What is the best response to a parent who refuses to move out of her rural home and is becoming increasingly forgetful & makes poor choices?

Your mother is from a generation that prizes independence, and does not want to inconvenience you. It is highly embarrassing to have to admit that we cannot care for ourselves regardless of age.
She wants to maintain her dignity, and you want to help her do so.

One solution that allows her to live independently yet also permits you to be close and keep an eye on her is to have a 'granny flat' installed on your lot.
My company makes a very simple home from a 40 foot shipping container that can be put on a concrete pad and then removed at a later time. The unit is a complete home with bedroom, bathroom/shower, kitchen and living room area, and is cozy enough to quickly become a familiar security for inactive seniors. For the active seniors, the small size encourages outdoor activity from golf and tennis, to walks of any length, and promotes interaction with grandchildren and great grandchildren.

This may be a practical compromise to the thorny problems trying move a reluctant, independent senior into the home.

The drawbacks are that it is not cheap. The unit costs $30,000, without the prepwork of a concrete pad, preparing utilities and obtaining the proper permits.
Other considerations include the fact that it is 40 feet long and 8 feet wide - many urban lots just do not have space.

But for those who do, it offers an alternative that keeps an aging parent independent while reducing the worry and stress on the caregiver.
The unit can be resold for full value, which helps to alleviate the financial considerations.

Can you get any evaluation/advice for a doctor or social worker? It does sound like your mum needs some care - re medecine, and safety at least. Falls can cause a lot of problems. Would she agree to/ are there finances available for in home care? Can you talk with your mum about her needs and how they would be best met? It does sound like she needs help with her meds at very least.
Both sunflo and jeanne have made some very good points.
Gently introducing some help may work. Let us know how it works out. ((((((hugs))))) Joan

I'm in favor of keeping people in their familiar and preferred surroundings as long as possible. We brought more and more in-home help for our Mom until her mild cognitive impairment moved into the dementia range and now she lives with my sister. I figure the in-home help gave her 5 more years in her apartment. (She is 92 now.)

We started with meals on wheels, and with stocking her freezer with microwavable meals and bringing her homemade items that could be easily heated in the microwave, like bean soup or spaghetti. She gave up using the stove.
We got her a medic alert button to report falls. (A cell phone would be even better in some ways, if the person carries it with her at all times.)
Our mom didn't take many medications, but, boy, she couldn't keep them straight and take them appropriately. We arranged for a visiting nurse to take charge of her meds.
When we noticed that she paid some bills twice and skipped others one of my sisters took over bill-paying.
We arranged for a personal care attendant to spend a little time with her a few times a week and do laundry and housecleaning.

Your situation is a little different. Mom was in an apartment and us children visited often. Your mother is probably more isolated, in a rural setting. Perhaps with some creative help you could give your mother a little more time in the home she loves. Could you hire a student to walk the dog with your mother at a regular time each day? Can you find a nice purse-type pouch with a strap that she can carry the cell phone around in. so she always has it "on"? If she needs help with meals or laundry or yard work, etc. can you arrange those things for her?

At some point she will probably not be able to stay alone in a rural setting. Maybe that time is now. Now is certainly the time to start talking about it. If it is done the road a ways it is still a good idea to start her thinking about the possibility of moving, where she would like to go, etc. And knowing that moving is coming eventually should help her be more receptive to help to make moving day further into the future.

It is not easy, is it? Forgetting her cell phone when she walked the dog is hardly grounds for making her move ... but it is certainly enough to get you worrying. I hope you can come up with just the right balance between her need for independence and your concerns about her safety.

I don't have a good answer, I'm in similar but more urgent situation now -- see my post about 90 year old mom I want to move to AL/memory care facility close by. She wants to go home and hire full time caregiver.

Good health or not; its a conversation you have to have. You'll ultimately have to decide what is best for your situation and personal needs as well -- can you supervise outside care? How will she still deal with taking care of the house, managing bills, laundry, meals. Being at home with care is still very isolating in the long run; caregivers won't want to be responsible for taking your mom on outings, shopping, movies, etc as part of their watch. As time goes on, more serious caregiving skill sets and resources are needed that a care facililty can better provide.

Best of luck, check my post and see what advice others give me as well. Many hugs!!