What do we do if mom is refusing all of our efforts to help?

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Welcome.

The good news is your elder is living her way & probably will do until the 11+ a half hour. A life well lived.

The bad news, as you read from many others who tread this path, there is not a lot you can do. It can be heartbreaking to watch.

Decide with your sister what's reasonable as to what you will both do regarding visits - maybe a daily phone call each - am & pm?

Unfortunately and this is often the case you can not "do" anything or "force her" to do anything. So it is a waiting game. you wait until she either agrees that she needs help and permits it OR, and this is the kicker, you wait for some catastrophic even to occur. A fall, her getting ill that will force a hospitalization then hopefully rehab and you can, at that point say, "mom, you can not stay at home alone. That means either having someone move in with her, caregivers taking shifts or moving her to Assisted Living or Memory Care.
The big unfortunate thing is often these catastrophic events do not end well.
If you can begin a conversation with mom in that way. If she is willing to agree that if she fell there would be larger problems, that might be helpful. But I can tell you my Husband was stubborn and there is no way that he would have agreed to have help come in, he would not have agreed to move out of his house. If he had not developed dementia he / we would have remained in an OLD 2 story house that was not in any way set up for "aging in place". If either one of us had fallen and or needed help it would have been a nightmare!

If she insists and you want to make this work then if possible eliminate her having to go upstairs. Move a bed down stairs, convert a room on the first floor into a bedroom. If you can make a bathroom easier for her to use. Rip out the bathtub and put in a zero threshold shower. If the toilet is a standard height put in one that is ADA compliant (if your mom is short maybe the regular one is fine)
I would place a door at the base of the stairs so she does not have to go upstairs and I would lock it so she can't go up stairs. (maybe a little excessive but it would be safer. It would also save a bit on heating you still need air circulation but you can close off some registers)

If this can't be done then the only thing to do is ... wait...
(short of having her declared incompetent and forcing her into Assisted Living and that may kill her just as quickly as a fall would)

Rosadelima.i am going through it with my mother at age 96 living alone in her 2 story house. She stays downstairs now since she can’t go up the stairs.

If she even has one ounce of competency in her, APS will do nothing unless she is deemed incompetent. The law is very clear. You can’t force any elderly person to do anything!! I mean anything!! I’ve cried to everyone who will listen. They all say the same thing. “I’m sorry there is nothing we can do Elaine since your mother is competent. If your mother doesn’t want to bathe she doesn’t have to, if she doesn’t want her hair washed she doesn’t have to, if she doesn’t want to change her clothes, she doesn’t have to. There is no law saying she has to.

Someone once told me they can’t make an elderly person bathe in a nursing home either. I just keep thinking if my mother did go into a nursing home that possibly the trained staff could talk her into it.

It is a horrible situation to be in. You can’t help someone who doesn’t want to be helped.

From what you write it sounds as if she is doing remarkably well, even for someone 75 or 85,... and she’s 95! I don’t see much that needs fixing here, I would consider this a huge blessing and invest time more into the relational aspects with her. Western society tends to automatically associate anyone over a certain age as most certainly needing a lot of extra help. A friend of mine pointed out she had known and also heard of a couple seniors in their nineties who participated in a walkathon and have zero dementia, happily it sounds as if she is cognitively ok, you said sometimes she has a bad memory but no dementia, and has overgrown toenails, and her independence is important to her, and that you stop by every week. Unless there’s other things you didn’t mention that are really serious and I wouldn’t imagine that’s the case this seems to be a case of not much needs fixing. you check in regular, she doesn’t have dementia, she has food — since you see here you’d notice if she wasn’t eating much at all you would be able to tell by her appearance, since you didn’t include weight loss she must be eating adequately. You say your frustrated she won’t accept more efforts of help, i think in a indirect way she’s trying to express one of the things you can do to help is allow her that freedom and independence she needs it’s actually an important part of her self esteem and overall health is to retain the level of independence she’s been able to maintain, I would focus more on relationship, talking with her having a cup of tea, talking about things that interest the both of you, your really fortunate she’s definitely in the small percent of seniors who do really well into very advanced age.

Is she safe?
Does she have problems with balance or movement that would indicate that 2nd story isn't safe for her any more?
Does she remember have expired food in her refrigerator that she eats?
Does she medications she needs to take regularly and a pill box to organize/remind her when to take them?
Does she forget about the stove or oven when it is on?
Is the home clean and garbage taken out regulary?

Is she healthy?
Does she bathe every day - smells fresh and hair isn't greasy?
Are her clothes clean and in good repair?
Are her nails clean and groomed?
Does she have access to nutritious food and eat enough to sustain her weight?
Does she have daily interactions with others who help to monitor her health?

If your answers to these questions and others that come to mind are mostly negative, then it is time for mom to live with somebody or have people come into her home. Consider that she needs day time "help" who will help with her personal needs and the needs of the home. Ask family, friends, folks from your community of faith, and "paid help" to come by every day of the week. You can have each person fill in a journal of what they did when they visited. You might also want to consider a few overnight visits to make sure she doesn't wander off the property at night.

Since your LO is independent-minded, it might be best if folks came to her as "visitors" to help or give her "gifts" of housecleaning services which are in reality home health care aides. Please remember that home health care aides can not dispense medications and only "remind" folks to take them.

Installing some cameras would be a very good idea at this point. My mother was still mobile, still able to do most self care and "seemed" okay. The forgetfulness itself isn't always a sign, however if there tends to be repetition of current issues, it could be a red flag. Repeating old stories from the past might be okay, but when they ask or say the same things within a short period of time, this is likely early dementia.

