There is a particular kind of 2am where you lie awake running the same arithmetic. She asked to stay in her own house, in her own bed, in her own chair, and you said yes. The question is not whether you meant it. The question is whether the yes you gave still fits the life she has now.
Local option: New Plan Care gives families in the St. Louis area in-home help so a parent can stay home: companionship, help with bathing and dressing, meals, and overnight care. Call (314) 405-0887.
The promise had terms nobody wrote down
When the promise was made, it almost certainly rested on facts that nobody said out loud. She could get up from her chair on her own. She could manage the bathroom at night. Someone was close enough to answer the phone. Someone was doing the driving, the shopping, or the calls that kept the week running. Those facts are the terms of the promise. When they change, the promise does not announce it. It just stops being true, and you are usually the one who notices, at the wrong hour.
Take ten minutes on a day that is not a crisis and write the terms down. Do not write the feelings. Write the facts. On the day you said yes, who was doing what, and how did she manage each part of her day? Keep the list somewhere you can find it.
Check which terms have moved
Go through the list one line at a time and mark each item as still true, changed, or unknown. Be honest about the unknowns, because they are where the 2am questions tend to live. Look for change in five places: her body (getting up, walking to the bathroom, reaching what she uses every day), her nights (how often she wakes, whether she is less steady or less clear in the dark), her meals and fluids, the people who were helping and whether they still can, and your own availability.
A single changed term is not a verdict. It is a question for the people who can answer it. Rewrite each changed term as a question you could bring to the care team or to her doctor. For example, instead of 'she is slower now,' write 'what has changed about how she gets up, and is it expected at this stage?' Questions like that are easier to act on than a general worry.
Ask what would make the promise true again
For each changed term, ask two things. What would have to happen to make this true again? And who can make it happen? Sometimes the answer is equipment or a rearranged room. Sometimes it is a scheduled visit from someone outside the family. Sometimes it is a conversation with her doctor about what is changing and what can be done. Those are different kinds of answers, and a medical question should not be handled with a grab bar or a family calendar alone.
Notice which answers depend on you alone. If nearly every fix ends with your hours, that is information about the plan, not a measure of how much you care. A promise that holds only because one person keeps stretching is a promise on borrowed time, and it is worth saying so plainly to yourself and to the others who share the load.
Have the conversation she is entitled to
She asked for something specific, and she is still the one who gets to weigh the trade. Tell her which terms have moved, in plain words, and ask what matters most to her in the change. Some people would rather accept more help than lose the chair. Others would rather accept a different room or a different routine than more help in the one they know. Neither answer is wrong. What makes the plan hold is that she knows what is being traded, rather than having the trade decided for her in the dark.
When the promise needs more than family
If the honest list shows that the terms have moved past what the family can carry, the promise is not broken. It needs a larger set of hands. A non-medical caregiver, hired in the home, can help with daily routines and can give medication reminders or pick up prescriptions as an errand. Decisions about medicine, including what is taken, when, and how, stay with the family, her doctor, and her pharmacist. Keep that line clear when you talk with anyone you bring in.
If you are not sure where to start locating that kind of help near you, the local help page lists the kinds of support available for keeping her home. If you want the full order to work through these questions, the start here page lays it out.