Is there a cost effective way to get my Mom additional care?

I would go back to the social worker at the skilled nursing facility and find out what other resources there are for your mother. Also check with your local Area Agency on Aging. They should be able to point you to some other resources as well. When each of my folks were discharged from rehab facilities following surgery, it took about two weeks to get all the pieces in place for follow-up home health aides, including occupational therapy and physical therapy. The follow-up care lasted for 12 weeks for PT. Neither of my folks needed help with OT or assistance in bathing and dressing at that point. Hope this helps.

Grandma Lynn gave the answer we would have. But in addition, there is a federally funded program that places elderly companions with elderly who need a little help called Senior Companions. You might want to check them out as an option, especially to see if they are available in your location -- http://www.nationalservice.gov/programs/senior-corps/senior-companions

You don't mention your mom's income. If she is poor, there is a program called the Alzheimer's Initiative that will provide 8 hours of care per week for an amount of money that is a percentage of her income. You can't get anyone to come for 1.5 hours unless they get $20/hour, and 1.5 hours is not enough time to get much done. I have hired a retired nurse to help me take care of my mother at home. This way she does not have to give up her own bed, her luxury sheets, her money that she wants to spend on Hair Color Experts and new clothing, a porch that overlooks the water and often has lots of sun for her to enjoy while she reads a magazine. In my opinion, private care is ALWAYS a better option than any assisted living or nursing home because you get one on one care. Nursing homes have one nurse per 12 or 13 patients and the patients who poop in their underwear do not get changed and cleaned up right away. My father was in assisted living because he was too sick to stay home with me. They tortured him until his doctor finally gave him a prescription for hospice, which Medicare will cover. He paid full price for the assisted living facility while others paid nothing (were on Medicaid) and he still got less attention than those who pay nothing because he insulted all the nursing home staff so they ignored him as much as possible. Agencies are expensive....so what I would do, even though it is not legal, is pay someone under the table to do the job and then all the money goes to the nurse or CNA instead of to the agency. Good luck.

You live in an expensive area in your state. The first question is whether you or your mother are willing to pay for a private home health aid. I am sure that there are many home health agencies in your area who provide private care. Then there is the option suggest by Beverlyhegdal where you pay the person directly. Both options have advantages and disadvantages.
People wanting private care often resent paying an agency because they perceive the owner is taking advantage of their clients by charging for overhead, including insurance, FICA, recruitment, payroll, scheduling and training. Thus they employ a private care aid, which they recruit by themselves and then pay them under the table to avoid the costs of being an employer. This option leaves both parties at risk, especially if there is a major accident.
The second option works if you are able to recruit, train and management what is essentially an employee.
Neither option will ensure that your loved one will receive the type and level of care you want for your loved one.

Sherry1anne
I resent and dispute your characterization of agencies. You should only make derogatory statements if you have used every agency in your area. As an agency owner, the people who resent agencies are generally those who think they can do it cheaper by themselves.
Unfortunately, many caregivers are in desperate financial situations and therefore willing to accept the conditions offered by those who want to pay the least possible amount for care by paying under the table.
The belief that you are in charge is often a fallacy held by those who want to pay as little as possible. In reality, a loved one's disease is often the control factor in hiring a caregiver.

Sweaping statements like those beverly made are not true. And yes you can find good caring people in both private and agencies. Saying ONLY family can provide good care is very insulting to all the hard working caregivers out there. Don't lump everyone in a big batch, do your homework that is what any reasonable person would do. And the post above has conflicting statements throughout.

Just remember, if you are "paying someone under the table" that Medicaid will consider those payments gifts if you apply for services later. Your parent will also not be able to include those payments in any medical deductions for income tax purposes.

The NH should have had the Dr write orders for home care.. Medicare will pay for follow up.. She will need to have a follow up appointment with her regular Dr and he will also need to get info from home care agency so medicare will pay..

Her gp can also prescribe home care.. When home care comes for intial appt. they will go over her finances to see if she qualifies for financial need..Make sure someone is with her for the intial appt. They ask a lot of questions and will ask financial questions..

As for the caregiver you might like to hire, skip the agencies. They are all sharks as far as I can tell. I had thieves, undependable workers who wouldn't show up etc. Check out care.com. I got a great women to come live in with us. If you are worried about the responsibilities of being an employer, go through a PEO. They will handle the taxes, workers comp, unemployment insurance etc. I used Einstein. I think they are a chain or a franchise. I'm in Atlanta, GA You pick your staff and then turn the paper work over to them. You are in charge.

ADCaregiver, as someone who has considered a private hire rather than an agency, not necessarily under the table, it has more logical basis. The nursing care that will be covered by some govt programs is actually more skilled than we require. They won't cover in home care unless the patient needs changing or feeding. We need someone to be there simply because he can change on a dime and we need someone there in the event of an emergency and to also keep him company, a companion. VA only wants to provide skilled nursing care and when they come there is nothing for them to do.