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My mother is truly a control freak, very fragile, gentle, and can go from kind to raging horrid in a second. I can't be with her, I'm sick myself, and I live a distance. she doesn't want to leave her home, and is resistant to accepting help, but is in dangerous and precarious position. I want to know more about the availability of home health assistance, its cost, etc...I'm clueless in this area, I so appreciate your help!

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Look up "Area Agency on Aging" in her county. Call them and ask for a "needs assessment". Sometimes it's the Human Services department of the county that conducts these.

You need professionals who will tell you (and your mom) what she needs. YOU need to be there for the assessment, so that someone will let them in (your mom won't) and so that you can gently correct the misinformation that she gives (of course I can shower myself!).

The AAA will generally let you know what assistance is available and if your mother qualifies for financial assistance.

Do you have Power of Attorney for Healthcare or financial? Will she agree to that? You might want to point out to her that if YOU don't have that authority, "the State" can send her wherever they want, if she becomes incapacitated. Would she rather you look out for her interests, or the government?

With stubborn resistant seniors, what sadly happens is that they fall or develop a life threatening illness, end up in the hospital and are sent to a nursing home (wherever there is a bed available at the time).

There is a really good article in the AARP newspaper this week about choosing nursing homes, you might send that to her and use it as a basis for a discussion of planning for the future.
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Molly, just as a start go online and look up social services for older people in your mother's neighbourhood - it may come under APS, or it may be Area Agency on Aging, just be persistent and you'll soon track down the relevant local office.

Then go and have a look at their website and see what advice and information they offer there. If you're happy to, you could then get in touch with them by phone and ask them for specific advice about what you should do.

I hope this will start the ball rolling for you; but do come back anyway and let us know how you're getting on. Best of luck.
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Molly, Medicare in my experience focuses on medical as opposed to social or behavioral needs, but a social worker might be able to offer some suggestions. You'd have to have a doctor script for the service.

As to "home health assistance" and cost, home health care scripted by a doctor can provide nursing, physical, occupational or speech therapy, home health aid and social work. It's usually for about a month if there's been an injury preceding initiation of home services.

Cost would be involed as an issue of private duty care, which is more like light housekeeping, meal prep, ADL assistance, i.e., nonmedical care. It ranges in SE Michigan from $19 to $25 per hour, with a minimum of 3 to 4 hours depending on the company. No script is necessary. It's entirely paid by the individual or family (unless Medicaid is involved but I'm not familiar with any role it might have in PD care).
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Just thought of something else. County health departments have various services as well. I don't recall specifically what exists in my county but I remember seeing something about a nursing visit. I also don't remember if that's a home visit or your mother would have to go someplace.

I also remembered that one senior center has some level of visiting nurse. Again, w/o checking, I don't recall all the details. I just noticed these entries as I was skimming through print-outs of what services were available.

Lastly, when I was trying to find a reliable private duty firm for my father, I contacted the VNA, which had in the past provided excellent post rehab home care (nursing, therapy, social services). In my county in Michigan, some VNA have gone private, and literally disappeared off the face of the earth. Some of the VNA offices remained nonprofit.

One of those could provide me with an aide to puree my father's food. I don't know if a visiting nurse might be available as well, but it's worth checking out. And a script wasn't needed.

A visiting physician service may also have a nurse who can come visit as well.
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