New full time live in caretaker. Anyone have advice?

You Mom must be young. Does she collect SS. Does she have any money? If not, you may want to apply for Medicaid in home care. She will need to be under a certain income level. Your income will not be counted.

You may want to ask her PCP about referring her to a pain specialist.

If this gets too much for you, you may want to consider LTC with Medicaid paying. This means Moms SS and any pension will go towards her care. The easiest way to do this is if rehab is offered the next time she is hospitalized take advantage of it. Have her evaluated for 24/7 care. If found she needs 24/7 care, then tell the SW that you can no longer care for her and she needs to be transferred to LTC. Then start the Medicaid application. A SW can help with that but be very involved with the process. Don't depend on someone else to do their job. In my state you only have 90 days once u apply to get what paperwork is needed together, spend down and get the person placed in a NH.

M, I am so sorry that your family is going through this difficult situation.

It sounds like mom is in need of a good facility. They will need what's called a needs assessment. Some places do this themselves and others require a doctor or nurse practitioner to provide. It is a good place to start.

Unless mom has a long term care insurance policy she will have to pay out of pocket for in home caregiver. Her health insurance will not cover 24/7 in home care and will only cover rehabilitation care in a long term care facility after a hospitalization.

The easiest way to transition her is that you tell the hospital that she is unsafe to be at home and they will help guide you to getting her placed and then the facility will help you navigate Medicaid.

If you want to keep her home, I would ask her doctor about hospice. Then interview the ones in your area. Failure to thrive is a diagnosis that should qualify her for this service. It doesn't provide 24/7 care, it provides bath aides and a nurse in home to help her comfortably die. She will not be going to the hospital or doctors to receive curative treatment.

You have some decisions that need to be made. Has your mom ever talked to you about her end of life wishes? Has she prepared the paperwork that gives you the power to help her?

Again, I am so sorry for your family. God bless and guide you through this difficult time.

Does your MIL have an advanced directive? Does she now want comfort care until she passes? Are you her POA and what has her doctor told you about her condition and her prognosis going forward? These are the places to start.
No hospitals keep patients for more than a day or two now, and that counts true even if you have open heart surgery. One quickly leaves the hospital to either home, extended care in Skilled Nursing Facility, or rehabilitation in a Rehab or Long Term Care in Nursing Home.
However Mom has good reason to ENTER hospital through the ER with any of the above you mention, especially uncontrolled pain.
At the instant of entry and every time you speak with doctor or nurse after that, it is crucial that you tell medical personnel that you can not longer "safely care for MIL at home, and will not accept her back into your home". Those exact words. Ask for a social worker to "help us with placement." To "Help us with care choices".
If you do not have POA, this Social Worker can quickly make you "temporary guardian" for your MIL. Then she will find a facility now accepting people, which will be difficult for her in Covid-19 times, (and IMPOSSIBLE for you). She/he will help you negotiate getting Mom on medicaid to help in payment. Be ready to give them a five year lookback on Mom's assets and expenditures (2 1/2 in CA).
If you wish instead to research what hospice care is on the internet, speak with MIL and try to do this inhome you will have a lot of help with care in her last days.
Crucial is that you and your wife recognize and accept, with these diagnoses adn this weight you tell us about, that Mom is likely dying, and crucial also is whether or not you accept that, as going into hospice stops treatment toward cure. Hospice and Comfort care is what is given in a person's last days. If a doctor believes that Mom's Hep C can be cured (there is now medication for this, very costly and not always successful) and COPD treated. That is to say is MIL now "end stage" in her illness, or is there hope with treatment. Whatever the outcome in those predictions by the doctor, her care now is too much for you to accept her back home. Don't allow them to convince you they will help; they won't. In home care is basically paid by your MIL's own assets. Not many can afford this.
You have a lot on your plate. Contact your Mom's doctor. Make an appointment if you are POA. If you are not first get a POA if mom is rational and can give you that permission. Get the information on Mom's current condition and your choices. Make yourselves a list. 1. POA 2. Doctor appointment for prognosis 3. Hospitalization. 4. Social worker for placement. 5. Gather financial records.
Wishing you luck.

