My 84 year old mother has the beginning of dementia. She really needs to move to assist living or get in home care, but flat out refuses. I live a 100 miles from her and my brothers live across the country. She is financially able to have the best care, but insist she is able to take care of herself. She is forgetful, forgets to take her medicine, wears the same clothes, and has rotten food in her refrigerator. There is no convincing her. She told my brother she would not move unless it was in a pine box. I am at the end of my rope.
If you don't have a pendant/watch for her "I've fallen and can't get up" moments, get one. $50 a month. For that price, it also sounds the alarm when someone falls. "Mom!! Do this for US!! We love you!!"
Things that might provide at little or no cost:
Every 2-week housekeeping for a few hours....or instead of using the time for housekeeping, maybe using it to stock her pillbox every two weeks. Or do all of her laundry and hang it back up in the closet. Or clean out the fridge. (That service cost mom $28 a month. She was not eligible for any subsidy because her assets were too high.)
Meals on Wheels, 5 days a week, $125 a month "suggested donation".
Snow shoveling/grass cutting $20 a time through the village senior program.
You might also make a few calls on your own for full-boat-pay services -- maybe 3 hours a day twice a week or something. Present that to her after the Senior Services people leave.
This'll let her know you mean business...that you're operating from concern and love...and make it real for her instead of, "Mom, you need some help around here."
See, when it all distills down, you want her in AL or to have household help so YOU'LL feel better. Yes, of COURSE, it's best for her; but if it's really not what she wants? You're stuck with managing the crisis that's sure to come unless she dies peacefully in her sleep. (So, if she refuses any and all help, start preparing for THAT moment in the meantime.)
About the worry. It will kill you, if you can't let it go. The first thing you must learn in caregiving, is to let go, and let God. You do the best you can. You can't keep your Mom safe and healthy. It doesn't work that way. No amount of worry, preparation, and effort, is going to keep your Mom from failing, then dying. The best thing to do is forget worry, and enjoy the time left.
Always remember she is your Mother. She has been a parent for your entire life. She tells you what to do, not you telling her. This will go a long way in her listening to you. By the way, from the tone of your letter, I'd say she did a good job. You're a kind loving person.