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It really varies by state and county. For example, in our county in Michigan, Grandpa could get up to 10 hrs a week of in-home care plus discounted services such as home repairs, lawn maintenance, Meals on wheels, and his medical alert button. That was without Medicaid, just through our Area Agency on Aging. That Agency acts as a conduit for federal, state, and local programs serving the elderly and helps assess and match the needs of low-income elderly.

Through Medicaid, elderly had a few options including two programs for those staying in their homes. Those provided in-home caregiving and adult day care, as well as a variety of medical and dental services. Sometimes there are vouchers to help pay for care in the home or to put toward assisted living. And then there is straight-up long term care Medicaid (ie for nursing homes.) None of these programs paid for night time care at home.

Sometimes there is also help through the VA for veterans and their spouses.

In any case, there may be a waiting list in your state so it is better to act sooner rather than later if you anticipate needing help.
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Provided they are poor enough, and have spend down all their savings. Also...they need to have income below ~$2k per month. Then...they can enter a NH paid by Medicaid. In some cases, Medicaid will pay some small sum for in home care....but it will not likely be for than 4-5 hours per week.
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