My Mom, who has been battling oral cancer for some time, now needs help with her medications. She needs general support - crushing the chemo and pain pills, reading the measurements for liquid medications (as her eyesight isn't great), systematic help in doing all this 4 times/day. She's still able to take the medications and feed herself thru a G tube. We're having difficulty finding alternatives to expensive in-house nursing care not covered by Medicare (don't believe she's eligible for Medical).

- Is there a way you've found to get Medicare to cover this in-house supportive care (if continuous vs. "intermittant")?
- Is a skilled nurse necessary for preparing vs. giving meds (per liability or can an less expensive caretaker do)?
- Is there a caregiving resource that lists licensed independent, contracting nurses (vs. associated with an expensive agency)?
- Understand after a surgery, agencies (approved by doctor and Medicare) can re-certify every 30 days so can continue skilled nursing care - is that really a viable option (she's planning another surgery shortly)?

Thanks very much for any help or suggestions!

Laura

There is an in home care program where caregivers are compensated for some of the hours they put in. I believe it's called IHSS ("In Home Supportive Services". It California the county welfare department administers the program (but it is federally funded). Spouses are eligible as well. I think the pay is around $10.00 an hour and there is an hourly, weekly limitation. If she is nearly blind there are additional state programs for that also. Talk to the hospital social workers about the different programs she may be eligible for. I would also look around for eldercare ministries from the local churches as they may help you as well. My father had much the same issues. I worked out a deal with a full time caregiver with a minimal salary and free room & board. Make sure that you stay involved however. I provided the respite care for the caregiver and we switched roles from time to time with me being the primary caregiver.

Crushing pain pills can be tricky if they are time release (they can cause an overdose). Make sure that you clear all of this with the doctor and pharmacist. I used a 72 hour transdermal skin patch instead (Duragesic) which was much easier to deal with. I only used oral meds for breakthrough pain and they could have been in liquid form to begin with. One has to be very careful about flushing the PEG tube so it doesn't become clogged as well.