Who Do I Contact?

Well I suspect there is the legal answer, and then there's what I'd do. 

First the legal part...    I'm not 100% on this, so a couple phone calls are in order.(I'd call a local hospice organization who would be sure to know the answers.)  This may vary by state, but I think that a person has to be legally declared dead - which would happen by a doctor, or hospice agencies can make this call if the person is under hospice care.  So a 911 call and transport to a hospital to be declared would probably happen in your case.  I don't think its ideal.... so the alternative.

What I would do?  I'd have a conversation with the daughter.  Is she in denial about her mother's condition?  Can you talk with her about the reality of the situation?  If the end is near, then she should probably call hospice, talk about options for end of life, funernal homes, etc.  Hospice can help you both make a peaceful and thoughtful process.  

I'd really like to know more too, so please let us know what you find out! 

I absolutely do believe that the daughter overwhelms her schedule so that she is too busy to tend to matters regarding her Mom, and that has been the case for as long as I have cared for this woman (over 4 years now) and no doubt reaches much further back than that.  I have tried to delicately raise the subject a couple of times, only to be met with responses such as, "we won't have to deal with that for quite a while" or "we'll look at that situation when it comes up".  Even though I provide her with a weekly care summary and always describe the state of her mother's health, she rarely if ever visits her and I don't believe she understands exactly how much her mother's health has deteriorated.  Since I am with her daily, I can see the weight loss from her severely decreased appetite, the weak state that she is in, and I know from several conversations that she is tired of living in pain and has accepted and welcomes that the end is close at hand.  I have informed the daughter of all of these things, but she just attributes them to old age.

I appreciate the information regarding the hospice.  I do realize that a doctor's signature is required on a death certificate so some medical contact must be made.  Now that I at least this much information, I plan on outlining your comments in an email and sending it off to the daughter and urge her to put her attention to that.  Even if she does not, and I suspect that she will just put it off, at least you have answered my question.  Thank you for taking the time to do so.

oh geez, that's hard.     I'm thinking you might have to be more direct as difficult as that might be.  hmmm  something like....  "You've said that you'd sort it out when the time came, and now my sense is that the time is very close.  I need some specific directions.  Do you want me to call hospice and set up an  appointment for us to discuss the process?  When's a good time for you?"    (and prepare for her to get angry and lose it.)

i'm just throwing out ideas here.  anything grab you?