Mom has Dementia and 3 compression fractures in her spine. The insurance co., is offering an at home aid 5 hours a day.

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How do we negotiate more at home hours?

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Are you talking about Long Term Care insurance or Medicaid?
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How do you negotiate? In the usual way: look at your mother's needs, see what ought to be covered by her insurance according to the policy terms and conditions, compare that with the offer proposed, and return to the insurer with a request for whatever you think it ought to be.

Does your mother live alone, though? What happens overnight, for example?
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Nobody provides 24/7 at home that I know of. Time for a nursing home.
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