There are state programs for in-home care, up to 38 hours a week for the disabled homebound. A caregiver can be paid to assist with housekeeping, cooking, laundry, bathing, errands, etc. The income guidelines are pretty strict. The program is typically called something like"Community Care for the Aged and Disabled" and will be run out each states Department of Human Services. It is possible to self refer for these programs or for a family member to refer, no doc or social worker needed. They send a worker out to the house to assess disability and hours of care needed. The goal is to keep people independent at home as long as possible. Here in Texas, an enrolee can even choose to have a friend or family member be the caregiver and get paid. This works out great for many families who are already doing this and going broke from not working. And the patient feels safe and comfortable.

Medicare will pay for a nurse home visit if a patient is receiving PT, OT or wound care or other special care for feeding tube, infusion, etc. Otherwise visits are pretty limited and will be brief and limited to nursing needs. A home health assistant will be VERY limited under Medicare and is not a long term plan.

The church and community resource tip is a good place to start for anyone above state program income limits. Some cities have an agency on aging and disability that can help with local resources and some even offer in home care at a sliding scale.

Such an important topic! Thanks for bringing this up.