Any advice about in-home care for Medicare patients?

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Help with bathing and dressing.

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Lolly, you call APS at your county social services and have her evaluated. OR you pursue Guardianship through the Surrogate's court. Soon.
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The above was a question, not an answer.
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I am originally from Canada and am shocked at how the govt does so little for their senior population. My mother was fortunate that my dad worked everyday and overtime for her to live in a very nice home and accrue a fair pension as well as gain access to money owed him him by the German Govt along w. her SSI. However unbeknownst to all of us, she had been gambling at the local Asian 7-11 where she had actually won $40,000 which she had to pay taxes 10,000 and gave my brother and myself everything but 1800 from the 30 left over. We still did know there was a problem until she called one day and said that her lights were going to turned off. I was going to school for my masters in ED. at night and teaching during the day. I rarely had time to pay attention to me. But that made me race over to look over her books and sadly I found a book with writing in it that was not legible and paid her bills for that month and the next with our money until other arrangements could be made. My father who was at the very beginning of Parkinson's and already had a triple bypass would have lost his mind. Being German, he had always been proud of his and their accomplishments and that they went so far from nothing after the war. He also ensured that my grandmother (mom's mom) always had a life with us till the day she passed on. I searched Mom's home and found literally 1000's of lotto tickets and these were turned into the IRS and later found out that she then was beginning to hide her activity when I took over. She was so over her head that we felt she needed to file bankruptcy and we were able to do so wo Dad's signature due to the lawyer's well- known status in our city. We were luck to sell her house in a day and planned for her to come and live with us. That worked for a week. Not being used to house rules- we asked her to smoke away from the entrance to the home. We gave her an entire floor and allowed her to keep her cats. But no she refused to smoke and childishly would blow it into the house and the stench of the litter boxes smelled our entire house up. I was livid. I was trying to help her and being treated like dishrag! She said then that she wanted a place of her own. I knew she would never know how to go about this not could she live in a house as she was 73 yrs old but she could not afford help as after selling her home and paying all he debtors she only had 95,000 left and on a daily basis was going out and playing the tickets and the lotto machine, taking at least 10 100 dollar bills out. So by July I found a lovely condo, furnished it, decoarated and painted it. I then bought her a brand new wardrobe that was practical and age appropriate, bedding, etc. She was also given a budget, took her to an GA meeting and put a binder of information together for her. But that was all in vain as I followed her after the GA meeting and the first place she went was back to the 7-11. So then I realized she could not have cash and checked with every establishment in the phone book and online and finally found one that she went to and they agreed( had them sign a document) that agreed to never give her cash for a card that she could use for only food. And Thankfully this worked. She was angry but I had no choice. I bought her a condo and she lived in in for 2 years during which she flooded it twice letting the water drip slightly from the sinks In the bathrooms so they could drink water they way she thought they liked to. At the end of the 2 yeas we had to replace the flooring under the carpet and the carpet and her AAA in- surance was going to go up and she could not afford that on her budget and lucky for us she go into a fender bender and called me and asked me if she had car insurance and could not remember where. That is when we had our opportunity to place her in the Savannah Commons. Even though we should have put her in the memory care unit, I could not afford it with her small pension and somehow she believed that Jay had money to burn and would take care of it. It was all so insane. After a year and a half in the open area, she was moved into the memory care unit where she stayed until she became unable to move her arms or legs, was incontinent, and in the last 6 months lost the ability to speak. It was a long slow was to watch your mother die. These commercials that talk about "A Place for Mom" or these movies that try to depict what it is like to have a loving member disappear behind the shrould of Alzheimer's are still so lacking in the reality of what actually occurs in the home. I watched it all and no one can ever imagine the complexity of this disease and the treatment they receive depending on the area of the country, the level of companssion and education of the aides and nurses and what type of mood they might be in. I was a counselor that worked initially with the indigent and individuals that lived on the street and others that should never have been released from the mental institutions they were safe in and the public was safe from them. Please tell me what is on the horizon now for my mother in law who has macular degeneration in one eye and a cataract in the other, is bent over so horribly from degenerative arthritis, and is now going into the 2-3 stage of dememtia. She can not recall or use new information and is insistent on staying in her home which is filthy with a capital F, has 2 floors, the second being quite steep. It is obvious that she is not tending to her grooming by the smell that permeates around her home. She refuses to sign an Advanced Directive or make any altercations to her will should her son pass away before her. She and I have never been anywhere near close and she is so narcisstic that in the past 12 years when we had to spend Christmas and Thanksgiving together, I had to put the gears in motion, watch out for my mom in her state, and neither Linda nor my husband did very much to help me. All the conversation was, was about Linda,Linda, LInda as it has been throughout her life She never even asked me about my hip surgeries recently as if they never had occurred. Jay is only doing his time to get his inheritance from her as she literally stole it fromher other son who was under the influence of alcohol and drugs when he signed a will she quickly had drawn up omitting Jay from this discourse at all. What do we do???
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The MD can order 60 days of home assistance under Medicare. After that you are on your own and it is not cheap.
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There are only two circumstances that Medicare will pay for home care, which I have described below. In summary, unless your father is eligible and wants Hospice services, Medicare will not pay for the type of assistance you mentioned: help with bathing and dressing.

In response to your question, I would try any of the following resources, if you haven't already:

(1) If your father is eligible for Medicaid, most states have an In Home Suppport Service (or similar name) that is complete services as you and your Dad determine is needed, including personal care assistance, complete paid by Medicaid. You would hire your own caregiver and the state would take care of payroll. A family member can also be paid by IHSS.

(2) The Caregiver Resource Center that serves your county has many programs to assist seniors, and they can provide any information out community resources available. Don't know what state you are in, but here is a link for California Caregiver Resource Centers: http://californiacrc.org/californiacrc/jsp/home.jsp
If you are in Montana, as indicated by Gigi11 above, then the following link will take you to the Cascade County Agency on Aging, which Gigi11 refers to:
http://departments.cascadecountymt.gov/agingservices

(3) If he is not eligible for Medicaid (but could become eligible, depending on income) and does not chose Hospice services at this time, you may consider a home health aide hired privately, if he can afford it. A person you hire yourself with very limited time just for what is needed, is more affordable by the hour than going through a home health agency.

Medicare information:
Medicare will only pay for home care visits for professional services, such as physical therapy, and only if coming out of the hospital and ordered by a physician. This does not help for assisting with the activities of daily living such as help with bathing and dressing.

Medicare will pay for help with bathing and dressing and any other personal care or medical need if a person is eligible and chooses to enroll in Hospice services.

My husband is currently on Hospice due to advanced Alzheimers disease. He formerly had received both adult day care and home care (In Home Support Services) paid by Medicaid. I am the primary caregiver and also being paid by IHSS. As you know from your own experience with both your parents, family caregivers need all the support we can get.
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If Medicare doesn't help, you might try your Cascade County Department of Aging Services. Sometimes grant money is available and/or they could refer you to other possible sources.
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Talk to the doctor. Home care needs to be ordered by her/him.
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