Q: I recently brought my mother to my home to live. She requires 24/7 monitoring, and I am single and work full time. Is there any type of assistance provided by Medicare or Medicaid to help off-set the cost I have to provide sitters for her while I am at work. All that I presently get help with is 3 hrs a day for her personal care needs like bathing. Thank you.

A: I wish I could tell you I had a pocket full of solutions for you. Sadly, our system here in the U.S. is skewed toward moving people into nursing homes if they need full-time care. Medicare covers only "intermittent" medical care in the home. They will often cover an hour or two of aide services a few times a week for bathing if the patient is having nursing or therapy services at home. This may be what your mother is now receiving.

Medicaid differs in each state, but in-home services are offered only for the very low-income and rarely cover the whole day, or every day. Medicaid home helpers are usually not professionally skilled.

Check with your local Agency on Aging about any programs that might be specific to where you live. Sometimes there are grants or other funding sources available that I would not know about.

If your mother has any savings at all, now is the time to put them to use. Many grown children try to cover the expense of care to preserve their parents' assets. Any investment counselor would tell you that this is not a wise investment of your personal funds if there is an alternative. It can work against both you and your mother if it ever becomes necessary for her to apply for Medicaid help.

It certainly isn't always the case, but because you can't be there during the day, and this kind of care can be exhausting, your mother might eventually benefit from nursing home care. I certainly recommend that you visit one or two close to your home soon, just so you know what your alternatives would be if you find you can't continue to provide the kind of care she needs.