She lays in bed for up to 12 hours and will not get up to go to the bathroom because she wears depends, which, after 12 hours, makes her drenched—we try to explain to her that this is not good for her skin and will eventually cause breakdowns. She does not eat unless cooked, and we sit the plate in front of her. She has slipped down (not fallen), but uses these incidents and states, "I do not want to fall." She has home health twice 2x week for physical therapy and an aide that comes 3x weekly to assist in showering. What else can we do?
Then I would have her evaluated for dementia as it definitely sounds like she has some mental decline going on.
It also sounds like her care is really beyond what you or anyone else should be doing in the home.
Your mom really now needs to placed in a nursing facility where they will change her diaper every 2 hours or so, and will get her out of bed in a timely manner.
Maybe if she knows she's going to be placed in a facility, it may motivate her to do more for herself at home, who knows? But I wouldn't hold my breath on that. She really needs to be placed sooner than later so you and your family can get back to just being her family and advocates and not her caregivers. And if money is an issue you can apply for Medicaid for her.
I wish you the best in finding the appropriate facility for your mom.
The truth is that if she is COMPETENT and ABLE then it is time for the "sit-down" in which you lay down the law. I would simply say:
"I so sympathize mom with your exhaustion and your feeling you don't want to try anymore, but the truth is that you will not be able to stay with me if you make yourself, for the most part bedbound. We will have to seek placement and care for you if this continues".
I am sorry, but it is the simple truth.
You may first want to discuss with her a full physical and a discussion with MD about low-dose anti-depressant.
The truth is we get tired. I am 82. We get VERY tired and quite easily and I still can remember my Dad saying he loved life, had had a wonderful one, but at his early 90s and still well he was quite simply DONE WITH IT. He was simply EXHAUSTED with it. I so now identify with him. We get ready to go, to be honest. Why stick around for the further losses? For the next Survivor season on CBS? Really. We have been here and done this. We don't see a whole upside ahead.
I remain very active, but the reason is that I know as an old retired RN, if you stop at this point you are down for the full count. You HAVE TO keep moving. You HAVE TO find interests. It is not a luxury you can afford to simply go to bed and pull up the covers, tho that's what my dad wanted. He would laugh and say "I am SO ready for the last long nap."
Then after a while in AL she stopped getting out of bed. No real medical reason. I think depression, anger, childish rebellion. Now she's in LTC because she lost her muscle mass and can't walk. All this behavior was an indication of her dementia, which starts very gradually and then by time close family members really see it on display weekly or daily, means it is already moderate dementia, not mild.
Your Mom may need meds for depression to start with. This may help make any future changes possibly go better. Hopefully she has a PoA (is it you?) Once she gets a formal diagnosis she may no longer be able to legally assign a PoA so you need to have this happen in the right order.
When you ask, "What else can we do?" I'm wondering what is the "do" part that you haven't already tried? Perhaps you are in a little denial about her cognitive impairment. I get it... it takes a while to internalize this reality. There's no cure for dementia so you need to think about how much more "doing" you are wish to participate in daily? It may be time to ramp up her in-home aids and then think about whether a MC facility may be in her future.