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I have an 89 year old mother who NEEDS HOME AID to help with meals, light housekeeping, running errands. She has dementia and early ALZ but she refuses any suggestion of care. She is 90% of the time out of it; but when I try to get doctors involved or get into the discussion; she rallys and says she can take care of herself and if I hire someone she won't let them in. We have discussed many times and she is distrustful of all outsiders -- that they will steal from her. I wish that as part of elder care -- that an elder get an mental evaluation along with a home visit after a certain age no matter their state of health so that they get a better feeling about home care as an option. Maybe as part of their annual physical after age 75 -- they sit in the doctors office and watch a "positive" video on health care options -- home care options so they get comfortable with the idea before its really needed. I hear a lot of stories of where we have to wait until something bad happens before we can force the issue. It seems like that is my option. I've been talking with my mother (when she was mentally strong and fit) for over 2 years including visiting some senior living and AL places near her and near me - just to let her (and I) know what was out there. She seemed open at the time; but as her health declined and dementia set in she is dead set against in home care or moving.