can’t walk a d is unpredictable they need 3 people
to tolite him ( he was completely independent when going to them) it’s too much staffing and they don’t want to do it. He is to use his diaper . He doesn’t want to and holds his bm’s for days . Of your mom has a history of Uti’s this diaper system is part of it due to staffing and be prepared for that . The “ system” has been gasoline on a fire on my dads aging and dementia. .A doctor there tolD me a seniors ability to survive In this system is dependant on their ability to accept care from it and for them to get access to what they need . Seniors not accepting leaving of their home can be a nail in the coffin . I wish we would have found a way to get him home . Now we are probably looking at his end soon . In Our experience for our loved one the system has less to offer on convincing people to accept care , you either take it or leave it . If your loved one can’t get in line with agenda in the system they fail . He didn’t have dementia prior to 1 year ago and was in good health a d now has cellulitis, mrsa , can’t even stand ( 1 year ago went in wandering 2 km uninjured and is in big trouble .
. if I could do it again I Maybe would try rewording the care and see if the person is more accepting . Tell her you have arranged for an at home Spa treatments as a treat ( bathing ) . Ask the person doing the care to turn on some relaxing music , turn on some electric candles, deep condition her hair , do it up snd have fun with it . Maybe do your nails at the end together . Have a nice spa lunch at the end ( make a special meal)
If it’s cooking tell her you want to try out a new recipe and would like her input. Allow her to feel like she has a purpose again and her input matters . I know this may seem like a lot of work but if we could take back putting my dad into the system we would . Now he has deteriorated so far in such a short time it may be too late . Please be careful what path you take with someone who doesn’t truly want to leave their home . Ask specific questions about what’s truly available during Covid . for example If she has to go to the bathroom every 2 hours do they really have the help to do that . Just remember she will only do as well as she will accept and if she feels forced from home it may not aid your situation .

Of course it's always better for the person to stay in their own home where they will be the happiest and feel the safest instead if some strange place with strange people that are not always nice, sharing a room with a stranger and having people tell you when and what to do. I completely understand her not wanting to go.

I too would rather take my chances in my own home even if that meant home alone.

Remember that Senior Homes, you have just as much chance to fall and they are always understaffed.

You should let your mom stay home like she wants.

She has just as much chance falling in a Senior Home.

Just do minimum for her and not do everything for her.

She doesn't need a bath or shower every day, once or twice a week is sufficient. She can even do sponge baths.

Install hand holds in her shower and a shower bench.

Make sure she has a walker with a Seat so She can sit on her walker or use it to carry something.

Have little meals pre made to last a week or easier yet, buy little microwaveable meals like Lein Cusine, ect.

Buy Easy and nutritious food to eat like frozzen pancakes, waffles, cereal, breakfast bars, breakfast drinks, yogurt, Instant cereal, milk, soups, frozzen dinners ect.

She can just give herself a sponge bath.

Along with her 1st Alert Necklace,
Set up Nest Cameras thruout her home so anyone at anytime can tune in by smart phone or computer, to see that she is ok.

Have everyone pick one day a week just to drop by for an hour.

Order groceries to be delivered at the time someone will be dropping by so they can put them up for her if needed.

You might not have as much peace of mind as if she's put somewhere leaving the responsibility to others, but you mom would not be. Your mom would not be at peace. You should let her continue to stay in her own home, at least until she no longer knows.

Better to be Free and take your chances than to be in Jail.

I hear you. It is hard to take care of another person 24/7 or even a portion of that time. Seems you have gotten all the volunteer help you can and that paid help for her to stay at home is not an option. It is difficult to balance caring for her needs and each caregiver caring for own needs and family's needs. Since you notice the stress her care is having on the family and that mom is contributing to it, something had got to change.

Start by having her evaluated by her doctor for health issues, dementia issues, and psychological issues. Her doctor may make referrals to a neurologist for an indepth dementia evaluation. Her doctor may also make a referral for mental health evaluation and treatment (since she is creating problems between family members and unrealistic about her health). Ask the doctor to tell her that she can not live at home anymore and that she needs to enter residential care facility. Many times a senior will listen to a doctor and follow his/her orders when the person won't listen to a family member.

If that doesn't work - and it should - then take her to the hospital when she falls again. Ask the hospital to help you with placing her into residential care facility. They will tell her that she can not go home and help with the process.

I can pretty much guarantee that she will be mad at everybody with whatever change you make. Expect it. Tell the rest of the family members to expect it. Give her a couple of weeks to get used to her new home. She might surprise all of you by settling in, finding friends, and enjoying it.

