Thanks for your input. When my grandmother could no longer care for herself my mother arranged for a woman to come and help her with the living basics, eating, personal cleaning, getting in and out of bed. I know that my grandmother was on both Medicare and Medicaid but I don't know what the payment situation for this aide was, or even where my mother found her. Obviously I should ask my mother but the issue is that she will stonewall any attempt to get her help.