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Mother lives by herself but needs someone who can carry her to doctor appointments, Light housekeeping, grocery shopping, small meals, errands.
She walks with a cane but has severe back pain and gets out of breath.
She has an RN come in for vitals and another person who helps her bathe
and change bed sheets when needed. (takes Mom an hour to do bed and
is very painful).

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If your mother is already getting some in-home services, talk with her case worker about her changing needs. The case worker evluates needs on a regular schedule (in our county it is twice a year). If changes arise between scheduled assessments, call the case worker.

A word of caution: do not let your mother meet with the case worker alone. Many elderly people simply do not give an accurate picture of what they need. Sometimes they are afraid that if they admit how much help they need they will be placed in a nursing home. Sometimes they are simply in denial themselves and sincerely (but wrongly) don't think they need help.

Mother needs to have an advocate with her who understands the situation when she is talking to a case worker.
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The nurse was assigned by her doctor. She comes once a week. The other
Lvn helps with her shower. They may be there an hour (total for the week). She needs other help especially transportation.
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Yes. She definitely needs other help. I suspect that other help will be available for her, once you go through the right channels. Go through the agency that provides the nurse and the bath helper. If you don't know who that is, ask the doctor's office.

You could also start by calling Social Services in your mother's county. Since she is already getting some services I think it would be easier to start with that agency and find out how to apply for additional services.
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