I did not expect them to be present 24/7, but the expectation and dependence on us as sole family is more than I ever anticipated considering my own health and that dad is 104 and neither of us alone or together has the physical strength to lift her if she poos or pees in the depends or on a bed pad. This afternoon, on my own, I attempted to deal with the situation and because she is uncooperative (unsure if she is being deliberate or it is the dementia...seriously hard to tell due to her life long personality) it was miserably difficult trying to get the sheet and bed pad out from under her which were soiled and especially the pair of Depends that the aides had gotten on her which were fully loaded....Hospice leaves a card with your "team" and a phone number that clearly says to call day or night; when that number picks up the message is an off-putting "we're sorry we missed your call...to leave a message etc, push 1, and then you can't but can wait for an operator who will then pass the message on. Today I spoke with mom's social worker whom I think I met the beginning of this week who came across as lacking empathy or understanding. They're big on referring you back to handbook they leave with hints on how to do various tasks, but without considering the capability of family, their own health issues, or lack of training. Some may not even be able to look things up on a computer. I conveyed we did NOT have unlimited funds and I did not intend to spend $20/hr with a 4 hour minimum for someone to sit on their ass and do nothing. ANd did they have anyone to suggest...they couldn't recommend anyhone, but she had a few names families had used before...names I was already familiar with as my agency has a prepared list with a disclaimer ready to share with people. I thought and expected these folks to be at the top of their game. Thus far not too impressed. Especially when I described how we had to call 911 AGAIN; mom had gotten her legs caught in the bed rail to the point I took it down to free them, and then she slid off the bed onto the floor. The fire guys suggested a pad they knew of that goes over the rail; when I asked about that the nurse on call who called back was not sure, and not sure if the company they used had them. She suggested putting blanket over the rail, clearly not comprehending the determination and capacity of my mother to defeat that.. I don't feel very supported by this organization and am most likely going to ask for another social worker. For starters.