Mom's on AD meds but still depressed and has no friends nor won't get help. What to do?

Mom lives in upstairs of my house, can't clean or declutter. She sleeps most of the day and only comes downstairs to eat or do laundry. I tried to downsize all her stuff when she moved in. She has every bit of furniture in her room that she had in her small house, and there are stacks of papers and hobby items everywhere. My garage and kitchen are full of the stuff she refused to get rid of and will never use. She won't go through the stacks of papers or stuff she can't possibly need anymore. She's on meds and goes once a month to therapy, but is still acts like she can't do anything. You can barely walk around in her room. I've mentioned hiring someone, and she says she can't afford it but she can. I'm worried that she'll trip and hurt herself and sad that she can't find her way out of the funk. I simply cannot do it for her. It starts too many arguments when I try to cajole her into throwing things out or donating them. She always says I have to go through those papers and update my records, etc. Always an excuse. She mentions projects she wants to do but won't even attempt them. The stuff is lying around everywhere in stacks. She reads all day or plays computer games when she's up, but mostly sleeps and so can't sleep at night She gets up all during the night which keeps me awake, and I can't relax when I hear her up there. She'll go back up after a noon breakfast and say she's going to clean up, but she never does it. She keeps getting distracted or something. She's still sharp enough to keep up with politics and stuff, but occasionally forgets her bills and needs reminded about upcoming events. I would like more time to work on my own projects and to go back to work, but I wouldn't be able to keep a job because she won't find alternative transportation for her dr. and store visits. I've provided her with alternative ride information, but she won't use it. I know a lot of people have it worse, so I hate to sound whiny, but I'm in my 50's and have my own health concerns, and two young adult children who need my guidance more now than ever; one is special needs. She can't afford AL and doesn't qualify for medicaid. Any advice or suggestions would be much appreciated.