Mom with Stage 2 dementia will not go to nursing home

It was 4.5 months from what point? That’s quite fast for decline. Do you know what caused the dementia? It must be so hard on the family. Glad you have her in a place that can manage her needs.

Sorry that was long and likely confusing. She had a rod placed from hip to knee on Jan 4. She had post-surgical delirium for weeks. Went to rehab and AL and fell again and broke her femur. Back to rehab. BUT finally after 4.5 months she has gone from bedridden to wheelchair and 2 assists, to walker and now rollater. Jan 3 she was in Independant living and had meals provided but took care of herself otherwise. Two meds (for cholesterol and BP). Now she is in memory care and is very confused all the time and has little ability to care for herself. It is SO sad how the surgery took so much from her. They were very cautious with anesthesia and used epidural type instead of traditional to try to avoid the known affects it has on elderly.
I hope that makes more sense.

Oh and vascular dementia from TIAs in 2018 approximately

@mmodirni
You and your brother are in a tough place.
Yes, get your POAs in order. A must.
I’ve lived thru this for 3 years and my mom passed a year ago.
I flew to Phoenix twice a month and stayed about 3-5 days each visit.
(She had the means, but tax wise, once in palliative care her accountant said the burden was enormously less and it was)
Safetys number 1.
Here are some ideas from my experience and a friend who is currently going thru this with her dad.
Mine: Mom was in a 5 star nursing center, campus in Phoenix.
Skip the 5 stars.. once in palliative care, the stars drop.
If you opt to put her in a nursing home, i suggest you hire a sitter to be with her at least 4 hours a day, at least 3 days a day. Why? Take her outside, accompany her to activities and learn the residence and staffs name.
I hired a recommended college girl from a church I knew in Phoenix as a SITTER, NOT Caregiver . Big deal with nursing home requirements, check with your state. Sitter was like a Friend (because she was) no licensing.
Also see if you can have an echo or other device in either place on 24/7
Sounds redundant, but like you, I was out of state. My bro who lives in Phoenix worked but was useless for help. And he was not POA. Chose not to help.
Your mom must have an advocate who visits often.
I deliberately kept my visits unpredictable. Staff never knew when I would show up. Because I was out of state, It was the best way to see how her care was really managed.

Friend: Has cameras all over the house and outside. Her husband (SIL) stays over at dads place at night. 6 pm til 7 am. Caregivers come during the day.
Air tag or tracking device on him and his wheel chair and consider one in a bracelet or chain around his neck.
Need also an id on bracelet with her name, your bros and your phone number in case she somehow wanders.
Hope this helps.
It IS a tough job and hard on everybody, but mostly the POA.
IF theres a way for bro to have her at his house, or he live at hers certain days that might help.

If you opt for nursing home, be sure you have an out in the contract.
In some states you CAN have a camera in the patients room in a nursing home. Check to see if her state allows it.
AZ does not allow them, hence an echo might work.
Blessings.