Is there one sibling who’s more inclined and ok to stay w her? The other siblings could chip in some amount so she’s paid at least some compensation to stay with your mom so she can remain whatever time she has left at home bc doing that full time it’s most likely they’d need and expect some sort of compensation to offset the costs to not being able to work and also to demonstrate appreciation- and since it’s a lot to do 24/7 she ( or he, I just used she bc most often it ends up being a female relative who does the caregiving) can here and there pay for a relief caregiver for a day or weekend. There’s definitely value in a senior especially of this age remain in their home - a big change to an unknown place with strangers is a factor in an increased risk of the senior having a sudden decline, sourced with a rn, a physician and long time caregiver agency owner. It’s hard though bc in re reading the op if I understand correctly she doesn’t want anyone there. If the one daughter who’s more ok with helping is compensated and given breaks when she says she needs them that’s pretty much the option that occurs to me

Saw the word narcissism mentioned a few times in your answers to others, and that in a year the siblings and their families are burned out, and this:

"My eldest has put so much of her time into taking on most everything to keep mom organized with monthly calendars to all sibs, takes to dr. appt.'s, arranges all other appt.'s, etc. She was with mom when she fell twice and literally freaked out. I think she is taking it on too much and taking it on to the point of damage to herself. Maybe the eldest feeling most responsible thing. ? I told her she could only do so much, and would have to let some of it go in letting mom discover she can't have everything the way she wants. Mom often gets angry with her and tells her she's too much of a perfectionist and doesn't want to listen to her. I'm not quite sure what this sister expects or why she feel so responsible. It's actually a bit ove the top at times. Mom needs to see reality and not have all that help."


I feel so bad for your sister, all of you really, but especially her, the one groomed to be your narcissistic mother's personal slave. I can imagine how burned out she is and it makes me sad for her.

I sincerely hope that at the family meeting all can decide to back off on any and all care until your mother is forced into professional care where she belongs. Why is your brother POA and not the oldest sister who is doing all the work? That's not right either. I hope he gets a clue and stops doing basically nothing while your sister is burning out and it's affecting her health.

Even with my guardianship, it took a medical emergency for the doctor to say that my dad could no longer live at home and that he needed to be in assisted living. Dad should have moved a long time ago but he wouldn't. Guardianship gives you a lot of authority but you can't just pick up and move a stubborn 92 year old.

We are in a similar situation. My mother is very much like yours .. demanding controlling and mean. We live with her because she is unable to live on her own, but she will not go to assisted living. She has to be taken to dialysis 3 times a week, and then there are doctor appointments on many of the other days. If she has a free day she insist that we take her somewhere and she gets very mad if we don't. Just this morning she called because we had to take a car in for repairs. It was only quarter to nine. She was furious because she woke up and we were not there to help her get dressed even though she has no where she needs to be. We were back by 9. She screamed at me and hung up on me. This is our retirement years. We bought a motor home fine years ago so we could travel when we retired, but all that is over and it just sits there while we pay for it. I don't know how much more of this we can bear. I have no answers for you because clearly they are in control of our lives and they know it, but refuse to think about what they are doing to us when there are other options for them. My mother has enough income to afford assisted living, but she refuses to even discuss it.

If she is competent - you can't just move her. No facility will take a competent adult who is refusing. You might have to wait till she is a "danger" to her self or others and step-in and get legal guardian ship.

Very Similar situation. As are most of us reading these postings - to gain ANY small insight to how to navigate these VERY difficult times. To make matters worse there is COVID.

I was able to get mom on Medicaid (dad on VA Aid & Attend) between these 2 sources we have 50 hours a WEEK. which seems like a lot and not to sound ungrateful - There is WAY more than 50 hours a week to regain my complete freedom(VERY little assistance from sibs). I AM TETHERED in ALL possible ways. Mentally, Physically, Financially & Business wise. No more are we children/daughters/sons. I Am a Life Care Planner & executor. I wish I could go back to being just a daughter but I know that part of the relationship is past. It is NOW all about quality of life at this point and HAS to balance in my life as well.

I wish there was an answer to this ever growing (people are living longer with critical illness)challenge. If there is 1 valuable lesson I've learned from my situation, it's I WILL NOT put my children through this.....I will realize that I've lived my life and it's their time to live theirs....I will give them 'early on' permission to Place me in a SNF or whatever is needed - guilt free!

Caregiving isn't just A JOB (to those CNA's in a SNF) you have to have a passion for the Elderly. VERY FEW of these type people exist, the good ones get frustrated by the short handed staffing and leave to find more rewarding & fulfilling industries.

