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Hi Mary,
We are a small group, so don't post super often, and mostly hang out in chat. Sorry it took so long for you to get a reply. I hope you will see this.
The most important thing in opening a conversation with her is not to make her feel judged - which can be very hard! Focus on safety at first. Does she have clear paths to the 3x it's, working plumbing? Safe clearance around her stove? Does she have a clean place to sleep?
Do not force her to get rid of things, focus on "moving" objects to get those things taken care of first. Focus on the fact that you love her and are worried about her safety. If she is able to let go of anything, even things you see as obvious trash, praise her. "Wow! Your stove looks great now! I'm really glad you were able to get rid of those butter wrappers, and your mail is all in this box for when you have time to look through it. It makes a nice safe place for you to cook."
If her home is not that bad, it is a slightly different conversation, but the attitude and approach need to be the same. And you need to identify a goal that motivates her. For example "I don't care what your house looks like. You recently had surgery and I want to be able to come in and check on you and help you with things. If the house is stopping that, I would love to help you with any parts that are too much for you to do alone, but don't worry about the house for me." Get in first. Be nonjudgmental first. Let her feel comfortable with you being there and safe that you are not going to start taking charge and taking or throwing out her stuff or forcing her into decisions she doesn't want to make. You can start a conversation from there later.
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