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How can I get someone to assess my mother in laws home and general care giving needs to see if there are any programs that can provide no cost or low cost assistance? She has been virtually bedridden for about a year and is a great fall risk. She has a husband but he is not capable of keeping up with her ever increasing need for assistance. We do not live in her area and I don't know where to begin to get her the assistance she needs. She lives in Central Texas.

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Try Medicaid. MIL maybe able to get some homcare thru them. Same with office of aging. They may have some aids. If she is bedridden, maybe check out hospice. Medicare pays for the service. Call her primary and ask him what he thinks about this. It may be best to travel there and help in-laws get set up.
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Thanks for all the input. I plan on discussing this idea with my MIL this weekend to make sure she is okay with the idea of bringing someone in for assessing her needs. I'll be sure to warn her to be aware of the possible sales pitches. She is typically still very astute mentally, But physically she definitely needs assistance.
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Hi,

I found this site for seniors in Texas. I hope it will help you in accessing the services your MIL needs.

http://www.elderoptionsoftexas.com/senior-assistance-programs.htm
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Barb, I was really shocked, especially when the so-called visiting physician service showed up after allegedly being told by one of the home care staff that they weren't needed. I had several moments of uneasiness as I thought of two of these people at my father's house, pushing to get him to agree to their services.

What made me concerned as well is that one the therapists was aware of this company, having told me that they complained that I didn't return their calls (which I did). I wondered if she was getting a kickback or something.

I also feel kind of sorry for the home care workers as it appears as though some of them are encouraged to recommend these other outfits.
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Oy, Garden, what terrible stories! I think this is the price of privatization of social services. Here in NYC, this is still mostly a governmental function, although the City does contract with private agencies (think Catholic Charities and various Jewish communal organizations).
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Barb is sooooo right! Since last year's cycle of hospitalization, rehab then home care, I've learned that home care agencies have or are creating business to business relationships which benefit them, and which they're trying to market along with their own services.

I've also learned to recognize the changes in their pitch. Some of them are really quite good - establish rapport with the elder, compliment, joke, be friendly and good natured, then segue into an expanded relationship between them and their business partners after changing the tone of the interview to one of needing literally everything.

If my parent had a dog, they'd probably have someone they'd recommend to do that, at $20 - $25/hour. Seriously, I was surprised at the smiling aggressiveness of the people sent to assess.

I've had to resist an unscrupulous alleged visiting physicians service, changing our Med-Alert arrangements, and having an also unscrupulous alleged "contractor" shoved off on us as part of private duty arrangements.

I need to get out my Sherlock Holmes hat (no pipe though) and be on the lookout for these unwanted arrangements being shoved off on us.
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Please let us know how this works out; we learn so much from each other here!
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Yes. MIL and her husband are finally to the point that they realize they need help and are willing to have someone come into their home. I found the agency serving their county and will call them on Monday to request a needs assessment. Thanks so much for the advice on where to begin.
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In my experience with in-home care, RNs do an initial assessment, and could bring in an SW for the issues of what help is available. I've also gotten advice from one of the Jewish organizations - I don't remember if it's the Jewish Welfare Services or another arm. They're very helpful and just a phone call away.

You can also contact the local hospitals and try to speak with a discharge planner (even though MIL isn't in a hospital), but the DC's are usually quite busy and might not have the time to provide advice.

County governments also often have lists of sources, and a health department staffer might be able to offer some guidance on how to get an initial assessment.

Is there any family in the area who are familiar with MIL's medical issues, and might have HIPAA authorization? If so, a geriatric doctor could be contacted, but would probably have to establish a patient relationship before ordering a care assessment.

Does MIL ever get out for medical visits? If so, that/those doctor(s) would be the first ones I would contact.

There are "ambulettes" that could take her to a doctor, but I would call some geriatric doctors first to see what suggestions they could make.

You don't mention her medical issues. I'm wondering if EMS could also take her (on a non-life threatening basis) to urgent care or the ER just to get the ball rolling on an assessment (assuming she isn't able to get out at all to see doctors and that professional help is needed for that).

I've gotten a lot of help from the Alzheimer's Assn. in locating resources, even though my parent doesn't have dementia. They have a very good response team and knowledgeable staff.

I'm learning about a different approach by the Area Agency on Aging. They've created a "Same Address" program with goals of keeping people in their homes as long as possible. It's a diversified program, but there definitely is a push to use their services.

What someone should be aware of is that they ARE in fact marketing their services, sometimes w/o focusing on the basic needs and services that address those needs, rather than a broader range of services. The sales pitch is subtle, initially.

There's also the VA, if your MIL's husband was a veteran.
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Each County in the US has an Area Agency on Aging. Look on the website for MIL'S area and contact them.

You are asking for a "needs assessment". Will mil and husband allow "strangers" into their home to help?
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