With both of my parents I quietly inserted myself into caring for them once I knew that knew that they were not being compliant with their doctor's instructions (my late mom had Parkinson's with dementia, my dad had congestive heart failure and diabetes).

I started with asking to go to doctors appointments so that I could be better informed. Once they were comfortable with me going/taking them, I asked the doctors how I could be helping them. I brought up points that I knew were obstacles: 'Dr. In terms of making my parents' home safer so that my mom is less likely to trip: what do you suggest?..."

Clear all mats, runners or other small carpets, de-clutter, have safety bars etc...

My parents' house was big, but full of clutter. I tried on my own to clear it to make it safer, but she resisted. After the the doctor's visit, she allowed me to remove some things. But it wasn't after she had a bad fall - over a pile of magazines - that I said that's it: and I organized the home completely.

She was upset at first, but then happy that she could get around easily.

Same with my dad when it came to his glucose levels and watching for wounds on his feet. I am a lab tech, so it didn't come out of left field that I'd be interested in wound care. He might have been more accepting of me taking an interest as opposed to my sister who doesn't have medical training, but I think you could still ask to be involved. And you can learn about how to be helpful.

When I would visit my parents, I would say 'hey dad, let's soak your feet' and I'd get everything ready and I'd check his feet as I dried them off (with his heart condition, it was difficult for him to carry the warm water and bend down to tend to his feet, so I had to).

He had one stubborn wound on his toe that I took care of. I was on it like white on rice. And helped by following the doctor's orders on how to almost get rid of it.

I was their daughter, and there is that difficult point for everyone involved where there's a 'parenting' switch.

You said your mom is 49 - that's relatively young. From what you've said, she sounds a bit like my mother in that it might take one crisis in order for her to wake up to the realization that she needs to comply to treatment and she might need to let her family assist her.

A few positive actions my parents took in their care awakened them, and they got back on a safer, healthier track.

With chronic illness, one of the things you often lose is some of your freedom, your right to choose, and your ever decreasing sense of abilities. It's rough. Sometimes people freeze and let things slide a bit after being diagnosed until something snaps them into fighting it.