What moral obligation do I have regarding my mother's care?

Do not bring her to your home. The best thing for her care is a skilled facility, especially because of the medical care she needs. She will have the skilled care she needs 24x7, you will be able to continue to be her advocate and daughter. Hospice care will follow her to the new facility, to make the transition easier on mom (if the new facility is in the same area) she may be able to keep her same team. Ultimately she has already told you she doesn't want to live with her children. You originally asked what moral obligation do you have regarding her care, you are caring for and about her by making sure she has the care she needs. Keep caring for her and loving her, know you are making a wise decision by ensuring she has the care she needs when she needs it.

Moral obligation? NO!! Your question implies that you really don't want to take on this responsibility but feel obligated and you want our opinion. Caregiving is a voluntary responsibility. So far it's all votes for a Medicaid facility. I concur. Grant your mom's wishes. You'll be glad you did.

"she did not want to live with one of her kids"

Follow you Mother's values - listed in the above sentence.

Take the Medicaid option with a clear conscience.

Maybe it sounds harsh but would a Medicaid facility be so bad? I'm not sure how any of that works but I think if you and Sis don't have the finances and can't afford to keep her where she is; and she doesn't want to live with you, then what other option is there.

I would choose Medicaid. You state that you are fearful. Please don’t take on this responsibility.

I would also respect her wishes of not wanting to live with her children. I love my children dearly but I would not want to live with them. They deserve to live their own lives.

Best wishes to you and your mom.

If she stated that she did not want to live with you, then accept it and be grateful she is so kind and caring you you! My mom does not live with me but expects me to move 800 miles to her in a state I hate and take total care of her when its time. She never once asked me how I felt about that, our relationship is not good. She keeps giving me instructions of how to whipe her butt when its time. This situation would not be good for either one of us....I'm afraid I would be in over my head and be mean to her. She's a bear to deal with and very demanding. Find a good place for her, visit often, and bring stuff she loves.

“She did not want to live with one of her kids”. If she were still cognitively intact, she would not want to live with one of her kids. Why would you assume there should be or would be, any difference now?

As mentioned previously, both dementia and brittle Type 1 diabetes will continue to increase her need for prompt 24/7 medical care as she ages.

Your MORAL OBLIGATION is VERY CLEARLY NOT to have her live with you. Relocate her to the Medicaid facility, visit as often as you are comfortably able to, and continue caring for her there without attempting to burden yourself with a very misplaced sense of guilt.

You are able to do just what she wanted. Be at peace doing it!

I think it's important that you honor your mothers wishes of not wanting to live with any of her grown children. Time to apply for Medicaid and have her moved to the nearby facility. If she's under Hospice care now, she will continue under their care when she moves. Grown children should never have to pay for anything for their aging parents, unless they really want to. You have your own family and expenses, you shouldn't have to take on any of your moms. That's why Medicaid is there, to help people when they can no longer afford their care. Best wishes.

I dnn't believe this comes down to obligation. I believe it comes down to what you wish to do and what limitations you have. I could not give in home care; I was a nurse. I could do shifts, but 24/7 care of anyone would break me in less than a week. So I wouldn't consider that.
As you taking on paying for this care, I would say only if you are independently wealthy. You and your sister should now be saving for the care that you will need in a world going forward. It is no time to pay for the care of an elder who would/could live a decade or more.
If you have been on Forum for any amount of time, reading postings, you will understand more what you are considering taking on. I myself would advise against it. But you must make your own decision. If your Mom will have to move from her facility in ANY case, this is a good time to give it a try; I think you would need to make it clear to YOURSELF, your Mom, your Sis and all others that this is an experiment.
Wishing you good luck. Only you can make this decision.

Your mother has stated her wishes not to live with her grown children. My dad had the exact same adamant wish. He always told us he’d seen it ruin too many relationships. I remain grateful for his wisdom. My mother spent four years in a nursing home, at first private pay with a long term care policy, and when that ran out, we went to Medicaid in the same place. There was zero difference in the good care she received whether it was private pay or Medicaid. I’m convinced the staff didn’t know which residents were paid which way, they simply provided care. Good places do have have “Medicaid beds” I hope you’ll honor your mom’s wishes and be her advocate in her new setting. Every resident in a facility needs family to oversee the place, have eyes on the care, it’s an important role in caregiving. Wish you both the best

Apply for Medicaid and get her placed into a nearby SNF. Unless you have a LOT of experience with end of life care and moderate dementia, I'd say it's a no brainer to put her into the hands of others who are trained to care for her and also have the right equipment, etc. My own mother lives in a Memory Care ALF, has moderate dementia, and will be running out of money sometime in 2021; I have no qualms whatsoever about applying for Medicaid to have her placed in a local SNF that we both think is quite nice. I am in NO WAY capable of caring for all of her needs and issues here in my home, period. No guilt about it, either, that serves no useful purpose. I've spent almost the past 10 years taking care of my parents needs and finances and have done my part to see that they've both been properly cared for. I call daily and visit every Sunday (for a window visit when weather permits).

So sorry you are going through such a difficult situation. Sending you a big hug and a prayer that find acceptance with your decision, whatever it turns out to be.