Mum 83 refuses care home but what are the options?

If your mum has no dementia and has the ability to make her own decisions about her life then it's time to throw the discussion back to her. There's no magical solution to this one. She's not going to get back to full health if she has COPD, so it's time for her to make her own adult decisions about her old age.

If she doesn't make any proper plans she runs the risk of events taking control of the situation and an emergency making the decision for her. If she's admitted to hospital she could end up going into whatever care home has a bed. Would she consider moving to sheltered housing?

Been through this with Dad.

They will only get frailer, and changes/moving gets harder as this happens - it's better to do things too early than too late. We had care in 4 times a day, but it was sods law that Dad needed the commode/had a fall when no one was around. It's really diffcult keeping someone at home when they're ill (Dad has got cancer)and it's not just general aging.

My only regret is tiptoeing around the issue when we should have confronted it head on.

It might help to break down the things that will need to happen for her to stay at home long term. So, if she can't get upstairs, does she have a downstairs loo so she could have a bed downstairs and stop using them? Or would moving downstairs mean a commode and so carers morning and evening to empty it (totally possible). If she could get to the shops etc if she could get to the bus stop, a mobility scooter would let her get out and about - might need a shelter for it in the front garden or a little ramp.
A cleaner once a week might be a good start to having someone come in and help her change her bed and so on and you've broken the mental barrier of her having someone come in.

Your mum needs an adult social care assessment who can look at carers/ finances etc. Ultimately it's her choice and YABU to be clear to her how little support you can give her.

People are allowed to make decisions that other people think are poor and that are stressful for others. It may just be that she needs to come to terms with the idea in her own time so she doesn't feel like she is being 'put in a home' which is really dehumanising.

I don't think anyone wants to move into a care home. However it is still the right thing when a situation gets to a certain point. Being able to visit your mum and have proper quality time with her, is very different from being exhausted in a caring role.