She is 84, still in her own home, and increasingly says she is fine when she plainly is not. I visit every six weeks. What do people in my position actually do first?
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Three states away is the hardest version of this, so be kind to yourself about it.
What I would do first, before any decisions:
Write down what is actually happening, with dates. Not impressions — specific events. Missed pills on the 4th, burnt pan on the 11th. It turns a vague worry into something a doctor can act on, and it stops the conversation being your word against hers.
Find out who is already involved locally. Neighbor, church, hairdresser, the pharmacist who sees her monthly. That informal network usually knows more than family does.
Get the paperwork sorted while she can absolutely still do it. Power of attorney and a health care proxy are far easier now than they will be later, and doing it while she is clearly capable protects her from being second-guessed.
Ask her what she is worried about losing. Almost always it is driving, or the house. If she believes you are not trying to take those away, you get much further.
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Adding to the paperwork point: get a durable power of attorney, not a general one. A general POA can stop being valid at exactly the moment it becomes useful. And have her own attorney handle it rather than a form off the internet — capacity questions are the single most common reason these documents get challenged.
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