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She can't make it to the bathroom and we clean the carpet once a week. Bought her an alarm necklace but refuses to wear it. Have apartment cleaned 2x's week. She fell in the shower, no necklace on of course, shower leaked into hallway that's how they discovered her. Fire department came, took 1hr to lift her into chair, she's 5'1'' weighs 300lbs. They asked my brother is this how you take care of your mother? She had boxes piled on her stove, fire hazard, garbage all over on the floor. She just tosses them and will walk over them. Bowels all over the place and flies so thick. Later discovered they were sewer flies from shower drain because of her going to the bathroom to shower and use to get urine and bowels off. She'll cancel the cleaning lady from senior alliance if she doesn't feel like getting up. What should we do???

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Wow. I can imagine how stressful this for you and what a terrible environment for your mother to live in. You didn’t mention your financial situation but based on your description on the environment she is voluntarily living in would lead to recommending assisted living or possibly memory care. Again, depending on financial ability perhaps medicaid. You can’t continue to do all this cleanup when it is obvious it isn’t appreciated as she seems to voluntarily make your work and expenditures harder than they need to be. Also health considerations for both you and your Mom. Get some help, the sooner the better. Sorry about your situation...
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If you or siblings are not her legal PoA and she won't sign the documents to create a legal PoA then there is nothing to do but to call APS and report her as a vulnerable adult. From your description she is a candidate for MC, not AL. They will eventually remove her to a facility and become her legal guardian. They will take over all her medical and financial management and she will be in a safe, clean environment and you can visit her whenever you wish. If doesn't have the financial means she will qualify for Medicaid.

Has she ever been checked for a UTI? Those are very common in elderly women and can cause symptoms like confusion, behavior changes and cognitive problems but an be cleared up with antibiotics.
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Rregarding what geaton777 said, if you let the state become her guardian they will seize all her money. Supposedly to be spent on the elder but wiped out by the guardian. This is a scandal that has been covered by 60 minutes. The guardian can pay themselves 6 figures per year per client and each guardian usually has 100-300 clients. Talk to a lawyer before you do anything if she has any assets at all.
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Appears to be self-neglect.

My Doctor told me, people have the *Right to Rot* if deemed mentally capable of making & understanding decisions regarding their living arrangements.

Such a hard situation, for everyone involved!

This is what I have been told is the pathway where I live;

Step 1. Involve Social Services (our version of APS) for investigation for self-neglect. If severe squalor, transfer will be made to hospital for full physical & neuro/pscyh review. If deemed *capable* - home with arranged home services (cleaning, personal care). If she cancels services, back to Step 1.

If/when not deemed capable, Guardianship applied & appointed. This could be family or non-family. Guardian then authorises transfer to appropriate residential care (MC if the $, or NH).

A Social Worker specialising in this area would be of great benefit to advise & assist.

It's a canoe up the brown creek. Only you can decide how far to keep paddling the canoe for your Mother or whether to get out now & call for help.
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