I don't know what's best for my mother and I'm really torn. Any advice?

Things don’t get better from here.

my mom didn’t want a caregiver. I lived out of state. On a visit, I contacted an independent caregiver company. They were super. Gave my mom minimal hours to start. Of course she sent the caregiver home. But I kept pushing, Told her they were coming over anyway. As time went on , my mom needed them more and more and finally saw the value. I also got her a home alert pendant. She said she couldn’t afford it, I told her she couldn’t afford not to have it.

you have to be frank and assertive. You should also start looking at the next step of where your mom will live, when she can’t live alone. It sounds like she’s not far from that… I wish you blessings, my m9m was difficult. If she had only been more reasonable, things would have been better for her…

I think psychotherapy is a wasted effort at this point. Your mother's age group views such things (normally) as a stigma, especially since you say 'she grew up thinking she needs to hide any sign of weakness, especially mental health struggles.' Why then, now, would she be agreeable to 'psychotherapy'??

You should probably go visit mom and see for yourself what your aunt is talking about and look into getting her placed. Of course your are stressed and anxious about the situation, who wouldn't be? If you are POA over mom, then YOU are the one who gets to make these decisions for her if she is incompetent to do so, which it sounds like she may be. Being incontinent, unable to cook and wash herself sounds like she's unsafe to live alone and 'what's best' for her is to have help. Be it in home help or to live in managed care, she needs help. At some point, respecting your mum's will to retain independence has to be overlooked when you KNOW she's unsafe! If/when she falls and gets rushed off to the hospital, it is very likely they will refuse to release her to live alone ANYWAY, and then the choice is taken out of her hands! If you go speak to her in those terms, perhaps she will agree to get the help she needs NOW, before the choice is taken away from her.

I see that you seem to have found someone to help your mom...........good news! I hope it all works out. Good luck!

You are not there and are unable to participate, though happily you do recognize that your aunt is right.
This is going to have an inevitable outcome either more or less disasterous. Meanwhile your Mom is not only limited for mobility, but it seems for mentation at least a bit, and with incontinence, which is a serious problem when you cannot keep up. I am assuming your Aunt is no longer young. Unfortunately she is, while helping and undoubtedly completely overwhelmed, enabling this. Were she to step away completely this would be one and done.
You Mom likely needs now to move into care. I doubt there could be in home care adequate for her staying in the home unless her financial status is fairly unlimited. You and Aunt need now to lay the law down to Mum together. Aunt needs to let her know she cannot go on as she is caregiving, and you need to let her know that she needs to be safe; you are far away and can't help.
I am so sorry it has come to this. And if Mum continues to refuse help I think that Aunt needs to back away and allow the incident that WILL happen TO happen so that Mum is in care and safe. We have seen this on Forum before. I am so sorry you are having problems getting your Mom to accept reality.

Certainly sounds like the time is past for mom to be able to successfully live on her own. I’m glad your aunt sees this clearly, she’s closer and has a good grasp on what she’s seeing. Though it’s hard to feel like you’re going against mom’s wishes, she’s not safe in the current situation. If she’s of sound mind you’ll have to wait for the fall so to speak, an incident that will force change, never easy but will happen. If she’s not of sound it’s time to make the decisions for her, despite the protests. If you and aunt prop her up less, it’ll haste the time that she’ll accept care

Agreeing with your aunt is not disrespecting your mother. Mum can have the wishes she wants, but most of the time reality gets in the way of wishes.

If Mum is competent, you can't do anything. If she isn't, then someone needs to take charge and make these decisions for her. If you hire caregivers, make sure they know they work for YOU, not Mum, and she can't fire them.

Unless her home is wheelchair-friendly, I'd be looking for placement, because she'll be in one very soon.

Your mother needs hands-on help now. She also needs psychotherapy. Try to get the carer (caregiver) into her life first though.
You and your sibling have a talk with her. Ask her if she would have denied the two of you care when you were kids if you said no to it.
Let her know how much it hurts the two of you to see her living like she is in a dirty house, incontinent and unable to keep herself clean, and not eating well because she can't do for herself.
She's your mom and you love her and she needs to know how it's breaking your hearts to see her suffer because she won't accept help.
I think your mom will consider help if you tell her this way.

Don't prop Mom up in her current situation. When Mom can't keep herself clean and safe, she is no longer independent. Life alerts are cheap, but her sister needs to be the responder because she lives close by. If Mom refuses to use it tell Auntie to have Mom call 911 when she falls or needs help. That creates a legal record which you may need to get her into long term care. Taking care of our elderly loved ones doesn't mean doing what they want, just as caring for a child doesn't mean doing what they want. We all need to remember that, but also act with love.

Your instincts are correct - you Mom needs help and living alone is a recipe for disaster. Please hire someone who is a good fit for your Mom. I understand this is a huge undertaking since you live abroad but it's a matter that must be attended to ASAP. Ignore your mother's protests. Anyone would want to remain in their own home with no help from "strangers" so your mothers attitude is very normal. Once she has help and "clicks" with her caregiver, she will see the value in it and her life will improve substantially. This worked like a charm with my own mother - she grew to love her caretaker and looked forward to her being there each day, and all of us were much happier.

your mother needs 24/7 care if she’s a fall risk..she is having trouble with all Activities of daily living (ADL’s). So either she goes to facility or has 2 12 hour shifts of caregivers…which can get complicated since they might not show up & some family member has to supervise, get supplies, pay bills buy food, prepare meals, wash clothes, etc etc etc…it’s a lot to manage from far away. Forget about the psychotherapy..that would be a waste of time…she needs different kind of help. Get her tested for dementia by neurologist.
Hugs 🤗

"needs care but also wanting to respect my mum's will to retain independence"

Aunt is advocating at the 'duty of care* end. She sees it as her family duty to protect her sister. But too much protection could lead to overriding Mom's rights to choose.

At the other end, too much freedom - allowing Mom her choice to refuse care could head into neglect.

Now there is no legal *duty* here. (Unless Mom has been deemed mentally incapable & a POA or Guardian is in charge of her affairs). We are talking more about ethics. Aunt feels it is unethical to leave her home alone when it is clear she cannot look after herself. Aunt has every right to install boundaries & not become Mom's maid. To not enable a *farce of independence*. So she has turned to you with hope for action. But you have no more power than she to force change...

I have been in a similar place.

My LO could no longer self care. It was obvious to others, but not to her. There were falls but no immediate crises of house fire, wandering or med mismanagement. No big crises to force change..

I too felt a moral obligation to not let her stay home dirty etc. I sought a LOT of advice.

Dr noted 'lack of insight' (med term anosognosia). Not saying your Mom has that but may be interesting to read up on.

So that advice would be for your Aunt. She can say what she will do & leave the home help brochures for the rest. Eg Leave a cleaning agency phone number, don't BE the cleaner. It is kind of a life teaching method.
(Obviously not leaving her in a dangerous way, eg without food, water, heating, power).

The big thing will be stay on the same team as your Aunt. She is the boots on the ground & you are both lucky to have her nearby. If you can get a plan & work together you will do well.

If Aunt gets overwhelmed & starts blaming you, try to refocus back to Mom's care. Explain you are as limited as she is.

My LO (who says she lives independent) was described by a social worker as *living alone, dependently*.

That took a while to wrap my head around. Would that describe your Mother yet?

PS
"She takes our advice for a home carer as an imposition and opposes it with all her strength".

If she can change her thoughts to *a home carer will help me stay in my home longer*...

Coz that's the truth.