New full time live in caretaker. Anyone have advice?

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

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.

Have you asked about getting your Mom Medicare on the basis of total disability? If she can’t work she surely will qualify.

Hi M, sorry you have your hands full for sure. You received so much good advice here already. Have you tried asking PCP for home assessment for pain and safety concerns? Nurse practitioner for pain management and weight loss concerns and Occupational therapist for mobility/safety issues? This might trigger some other available resources. During Covid more home visits are being done and maybe you could get someone in quicker than 2 weeks for PCP appointment. I would also place a commode near bed in the near term so she doesn’t have to walk to the bathroom and risk falling. Provide liquids for immediate nutritional needs which might be less painful than trying to eat, This sounds so overwhelming. I’m very sorry for all of you, I hope you can get some help soon.

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.

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.

My heart goes out to you. I watched my brother suffer and die from HepC. No cure back then. Thank God, there is a cure now. My brother ended up in an end of life hospice facility where he received wonderful care. He died peacefully.

You have so much on your plate! A new baby, a mom living with you. That’s an awful lot.

My mom has Parkinson’s disease and as most know, it is a dreadful and progressive disease that has no cure.

Mom would fall getting up to go to the bathroom in the evening after the doctor’s offices would be closed so off to the ER we went.

On one occasion, mom was there for several days. I explained to them that she needed more help than home health and the doctor ordered rehab.

Rehab in a facility helped tremendously, followed up by another round of home health.

She is now under hospice care and hospice does a good job of keeping her comfortable.

I simply couldn’t care for her anymore after caring for her for 15 years in my home. It’s exhausting!

No one can go non stop caring for someone without help. My siblings did not help me at all.

I waited on mom hand and foot. Mom is a perfectionist and needed so much care and there was no compromising with me.

Mom complained even though I did all that I possibly could and then some.

I learned on this forum and my therapist to set boundaries but it didn’t sit well with mom. She complained to my siblings.

My siblings took her side and criticized me. So I ended up telling them that they could take over her care.

She is now living with my brother and now and hospice has stepped in.

I am glad that she has agreed to hospice. She expected me to do it all as the woman.

She doesn’t argue with my brother as a man because she is old fashioned feeling that a man knows best.

She sees women as servants. Crazy, I know but we cannot change other’s attitude or behavior. We can only change our reaction to it.

So do what you need to do for you. Your mom will have to adjust.

I am so sorry that you are struggling with this situation.

Take care and best wishes.

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.

"...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.

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.

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, 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.

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.