X-Border Caregiving?

llonandes

Hello Everyone. I’m having a tough time wrapping my mind around the realities and implications of what my soon-to-be 75-year mom and all of us would be going through with her Dementia. As a younger lady, and even after my dad passed (almost 12 years ago), my mom has always been independent and bold. And she expects everyone also to be strong & deal with life.

She couldn’t stand both her daughters-in-law and always pushed our families away until disaster struck. My dad was diagnosed with a rare form of Cancer at 63 and passed away in the next couple of years. She mellowed down and was open to having the families around. Again, not a big fan of enjoying her grandkids and/or living with us. She remains stubborn and lonely. Most of her other relationships are highly suspicious and not at all trustworthy. She’s seen too many hard times to trust “outsiders” to help her. 
We haven’t formally diagnosed her condition with a neurologist. One part is that she’s terrified of what a doctor would tell her and potentially prescribe for her. The other part is whether any of that diagnoses would help her live a quality life. She has seen first-hand her older sister go through those routines. Her sister, a few years older, has been going through the same journey for almost 5-7 years now and is currently limited to 100% home care. My aunt's condition is severe; she doesn’t make any conversations or even recognize her kids anymore. She’s mobile at home and resigned to full-time care.
My mother lives alone in Mumbai. I’m based in the US, and my brother is based in the UAE. Due to proximity, my brother has been visiting her more often than me. My brother tried to take her to his home in the Middle East, but she insisted on returning in two days. Being in a new location disrupted the life pattern she was accustomed to. Staying by herself for many years, she had developed a routine: going to church every evening. She walks to and fro, about 15-20 minutes, to church and back. She accounts for that as part of her exercise and feels good about keeping up with it daily. She also encounters familiar and friendly faces that she interacts socially.
At home, for the most part, she enjoys sitting on her bean bag on her 5th-floor enclosed balcony. She turns on the radio or TV for noise. She read the newspaper. She tries to keep the home clean, the best she can, without a maid. She washes her clothes and puts them on the line to dry. She enjoys chocolate and sleeps reasonably well. 
Her condition has been getting worse. A lot has happened in the last six to eight months. She’s lost a few cell phones that my brother dutifully replaced. She’s forgotten the house keys that neighbors helped her break door locks and replace with new ones. She’s stopped cooking for herself, instead buying food from out & mostly microwaving. Some days she survives on fruits and snacks. She argues that, as one grows older, you don’t need a lot of food. She refuses any kind of tiffin service. Financially, she doesn’t count cash anymore and has no credit cards, which is good. We ensure she has a reasonable amount of cash stashed in different places for her to use. 
Our biggest challenge today is getting her to accept some help. If we find the right type of caregiver, we need her to accept that the person will be around, at least during the day, to help her with small tasks. Another concern in India is entrusting a stranger to care for a mom. Ideally, she would not mind if we were around her. But we can't now live with her because of how we chose to build our lives abroad. Neither would she be willing to live with either of us in a foreign land. As the prospects of her memory and her physical condition deteriorate, we will be left with little choice. 
I’m hoping someone here can identify with our situation and help us brainstorm ways or means to provide care, either cross-border or be able to help us make a critical life decision to move back to India. In Jan this year, I spent about two weeks with my mom (1:1) in Mumbai, the best two weeks of getting to know the older mom and listening to all her stories she remembers. It was tough leaving her back. Today, she invited me to come and spend a few days with her. She forgot I was there a couple of weeks ago.

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