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I found this site for seniors in Texas. I hope it will help you in accessing the services your MIL needs.
http://www.elderoptionsoftexas.com/senior-assistance-programs.htm
What made me concerned as well is that one the therapists was aware of this company, having told me that they complained that I didn't return their calls (which I did). I wondered if she was getting a kickback or something.
I also feel kind of sorry for the home care workers as it appears as though some of them are encouraged to recommend these other outfits.
I've also learned to recognize the changes in their pitch. Some of them are really quite good - establish rapport with the elder, compliment, joke, be friendly and good natured, then segue into an expanded relationship between them and their business partners after changing the tone of the interview to one of needing literally everything.
If my parent had a dog, they'd probably have someone they'd recommend to do that, at $20 - $25/hour. Seriously, I was surprised at the smiling aggressiveness of the people sent to assess.
I've had to resist an unscrupulous alleged visiting physicians service, changing our Med-Alert arrangements, and having an also unscrupulous alleged "contractor" shoved off on us as part of private duty arrangements.
I need to get out my Sherlock Holmes hat (no pipe though) and be on the lookout for these unwanted arrangements being shoved off on us.
You can also contact the local hospitals and try to speak with a discharge planner (even though MIL isn't in a hospital), but the DC's are usually quite busy and might not have the time to provide advice.
County governments also often have lists of sources, and a health department staffer might be able to offer some guidance on how to get an initial assessment.
Is there any family in the area who are familiar with MIL's medical issues, and might have HIPAA authorization? If so, a geriatric doctor could be contacted, but would probably have to establish a patient relationship before ordering a care assessment.
Does MIL ever get out for medical visits? If so, that/those doctor(s) would be the first ones I would contact.
There are "ambulettes" that could take her to a doctor, but I would call some geriatric doctors first to see what suggestions they could make.
You don't mention her medical issues. I'm wondering if EMS could also take her (on a non-life threatening basis) to urgent care or the ER just to get the ball rolling on an assessment (assuming she isn't able to get out at all to see doctors and that professional help is needed for that).
I've gotten a lot of help from the Alzheimer's Assn. in locating resources, even though my parent doesn't have dementia. They have a very good response team and knowledgeable staff.
I'm learning about a different approach by the Area Agency on Aging. They've created a "Same Address" program with goals of keeping people in their homes as long as possible. It's a diversified program, but there definitely is a push to use their services.
What someone should be aware of is that they ARE in fact marketing their services, sometimes w/o focusing on the basic needs and services that address those needs, rather than a broader range of services. The sales pitch is subtle, initially.
There's also the VA, if your MIL's husband was a veteran.
You are asking for a "needs assessment". Will mil and husband allow "strangers" into their home to help?