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91 year old parents taking care of 94 year old aunt. Since Christmas all their health has declined. Dad the worse with Dementia, mom with mobility issue. Medicare will not pay for home health and all facilities in the area are horrific. My sister and I still are working to support our families and live an hour and a half away. How do we keep them comfortable and safe in their own home without sacrificing our homes and income?

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Getting them the help they need is not your expense, it is theirs.

As Barb suggested call the Area Agency on Aging, in their area, for an assessment of their needs. And check into Medicaid for them.
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How do you know they will not be eligible for LTC Medicaid?

91, 91 & 94. Nothing is going to turn around and get better.

There will be facilities that will be able to provide the level of care and oversight that this trio of nonagenarians needs. It may be a NH over in a more rural county. Most NH I’ve found are doing their best to provide services & care within staffing requirements set by the state. Some states daily Medicaid room & board reimbursement rate is low, like $160 a day. When my mom went into a NH on Medicaid, TX reimbursement was then at abt $148 a day. To cover operating costs NH needed 20/25% under MediCARE rehab coverage and another 20/25% as private pay or is an older facility that was small so has lower staffing requirements. There’s only so much Ritz Carleton on a Motel 6 budget.

You know the answer to your question...... they need to be in a facility.
Whose application to do first? That to me depends on who owns the home. So whose the homeowner?
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Have you contacted the local Area Agency on Aging and asked for a needs assessment?

Are the facilities near you better than in their location?

Have you looked into getting them qualified for Medicaid?
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Hire an in home caregiver.
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