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My mother will be 89 soon and has early stage dementia. What do I need to do to get Medicare to pay me for her care, instead of paying a stranger?

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Sorry, medi-care will not pay you. However, if mom is on medi-caid, your county or state will likely have a program that will pay you. Good luck.
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Not that I am aware of, though some states are trying to change that.  I got advice from an Elder Lawyer about getting paid by my Aunt's funds, and how to keep records in case she ever needed Medicaid.  The VA has some plans for pay with homecare, but we never got that far.  She was in the Army in war time as an RN, but sometimes there is VA help for spouses.

Strangers sometimes become friends.  Only one caregiver I fired.  Another became a family friend and is now helping husband and me, yes for pay.  She well deserves it.
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Medicaid, not Medicare, depends on the state whether or not they will pay a family member anything at all.

Keep in mind the stranger, will have training, experience and will give you a break.
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