Mother is 93, lives alone- she likes it that way and does not want to live with anyone. Showing some signs of concern. Any advice?

My mother is 94 lives in the mountain area of NC, she refuses to move, she refuses help, so my brother & I have given up, we will wait until something happens then we will address the issue.

My 93 yr old aunt (with dementia) lives alone. She did see a neurologist several years ago when she was seeing a regular Internal Med doctor. Once we started with a Geriatric Primary, we stopped seeing other doctors. She sees the geriatric once a year. She also has HH through Original Medicare, Daily aides to help with ADLS
We started with HH, added the aides, and other support. She’s very happy at home and it works for her.
She does take aricept and namenda or Namzeric (a combo drug of the two). It’s difficult to know how much or if it helps but I can say that her dementia has progressed very slowly. The neurologist (and every other doctor who has weighed in) suggested she stay living at home.
And yes, the UTI is always the first thing I suspect when she “acts out”. It’s not always a UTI but it has been. Don’t quiz your mom on whether or not she is having pain when urinating etc. and think that’s all you need to know. With the elderly symptoms are different. Just get her a test with a culture to make sure she receives the correct antibiotic if an infection is present.
Do any of her five children spend the night on occasion? You can learn a lot that way.
My aunt, as mentioned, has a daily aide, HH, a bathing aide, therapy, MOW, church visitors, regular family visitors, a couple that go over twice a week to prepare her food and set up her meds and I can still learn a great deal about what is going on with her when I stay over. It’s very easy for elders to “showtime” on the phone or with casual visits. Not so easy when you spend a little time. I also keep a daily calendar where the aides record her daily bp and pulse and do a check list for things like Thyroid pill on empty stomach, clothes changed, which bp med taken. She has to take an alternate one on days her pulse is low. I use this as a reminder for the aide and to track how she’s doing. The HH nurse weighs her weekly so I can see if she’s gaining or losing. Sometimes she appears not to be eating so much but if her weight is fairly steady I don’t worry. Someone who loves your mom needs to lay eyes on her on a regular basis. We also have cameras and a Medialert system.
I highly recommend the book “Being Mortal, Medicine and What Matters in the End” by Atul Gawande.
Also look up confabulation.
I probably would take your mom to a neurologist if she’s willing but I agree, get the UTI test first.

So, when those closest to her start realizing that she isn't handling her ADLs (Activities of daily living) how much will they orbit around her until they are exhausted and resentful and your mom continues to need more and more oversight? Things will not get better for your mom at 93 and your family should be planning for what this means for her and your siblings. I'm not sure going to a neurologist is the immediate answer, as they will just be telling you that she has some sort of dementia (probably). What would be practical is getting her tested for a UTI as this may be the underlying cause of her behaviors, and UTIs are extremely common in the elderly and antibiotics will clear it up and she may be back to her "old" self.

I'm hoping your mom has all her legal ducks in a row: a designated PoA for medical and financials at the very least. If no one is planning on being her full-time caregiver then someone needs to start researching facilities as this is time consuming to do. I wish there was an easier answer. Peace to you and your siblings as you journey down this path with her.