She will not allow me nor anyone else to be in her house for very long. She refuses to move into assisted living. I worry about her cooking for herself. I try to go visit her a couple times a week. I call her twice or more times a day.
She is very independent.
She refuses to move into assisted living - who asked, why, in what way, and to what facility?
I worry about her cooking for herself - why?
What sort of signs are showing you that she is becoming "a little forgetful"?
We have a lady of a similar age who has just ended service with us who is *fine.* She is amazing. She shares her food preparation areas with her cat, which makes my hair stand on end and turns my stomach, but she has been doing that for twenty years and it hasn't done her any harm yet.
We have a lady ten years younger who doesn't want us to end service, is perfectly capable of preparing her own meals, but feels she can't cope. She isn't fine. We're working on building her confidence; I privately suspect that she wants to move into a facility but doesn't want to admit it to her family.
The point is that at this stage the thing to do is explore your mother's wishes, worries and priorities, then promote her safety and wellbeing within those constraints. Don't tell her what to do. If she's finding any particular task or routine difficult, ask her what help she'd like with it.
If her main goal is 'staying home' or 'doing it all herself' try finding out the whys behind this.
Being with her things?
Not being bossed around by others, told what to eat & when to wash 'institution-style'?
Many older people picture 'Nursing Homes' as dark, dire old 'mad houses'.
But some assisted living are more like cruise ships or hotels.. although short staffing & Covid has taken a large toll on quality & care 😥.
Accepting home help services helps many to stay in their home longer. The person gets to stay amongst their things & continue their own routines. It is a trade off.. a little more help/safety for a little less privacy.
While you are visiting, it wouldn't hurt to keep your eyes open.
Any scam calls or mail getting through? Scorched pots in the kitchen? Food past use by dates? No evidence of proper meals, just tea & biscuits? Unsafe walking on stairs or holding furniture? Heating up sky high? Or not on when it should be? Wearing multiple layers of clothes instead of remembering how the heater works? No bathing taking place?
What services may be useful will depend on what she is starting to struggle with.
Meal delivery service is a good starter.
The is such a thing called Apparent Competence. We learned this phrase from the social worker who was helping my MIL. MIL *seemed* to be ok...but we eventually saw that in phone conversations she would give general responses to any question we asked. However, when the social worker asked what year is it, who is the President or what season we are in, she couldn't answer correctly. We couldn't figure out why MIL would tell one of her sons one story, son #2 a different version of the same story and son #3 yet another altogether different version. She would call claiming she lost her purse and then again that it was stolen (it was in her house and she couldn't remember where she put it). She wasn't taking her thyroid meds even though I would ask her about them and she'd swear she took them but there they were scattered on her table. Her food was rotting in her fridge because she thought she'd eaten but hadn't. She was writing multiple checks from multiple checkbooks and was overdrawn by $900+. Mail was unopened. She watched a lot of tv and didn't do much of anything else. She was in her late 70s.
I accompanied her to a doctor's appointment that I made on the pretense of "required annual physical by Medicare". At this appointment I had a pre-written note that I discretely handed to the staff outlining our concern for her memory and requesting she be given a cognitive and memory test. They were happy to do this. Then I sat with her in the exam room, behind her so that when the doctor asked other health history questions I could shake my head yes or no because she wasn't answering accurately. I was shocked at how poorly she did on the tests (couldn't draw a clock face or add the correct time, couldn't remember the 3 words after 10 minutes).
At a family gathering my MIL pretty much fainted and we eventually figured out it was because she hadn't eaten that day. Not remembering to eat was the definite trigger to act. She needed to be in an environment where she could be fed, safe and socialized. She is now in a very nice facility on Medicaid in a private room and enjoying the company of staff and other residents.
My point is that you will need to snoop around her house to see what other evidence of memory impairment there may be and how pressing it is to address it. Is there anyone who can visit her with you to act as a distraction so you can poke around to check on things? I would tell her a therapeutic fib to get her in for a physical and request the cognitive/memory test. This way you'll know what you're dealing with. At this exam ask for the HIPAA Medical Representative form and encourage your Mom to write in your name. This will allow her doctor to discuss her private health info with you without your Mom giving permission or having to be present for the conversation. Hopefully you are her DPoA... if not, encourage her to get this in place for her own protection.
"Apparent Competence". Hadn't come across that phrase before - makes good sense. Yes, my relative might be considered competent.. until you delve a bit.
I agree that it may take a few good chats to illuminate what help is needed. Next comes how best to implicate that help.
If dealing with truly unreasonable people, who lack insight or judgement, you may have to work behind the scenes, but the OP's Mother may be quite reasonable yet - I'll wait for an update.