Just as we all have done raising our Children we have to have tough love. MANY on these forums struggle with how to care for our loved ones that DON'T WANT help & yet we SEE the needs (hygn, meals, house work, repairs, fall haz, bathroom etc). I personally, have had to step back from my Father who refuses to accept that he needs help. In one of the heated conversations he advised me that he has never asked for my help. It was eye opening to me that he was mostly correct.....he had not asked for much of the help I WAS (WAS) doing. I believed I was HELPING him, when in fact I was helping myself being that I can SEE what needs to be done and doing it. It wasn't appreciated. So now I dont do anything that isn't asked for.....It is harder to not do what I see needs done than the struggle to do ALL that needs to be done. I think?

I contacted the local Center for the Aging (Texas/Counties have these) they offer FREE Counseling. One of the recommendations is to keep a journal which is a little therapeutic but MORE over it is a source to refer back to WHEN THE day comes that SNF becomes the only - last option and I have to use the Courts to do it. Next start the planning. Research & site tours (when & where possible), begin to get financials in order. Medicaid does a 5 year "look back period" so the sooner YOU begin to prepare for this path the better. This is a tactical challenge and isn't done overnight. YOU DONT need an attorney, print off the application and start on it now....so you know what will be needed when time comes. If I can do it ANYONE CAN.

Churches are a great resource for caregivers as well even if only for respite/a break. Post for interns (They need "hours")at Post Offices local stores anywhere there is foot traffic.

To those that are reading this, I pray Gods resources abound in your life and that your needs are provided for supernaturally. That God will refill your energy and provide insight into your specific situation. In Jesus' Name AMEN.

Unfortunately, if she is still mentally sound you can't force her to do anything. So many families are in the same situation as you. The elder's "stubbornness" often ends in a tragic outcome like a serious injury or death. The whole family needs to be united and have a kind of intervention with mom and lay out what her options are. The family meeting her every need around the clock is enabling her denial of thinking she's still independent and capable of being on her own. She isn't. If that was true she would not need a different family member at her house 24 hours a day.
If her only option is AL then that's her only choice. If it's possible for a live-in caregiver to be in her house (if you hire privately the pay is negotiable), then maybe that. There are choices here.
The family together must ask her plainly if pride and stubbornness is more important then her life. That if she falls one more time she will die. If she survives, moving to AL or accepting a live-in caregiver will no longer be decided by her or the family. The state will decide and they will put her in a nursing home. This may be enough to get her attention.
If it doesn't and she continues with the obstinance and asinine stubbornness of refusing to move or accept any outside services, then all of you will have to leave it there. The family can start living their lives again. Everyone needs to stop taking turns staying with her for days at a time, waiting on her hand and foot, and being responsible for her health and safety. None of you for any reason should tolerate her mean and abusive behavior for one more second. Give it right back to her.
You and your family can still help her out some, but stop being at her beck and call 24 hours a day. It's hard to do this but you have to. If she's still mentally sound then it's her decision.

I doubt she will qualify for assisted living based on all the things you have to do for her. AL means there is staff on hand to help with little things, but patient can still manage on their own in their own room. AL is very expensive and not going to be covered by Medicaid. Medicaid covers NH bed when you run out of cash or other assets that can be liquidated. The house is excluded from that, however it will be considered when she passes as a means for Medicaid to recover what the state paid out for her NH care. There is a MERP (agreement to allow recovery on what is left in her estate at the time of death).

You can figure out what her income is each month and go from there on what she can afford. She could get Medicaid help for a NH bed or she might have enough income to be a self pay patient. Based on all the things she is unable to do for herself, she will probably be considered eligible for NH care due to her medical need.

Her plan is to live in her home and take care of herself. Let her know that the children are wearing out and cannot manage her 24/7 care any longer. She can go to a facility with request for PT/OT to help her reach her goal. Her house can sit empty awaiting her return. Talk to her dr about the phys therapies in NH. He can also reorder the in-home therapy she used to get (they let you have a month or so, deny you, and then wait a mo or so to request renewals). All she has to do is always mark on the paperwork that she 'intends' to return to her house (even if you think it is impossible) to keep house until her death.

Push the NH as a way to get stronger with 24/7 care all under one roof. Easier for all of you. Tell her that after a year, her kids haven't been able to get her stronger, so she needs trained medical people to help her meet her goal. Good luck.

You and siblings are thinking correctly and asking very important questions. As you mentioned she gets obsitate and stubborn. Instead of fighting with your mother or your siblings. Get your pastor or someone from the AL get an avocatr. Who can talk to your mother and convince her this is the best for herself and her children. Have meeting with everyone there and lovingly te get hour feelings and shy it is best she go to AL . She can take her most prized possessions. Have an advocate to oversee the meeting.Good luck and God bless.

