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My mother-in -law is 77 years and a stroke patient with type 2 diabetes , pace maker, copd, to bed. She needs help in and out of bed, on and off potty, confined to wheel chair. she needs continuous around the clock care due to her stages of dementia.

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Where does she live right now? What income does she have? Who has POA? If she has a low enough personal income and assets, and is living at your home and you are taking care of her and plan to keep doing that, there is likely to be some additional help through medicaid. I would love to know what you find out!
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At 77 your mil being bedfast & with a multitude of significant health issues, she may need a higher level of care that can be provide at home. MedicAID will need to evaluate her both financially and medically to be ineligible for Medicaid CBS - community based services or for IHHS - in home health services or cash & counseling programs that freqfyler mentioned. If your state is going to PACE (which is the format states are moving to)then she will need to sign up for that and they will evaluate her care level of need.

If her level of skilled care needs exceed whatever your state places as the maximum allowed (32-40 hrs) , medicaid will not pay beyond a certain point as that level of care needs skilled nursing care in a facility (a NH). Medicaid pays for NH in all states at participating facilities.

Now mediCARE's hospice benefit could be available to her if it's is determined that she is likely terminal within the next 6 mos. Being bedfast alone is one criteria for hospice approval (my mom was on hospice 18 ms after a hip shatter @ her NH and was bedfast that entire time). At home hospice is a wonderful benefit but limited to maybe 3 - 4 visits of 2 - 3 hrs per week by hospice. Family is fully expected to have someone there the rest of time for caregiving.

Often family use the elders SS & retirement income to pay for a caregiver during the day while they work & family does evening & overnight duty. Your mil has income of some sort which can be used to pay for caregivers whether paying family (you should have a legal personal services contract done so no issues with Medicaid on gifting) or paying a service for caregiving. If this isn't bring done, why not?

If your hope is that there is going to be a program to provide 40++ hrs a week caregiving for mil in your home that the government pays for, well not to sound harsh but, that is just not going to happen. The cost efficiency of doing this at someone's home is not there, much less the ability to have skilled care as needed. 24/7 care = NH.
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That’s a very common question asking about being paid. Majority of grown children do not get paid for caring for their parent or in-law, unless the parent is financially able to pay from their own pocket. If a parent can afford to pay you, the parent might as well hire a certified trained caregiver allowing you to keep a full-time job.

If you live in the States, see If your parent qualifies for Medicaid, the State might allow a trained Caregiver come in to help for a couple hours. Also check to see if your State is one of those States that has a “Cash and Counseling” program to help you out, it‘s worth looking into. Note that each State has their own rules, regulations, and programs.

Also contact your county agency on aging for programs such as Case Management, Meals on Wheels, Adult Day Care, housing, care referrals, etc,... go to the website link below.... click on your State.... now click on the city/county. https://www.agingcare.com/local/Area-Agency-on-Aging

And please come back to the forums if you have any Caregiving questions, we would be more than happy to share our experiences with you, and give you ideas on what to do.
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