Medicaid will only pay 8 hours a day for our 90 year old, advanced Alzheimer's mom who is bedridden. What else can we do?

They worked and saved for this time, when they need it. Other than the finality of placement I don't really know. I doubt that even Hospice will give you more care than this in home. Not everything can be fixed and there seems to be no answer for those being kept alive, and only that, bed ridden and with no quality of life at all. I am so sorry. I sure wish you luck but have no answers. Hope others in your area might have ideas that will help, but many across the country will be very very envious at the amount of care you are currently receiving without placement. I sure wish you the best.

Pretty much any homecare agency will arrange round the clock care for a client. Medicaid will be who pays the homecare contractor. Medicaid will not pay for round-the-clock care at home. You're lucky to be getting eight hours a day in-home care paid for by Medicaid. Most people don't even get that.
Your options for keeping your mother at home are you can take the eight hours a day that Medicaid will pay for and privately hire aide care that your mother or your family pays for to work the other 16 hours in the day. Look on a caregiver website and check people out. Hiring privately means you can negotiate the pay.
Another option is the family can cover the remaining 16 hours a day that Medicaid will not pay for in shifts.
Or you put her in a nursing home. Medicaid will pay for that.
They will not pay for 24 hour care in the home.

Many elderly people worked hard and saved so that they could get the care they needed when they were old.

Just need to make a statement about the live in. And I will be corrected if I am wrong. You do realize that the live in is allowed free time to herself. You cannot expect her to be there 24/7. There are laws regarding live ins. They get time off like any other job.

***disregard. Didn't see the update*** glad it worked out 😀

It must be very hard. But you will need to be realistic about what is available.

If the main priority is HOME until the very end, then the choices will be: family do the other 16 hours, private pay the 16 hours or maybe 8 hours with no night care (have a good pressure receiving air mattress & incontinence pads in place). I don't mean abandon overnight - this would be only if a responsible adult lives there onsite.

Does Dad live with Mom? Is that the priority? To keep them living together?

If family or funding can not cover the 16 hours left in the day, then a compromise will have to be made. Maybe they spend a lot of the day together (at a local Nursing Home). Dad then goes home for a good night's sleep while Mom sleeps there. Many get used to this out of necessity.

I hate to sound uncaring, but if advanced Alz & bedridden - what sort of recognition in her surrounds does Mom still have? A room decorated with her own throw rugs & photos may look & feel home-like enough?

Thanks for everyone's help and advice. Our mom was actually offered a full time live in and Medicaid is paying 100%. That is because in New York, they offer live ins in the most extreme situations only (our mom) but the aide only gets paid for 13 out of the 24 hours for the live in care. Our mom is doing well since she is in her own environment. Our attorney told us that New York isn't the worst when it comes to qualifying for Medicaid.

Like others, I'll admit I was stunned at the limited options for those needing 24/7 care. Numbers don't lie, but I am still dumbfounded that NH care is cheaper than in-home 24/7. If that's the case, then that's the case. Not much an individual family could do about it, but it was still hard to run those numbers in my head. My elder didn't want facility living, but either could not or would not do what was needed to remain home. After years of living alone, she now needed 24 hour supervision and could not understand why that was so. I could go on all day about the stunts she pulled during the times she was alone and when we'd try to talk to her about it she would shrug the shoulders and expected us to simply be there more - but at the same time saying she was "fine" on her own (she wasn't). I think we qualified for a few 4-hour blocks of care and maybe one overnight a week or something very minimal. I can't remember the exact setup. And it would not start immediately and, trust me, our need was immediate. We sought placement after a fall landed her in the hosp/rehab. She needed 24/7 care. Period. And a facility was the only way we found where she would get that. She (and a few other onlookers) deny that she needs this type of help, but those folks were not the ones caring for her and trying in vain to keep her home. LO does not remember all that we tried. She also does not remember/realize that many of the "girls" who came to the house were private pay (from LO's rapidly-depleted savings).

Please consider placing her in a nursing home.

Keeping an aging person at home requires family or friends to do most of the caregiving. If you are lucky, Medicaid will offer some part-time assistance, but it is not a full-time care insurance plan. Many people have no assistance from Medicaid or anywhere else. I agree with MACinCT that you are very lucky to get 8 hours of help.

Sorry! It is time to consider at nursing home if family/friends can attend to her.

