A few boxes on the porch are normal. A pile that grows over a week or two is a different thing. It is one of the few signs of trouble that shows up from outside the house, where you can see it in a photo or hear about it from a neighbor, long before anyone admits something is off.
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The pile itself does not tell you the cause. What tells you is what is inside the boxes, what she has opened, and what she cannot explain when you ask about it.
The patterns that matter
Look for four things. The same item arriving more than once, which can point to repeat orders. Boxes that are never opened, which can mean she is not reaching the door or no longer recognizes what she ordered. Items that are opened and never used, which can mean the purchase was not what she meant to make. And orders from sellers she does not recognize or subscriptions she does not remember setting up.
Any one of these can have an ordinary explanation. Two or three together, over a few weeks, is worth a closer look.
Check it without making it a test
If you have access to her order history, with her knowledge and agreement, scan it for repeats and for new sellers. If you do not have access, ask her to read you the names on the last three deliveries, as if you were curious about a gift. Her answers will tell you more than the boxes will.
Ask a neighbor or a nearby family member to take a quick look at the porch on a set day and report what they see, including the number of boxes and whether any are dated or opened. A simple, repeated check gives you a baseline, which a single alarming photo does not.
Watch for the money side
Unknown sellers and unfamiliar subscriptions can also be a sign that someone else is using her card or her name. If the packages do not match anything she remembers buying, treat that as a reason to look at the card statement together and to call the card issuer, not as proof of anything. The steps are the same whether the cause is memory, confusion or a scam: check, write it down, and ask for help with the next step.
What to do tonight
Ask her, in a relaxed way, to read you the names on the three most recent deliveries. Ask a nearby person to send you a photo of the porch in the morning. Write down what you find, the number of boxes and any you cannot account for, so you have something concrete to compare next week.
What to bring to the doctor
Note the specific things you saw: repeat orders, unopened boxes, purchases she could not explain, and what she said when you asked. Tell the doctor the pattern and how long it has been going on. The doctor is the one who can judge what the pattern means, and specific examples help far more than general worry.