My mother's condo was mostly 1 floor, but there was a finished basement area. Granted she didn't use it much by this time, but those stairs were awful! I hated using them and was concerned about falls. She denied using them or going down there, but the cameras YB put in told a different story. Not much usage, but it only takes once! I did have to get WiFi installed, but it was very helpful being able to keep "eyes" on her. There were 3, one outside the door to monitor anyone coming or her going, one inside the door, that could view the table where she would eat and/or spent a lot of time and one in the basement.

For the most part, she was okay to be there alone. We did try hiring aides, mainly for a sanity check as none of us could check daily, and to check she took her meds. The agency sent a nurse to eval mom, and this included a better cognitive test than the one they use in a regular doc office. Medicare DID pay for this test. She recommended a timed/locked dispenser and the aides (only the 1 hr minimum) would check and remind her to take any she missed (they can't dispense, but can remind.) The plan was to increase the time/days as needed, but less than 2 months later she refused to let them in.

The cameras WERE useful in that they can be enlightening. She developed a kind of OCD behavior before bed, ramping up to 1-1.5 hours of checking several places before she would go to bed. Probably some form of sun-downing, but she wasn't aware she was doing this.

After refusing the aides, I searched for a place closer to me for her. Thankfully they just opened the MC unit in time. Had we not been planning to move her at that time, she might have died from cellulitis, as she "bruised" her leg and didn't have enough sense to tell one of us or seek treatment. That is bad enough for anyone, but can be a quick killer in the elder! It delayed her move a few days, to get initial treatment started and required TWO rounds of anti-biotics, elastic stockings and wound care for quite some time.

The things you don't see when not living there would probably make your hair stand on end!!! Cameras are the next best thing, if you can't arrange for one of you to stay for several days or a week. Early dementia has the capability, in many cases, to hide itself from us. When we don't see someone for anything other than brief visits (includes doctors, they don't spend enough time with the patient to see through the charade!), we can miss the early signs.

Mom used to have YB clip her nails now and then, but rather than haul her to a podiatrist, the MC unit brings in a home health nurse who can clip and trim nails. Perhaps you can find one who can come help her with that. I understand she doesn't want anyone in, but if you go that day, be there with the person and see what can be done, at the very least she would get one trim! If not, she could end up with infections and/or need more invasive treatments at a podiatrists! Coax as best you and the nurse can, offer a reward of something she especially likes.

I would definitely either find a way for one of you to stay with her for extended time, or install cameras. She is likely a disaster waiting to happen.

As the daughter whose mother just passed away in a facility, I can't agree more with those who are telling you to let your mother be. Let her live her last days as she wishes and no matter what happens, be proud of yourself for allowing that. I know it is hard and not guilt free for you, but I can tell you that any option you force upon her will also not be guilt free or easy. Imho, telling her that you will do as she wishes is the best gift you can give her. If you can quarantine yourself for 14 days and visit her, that would also be awesome. Isolation for the elderly is worse than death.

It is heartbreaking to see the elderly deteriorate. There are several emotions that they feel too.

They don’t want to be a bother to anyone. They are modest so it’s embarrassing to have help bathing, toileting, etc.

If they previously fell in the shower like my mom has it is frightening for them.

They wish to remain independent and many people are extremely set in their ways.

It isn’t always easy caring for parents. It can be challenging. Best of luck to you.

Install cameras in the home and buy food that is easily fixed like microwaveable and instant and ready made like yogurt, breakfast bars, applesause, milk and juice.
Do what makes your mom happy, don't worry that her home isn't that clean. Ckean the bathroom and kitchen when you go there to visit.
Install Cameras in the home so you can keep an eye out. Unless she is smelling, don't be concerned how often she bathes as she can clean herself with a face cloth as in spit baths.
Make sure a couple handrails are installed in the bathrooms where most Falls occur.
Better to let your mom stay in her own home in comfortable and familiar surroundings and be happy then to make her miserable by trying to make her move.
Let your visits be fun not have her dreading that everytine you come all she hears is complaints, even if you think it's only because you care about her.
Juse make things easy for her. If she doesn't have a bed downstairs, bring one down from upstairs.
Most seniors don't live very long moving them, especially in to a Senior Home, they get depressed and have to be told what to do and when to do it and sometimes are treated bad.

My 96 yr old Dad is living in his own home but he has dementia so he has Caregivers.
I have Nest Cameras set up so I can check on him any time 24 7 and make sure he is being treated right.
Do the best you can, offer help and let your mom have a peaceful last days, months, years she has left.

Maybe you could find a Live In if your mom agrees.

Put yourself in your mom's shoes and think about what you would want because your time will come.
People think placing a loved one in a home is best for them but in reality, it's really done more of what's best for them so they don't have to worry about the loved one.

Lealonnie1, one of our most frequent and loved posters on Forum, can tell you exactly what you have to look forward to, as her Mom is just the same, and now she is in hospital with a stroke and the people caring for her Mom looking at her like "How come her feet are dirty". Her post today is in Discussions. Well, basically because Mom refused help and care. She did it her way. Likely the stroke would have happened no matter where she was, but her daughter has the added sadness of knowing that some little time passed before she was found.
Honestly, there is little you can do. Some of these stubborn folks want to stay home and do it their way. I had a MIL like that. There is nothing you can do but offer help and safety and you have done that. Yu know where this will go; likely Mom does as well, and still prefers to do it her way.