There is no convincing. Do not argue. That is a trap most/ many fall into.
Do not engage in the back and forth arguing as it is wasted energy and nothing will come out of it besides both sides in their own corners.
You know your mother won't (or can't) change.
Who is the POA?
It is up to you and others in the family to make decisions.
Of course she will rank, scream, be angry. This is (likely) how she gets her way and people cave in to her demands (some out of caring/concern/even guilt, some likely out of fear).
You need to stop giving in to her and tell her:
"This is what I will do . . .
This is what the family (or specific person) will do. ...
This is what "we" need to do now . . . (assisted living?)

No, OF COURSE NOT - she will not be open to working with you.
This is a given. Expect it and be ready for it. Stand your ground.

You need to take control of the situation.

My friend (88) just had a stroke and can't walk one step w/o a two person assist. He wants to 'go home' when he doesn't have any / enough help. There is NO logic when a person feels they are losing their independence. There is immense FEAR and ANXIETY. The 'best' you can do is HONOR how a person feels by acknowledging them. Yes, I understand you want to . . . Yes, I understand you do not want to . . . Let a person know you hear them.

They will hold on they cannot (or will not) accept logic and safety measures. This may be human nature for some. It is sad and very unfortunate. As I say, do not allow yourself to go down with a sinking ship. Yes, you may feel 'bad' 'guilty,' and all the negative feelings and emotions. Feel through them.

IF you are able to move her into assisted living - do it if you legally can. Depends on how much (longer) you want to manage care as it is now.
It may likely be up to you and the rest of the family to make decisions.

I feel for you and your siblings. It is always best to move a parent before they are at their absolute worst.

It would be easier for her to move now so she she has time to become used to her surroundings.

Depending on Covid restrictions, a big plus is so she can socialize with others.

Has she been vaccinated for Covid? Have you looked at facilities?

Does it have to be assisted living since money is running low for care?

Why not look into applying for Medicaid and she can enter a skilled nursing home?

Honestly, it doesn’t sound like she is even interested in finding a new home to reside in.

I would not ever suggest that she move into one of your homes either because she doesn’t want to be told what to do.

Obviously, she wishes to live life as she desires to live. That’s normal because it’s hard to give up our independence but sometimes it is necessary for valid safety reasons.

It’s sad that she isn’t agreeing to move because it places more anxiety on the family while she is at home.

As far as falling, she will fall anywhere but at least she would have help available at all times.

I think that you are doing all that you can for her but it becomes a burden on the family to care for her.

You are blessed that more than one person is caring for her. Many times only one family member does everything.

I hope you find a viable solution soon.

Do you think if a social worker would speak to her that she would listen?

Have you contacted Council on Aging for some help?

Does she receive meals on wheels? Can she get groceries delivered?

Take advantage of whatever help there is to assist in her care.

As some wise people on this site said to me: “Your mother is only managing in her own home because you are doing all the work for her!” This is you and your siblings’ situation too. Time to look into a care facility and get back to your lives. I think if she falls again and has to go to the ER, you can have the doctor on staff write it up that she is no longer safe in her own home. Let her seque that day into a care facility. She’s already fallen and it’s documented with rehab. You can have the social worker start the paperwork for Medicaid. Start getting all your paperwork in order now.

My siblings and I have been down this road with both my parents. Both are gone now. Mom had Alziemers and Dad kidney disease. In the earlier stages of the disease my mother for about a year had to be placed into assisted living because the disease made her make my dad public enemy #1. Dad was a career Air Force man and my mother stayed home to raise us kids till the last was in high school. She joyfully for the first time in her married life entered into the work force (to my dads dismay).
My dad hated being separated from my mother and even though the disease had her physically and verbally attacking my dad, she too hated being separated from him. When he had had enough he gave us a time frame and said "get the family home (of 50 years) in order cause whether we liked it or not or the home was ready or not he was bringing his wife home". It was absolute chaos and at times impossible but MOST of us got it done and to his credit, my dad collected my mother and brought her home. There always seems to be siblings who just flat out won't help and it sucked. My parents were not wealthy but they were good honest people and did the very best they could to raise their family. Whatever hang ups my siblings have is on them. There were so many times their help was desperately needed but they would not help. It was very difficult but between my parents income and my husbands and mine and having to go through a boatload of caregivers and finally being blessed with a good one, dad was right in insisting my mother be brought home.
Your mother is 90 years old. How much longer do you and your siblings think she has left on this earth? When did it become so customary to shelve away our elderly. For God's sake suck it up and do what you all have to do to let your mother finish her life the way she wants in HER HOME.