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She needs bath help. MIL moved in due to SIL having a massive stroke. MIL is sight limited, hard of hearing, has loss use of one arm and has limited mobility in her other arm and legs.
She is very angry. When I went to see her after my SIL's stroke, it was obvious she had not bathed in weeks. Her clothes, and chair were soiled with feces and urine. The apartment reeked of cigarettes. It took multiple washings to get the smell out.

I need help getting her bathed twice a week. I currently do it but it is struggle. Does Medicare pay most of the cost?

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Please call your local Council on Aging as someone else suggested. It depends a lot on where you live of course because these helpful God-sent people rely on state grant money and I'm not certain but probably federal money too; but they will help you. The help you get might depend upon how much income you have, or it might not. It is very much a means tested program but they will work with you and stretch out every dollar they can provide legally for you. They are especially attentive to the health and well being of the CAREGIVER. They know what you as the sole caregiver are going through. In our case though my Mother has to live in my home, the cost for her aide is based on my stepfather's retirement income. (I believe he pays about $85 a month for 9hrs. of help each week.) But the aide's help and just her quiet (okay, well, not so quiet, but's that okay with me!) presence is worth a PILE OF GOLD to me. It takes a lot of stress off the caregiver no matter how long the aide is in the home. Best of all though my Mother will eat and take her pills for Nikki, when it was very easy for her to say NO to me about the pills especially) Though dementia has robbed her of her ability to speak whatever it is she's thinking, she does to some degree comprehend what's being said , and whenever Nikki is here she finds an awful lot to laugh about. Please don't hesitate to call them. You sound a little "desperate" for help and that's the point you'll be making to them. Because unfortunately you cannot go to Medicare and expect them to pay for this kind of help. You could of course try to have your Mother-in-law agree that some of her check should be used for her care and then perhaps you might be able to supplement the COA provided aide's hours. Another good thing about the Council on Aging is that the agencies who supply them with employees, often employ people who would otherwise have a hard time finding a job. It's a win-win, so don't delay! Good luck!
P.S. Don't be so quick to blame the painkillers at least not until you personally talk with her doctor. Your MIL might have serious pain and is nasty because she isn't getting ENOUGH relief from the painkillers. Also with all of the chronic problems you listed for her, especially sight limited, how could anyone expect her to be perfectly groomed (how could she even bath on her own; I couldn't do it by myself when I broke my hip and I was only in my 50's and in relatively good health but still couldn't make it past the small shower ledge!) and keep her house clean. As for her smoking definitely insist (try?) on taking the cigarettes away from her, using the usual excuses, like you don't want her smelling up your house, or the house to burn down due to a cigarette left lit somewhere and forgotten about) in addition to which NOT smoking will help her aches and pains to some degree, she'll breath better and have more energy..
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Gold, she needs to be seen by a doctor to have her "activities of daily living" skills assessed, or even better, have the doctor order them assessed by an occupational THERAPIST. DRESSING, toileting, feeding, grooming, these are all ADLs.
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Thanks everyone for your answers. Medicare will pay for home help if you are home bound. Unfortunately she told the Dr. that last year she went out to dinner so he said no way. We will have to absorb the cost. She is down to very little money. It is hard to place folks in a nursing home who still have their cognative skills but lack physical skills. Only bad thing is she insist on bad mouthing us to everyone she can.
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Can she afford the in-home help she needs for the next 3 months? Would she qualify for Medicaid?
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Unfortunately my SIL went through a personality change. She began to spend most of her time away from the apartment and drank and smoked heavily. This caused the stroke.

I have already installed ramps and grab bars in a bath. I just need home help for 3 months because we are remodeling a bath to accommodate a wheelchair. Her mind is still sharp but her attitude stinks. I suspect she is addicted to pain killers. She takes 3 a day and I am sure she is depressed. She is angry because I won't let her eat in her room. It took over 6 hours just to clean her room because of the spilled food on the floor.
She wants to eat donuts and garbage all day. I prepare 3 healthy meals a day along with giving her boost, I am rewarded with either tears or the stink eye.

Wish me luck, and thank you everyone for your answers. I have a feeling I will be back soon for more advice.
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Oh, my she should not be living alone. Assisted Living could be a possibility, if she can walk 250 ft unaided and she does not poop her pants. Definitely have The Talk with her MD.
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Goldenmom, oh my gosh, if you found your mother-in-law and the home in that condition then that tells you that caring for the mother-in-law could be very challenging, to a point of exhaustion, which explains why everything looked the way it did.... being a caregiver almost killed your sister-in-law.... you don't want to be next having a massive stroke.
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They will pay for a visiting nurse for specified amount of time. This includes therapy and a bath aide if needed. After that you're on your own and may wish to check into private pay home care or long term care of some sort. A residential care home will be less expensive than an assisted living facility in most cases but do your homework and check them out thoroughly before you commit to any contract.
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Check with your local Area Agency for the Aged to see if they have services that you can be covered by.
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Generally, Medicare does not pay for long-term care–a term used to describe non-skilled personal care such as help with activities such as bathing, dressing,
eating, getting in or out of bed, and using the bathroom. It does pay for medically-necessary skilled care, which is usually available for a short time after hospitalization. Skilled care refers to a level of care that includes service that can
only be performed safely and correctly by a licensed nurse (either a registered nurse or a licensed practical nurse. If she has long-term care insurance or is on Medicaid, it MAY cover part of the cost. Medicare (according to the government website) does not unfortunately cover these home health aide skills.
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