Elderly people who worked hard all their lives to save their money now have some financial resources to help them in old age. That is the point! Old age, sickness, death, all are just pas\rt of life and if you save money you will have more options than those who don't. Frankly, I don't understand why you would think it would work any other way? I know some European countries have programs that really help in old age, but here in the US? We are busy shredding the safety net. We cannot have it both ways.

We found the same thing. We thought receiving Community Medicaid would help keep our New York State relative at home. However, finding someone to accept the limited pay they offer was difficult. The workers are paid so little that they sometimes just don't show up because they can make similar money at a retail shop. You need a Plan B for care every single day.

In addition, once 24 hour care was needed, Community Medicaid would not pay as it then became more cost effective for the Medicaid program to have the patient placed in a facility for care.

I think the government would like to keep people at home but it requires a large participation on the part of the family to do that- and at some point that just becomes too much.

My understanding is that while NY used to pay for 24/7 care, the state just cannot afford to anymore.  You may have to put mom in a nursing home.  I am sorry.  24/7 care at home is generally more expensive than a NH, although in NY, the law is that live in caregivers only have to be paid for 13 hours, if they can sleep at night. But I think it is harder to find people willing to do that.

If I were in your position, I would seek out the assistance of an independent social worker who is knowledgeable about the medicaid interview process.
I know a lot of the approval depends on how your brother answered the questions. If you can find a SW who knows the "right" answers to give, then you can likely get those hours increased substantially.
The same thing happened to an acquaintance of ours whose mother has advanced dementia. After she got some advice from a SW, she asked for another interview and got many more hours added.
Reach out to your local senior center, if you have one, and start there, asking if they can recommend a SW/counselor who is familiar with the medicaid system.
Good luck.

Frustrated, it's isn't true that the government doesn't tax the rich.  It does, but a lot of loopholes are available for the rich to exploit, so they can and do minimize their taxes.

The government does tax the rich. It is the poor who don’t pay taxes. Quite a few Americans have zero tax liability because they don’t earn enough money. If we can’t take our money with us when we die, why shouldn’t we spend it on our care until we die? The government shouldn’t pay our way as elders just so we can leave money for the next generation. I understand you are frustrated but your mother is quite privileged compared to many of the elders the people on this forum are taking care of. NY is just about the only state that pays for round the clock home care. With the exception of perhaps MI, no other state pays for live in help and no other state pays for more than 8 hours a day. most people are lucky if they get hours a week of home care through Medicaid. Some get 30-40 but most do not. And none of them get live-in help.

Thanks for your reply. Sorry about your brother. I think if you worked hard all your life, it's your money and you shouldn't have to use it on home care. We should have what our European allies, as well as Canada, Australia and many other nations have, and that's universal healthcare. Our country is maybe one of 2 advanced democratic countries that doesn't have this. Since our mom is in New York, since I wrote on this forum yesterday, she was just offered 100% coverage for a live in home health aide. The aid is only being paid for 12 hours a day and not 24. We were told that compared to other states, NY is more fair with medicaid. We all work and we pay our ta xes. But sadly, the government doesn't tax the rich, so we all pay more. Good luck to you and your family.

You say that many elderly people worked hard all their lives to save their money, and for what? I understand. I am 78. My brother died this year at 85. We both worked hard all our lives.
Once someone is on medicaid it means that no matter how hard they worked, they have now outlived all the money they saved and clipped coupons for. And the Government is now paying. The current Special Edition of AARP about Medicare, Medicaid and Nursing homes tells just how MUCH they do pay of the taxpayers money.
I myself have now outlived everything I put into Social Security. And it was a LOT as I was an RN; when I worked double shifts in the Clinton years I would look at my check and say "WOW, I am happy. BILL is happy. We are all happy". But see, now I have lived to 78 and still going, my partner is 80. We have now drawn all that money down and MORE and the government (that is to say you, the taxpayer) is still paying for us.
You are doing the best you can to get care for your loved one. You can do no more. I do not think that 24/7 care exists in an inhome setting, but I cannot swear to that. You may be looking at LTC facility as the only choice for 24/7 care.
I am not unsympathetic to your plight. Given my age I can't AFFORD to be, because as the old adage goes, "there but for the grace of god go I" today.
I wish you all the luck. I wish I had some advice of any real value to you, but just want to say that how long we live, and what needs we have, just cannot conceivably be met by a government with huge deficits and taxpayers already groaning under their burdens. I wish it were otherwise.
I hope others have ideas of contracters to explore.