"...Can all of these diagnoses for LTC and rehab be done at the ER?..." Please don't treat the ER as if it's a substitute for primary care. No, they cannot make all those diagnoses in the ER. The purpose of the ER is to diagnose what is ACUTELY wrong, not what is chronically wrong. Next time she falls, call an ambulance and she will go through the ER. Once there, ask for both a case manager/social worker and a palliative care consult. Hospice is for people who have a terminal diagnosis, and it doesn't sound to me like your mother has one.

If your mom's PCP is part of a health network, I would start by calling his/her office, and ask if they have a care coordinator on staff or available within the network. My mom's PCP had one who called me (I hadn't known it was even a service they provided) and offered me any help I needed. I didn't really need her services - by the time she had reached out, my mom was already on hospice, and her care was coordinated through them - but it seems like someone like that might really help.

It also seems, especially when talking about elderly patients and diagnoses of illnesses, that one doctor "begets" another - ie: you see a cardiologist, who sends you to a pulmonologist, who sends you to a nephrologist, who sends you to a gastroenterologist, and so on and so forth, until it seems your life is one long visit to a doctor's waiting room. So the other option you might want to consider, if there is one available and your mom is agreeable , is to seek a geriatric specialist instead of continuing with her PCP. They seem to be better at narrowing down what's "necessary" and what isn't, as far as doctor visits and test, etc.

It's going to be difficult for you and your wife, especially with a 5 month old baby. Your first priority must be to your child and wife; there is no shame with admitting to yourself that you can no longer keep mom at home and need to seek a care facility for her. I doubt there's ever been an elderly person who, given a choice of staying home or entering a facility said "oh my, I'd much rather be in a facility than the comfort of my own home." When it gets to be too much to handle, please keep in mind that there are other options for mom.

I wish you the best.

Imho, you may want to consider Hospice eligibility. Prayers sent.

It sounds like maybe your mother would be eligible for hospice. They provide (for us, anyway) a bath aide 5 days a week who will also change her bed, wash her hair once a week, keep her nails trimmed, and if needed, she can help with breakfast (instant oatmeal). If you don't already have a hospital bed, bedside commode, and/or over bed table, hospice provides one for you to use. They also provide diapers, bed pads, no-rinse shampoo and soap, and cream for the diaper area. Hospice is for those whose life expectancy is 6 months or less, and from what you say, she sounds like she would be a candidate. Our hospice nurse also comes twice a week, a chaplain comes once a week to read the Bible, pray with us, and gives communion. They provide a social worker to help work through your questions and give you extra support. Hospice is a free service provided through Medicare. You will still have to do a lot for your Mom, but it will make it a LOT easier for you. Please keep us posted!

M - just a quick response regarding Medicaid. I don't know if Medicaid application is standard across all states, but in Illinois, when you do the Medicaid application there are boxes you can check off indicating medicals bills were incurred in the past 90 days. Be sure you (or a social worker) checks them. The form (or online application) will later ask for MIL's income for those 3 months. Simply fill in $0, as she is not collecting SS yet and her SSDI is pending. Make sure you are keeping copies of all bills and receipts for anything you have paid out-of-pocket. Try not to pay the new larger bills as they can be submitted to Medicaid. I am so sorry for your difficult situation. It is indeed very sad.

If she has Medicare and/or insurance, talk to the doctor about getting some home health assistance. Nurse can visit weekly (maybe more) and there is physical/occupational therapy that might help. Nurse can probably get you info on nutrition to beef mom up a little and help anemia.

Get her a gait belt (she wears around her waist and someone can hang on to the belt as she walks) if she needs assistance when walking. She cannot open the plastic daily pill sorting boxes? They are much easier than opening a pill bottle. You can also check w/her insurance to see if they will do pill packs for her meds. All pills taken at certain time of day are sealed in a pack together. A bedside potty chari (if she can manage a short transfer) may allow you to sleep at night without having to walk her all the way to the bathroom.

You can also talk with doctor about hospice type assistance and palliative care to help with her comfort. If she really needs to be in a facility for round the clock available medical care, the doctor can answer those questions, too.

It sounds like she would be eligible for Hospice. You would get help and equipment that you need to help her. Medicare covers Hospice so you would not have any cost.
That does not address the problem that you have with a house bursting at the seams and caring for 2 vulnerable individuals.
By the way if/when she falls call non emergency number and ask for a “lift assist” the Paramedics will come and lift her. If there is no transport to the hospital in most cases there is no charge. They are trained to lift someone without hurting themselves or the person being lifted.