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If you go with home care, you will need more than 1 caregiver. Every caregiver deserves to have time off every day and days off every week. Seems that your sister may require round the clock care.
As explained in other posts, you may have difficult ‘finding’ and even more difficulty ‘paying’ such a person (or one person plus one or more relief). This is about adequate care for your sister, not whether or why you are "scared of elder care facilities". Reconsider the practicalities of this - quickly!
Make sure that you find more than one for the job. Even the live-in caregiver will require breaks, nights off, days off. The amount of hands-on care will depend on her physical condition.
You should also contact an elder attorney to help you set up the contract between your sister and the caregiver to keep all records above board.
You may want to consider letting her go to a facility and if money is not a concern you can pay a "sitter/caregiver" to stay with her at least over night to see that she receives the care she requires. Unfortunately Memory Care is only ALF and can no longer care for her if she requires a higher level of care now.
But, do you fully understand the cost of this hope for home-going? Just over a year ago I saw 100s of thousands of dollar hemorrhage out of my friends accounts as she had the 24/7 care of two women, 12 hour shifts, 24/7. And they were CHEAP at 20.00 an hour. Figure out the cost for a day. A week. A month. It is enormous.
You are here describing someone who is unfortunately likely needing hospice care. If those fists are still clenched you are looking at decerebrate posturing which indicates SEVERE damage to the brain from which recovery is almost certainly not going to happen. If there is a choice for tube feedings and such to sustain life in this condition, this can go on for a long long time and requires nursing care, not a sitter. Skin breakdown will ensue. This is very costly care which unless there is a great deal of individual wealth I cannot imagine this being sustainable.
You now have used the time that medicare will allow for SNF or for any rehab hope (there is little) and the facility will not keep the patient; long term care either temporarily or pemanently is required until you make home arrangements, which I as an RN would never attempt to do for my own family in this condition. Your loved one will quickly move, according to law, from Medicare to "private pay". So if there is money, at 600.00 a day it will quickly evaporate.
There should be placement now. Time will be the arbiter in this sad and dire situation. I am so dreadfully sorry. I would opt now for LTC placement which will be easier done through this facility than from home, and would discuss hospice care with doctors. I hope someone knows this dear one's wishes for end of life care. I would not want artifical feedings by tubes or IVs and that is already written in my own advance directive. It prolongs greatly what is a torturous situation.
What you would be asking of this one person is not fair and I don't believe anyone in their right mind would accept the responsibility of it all.
Your sister now requires 24/7 care with a whole team of people and therapists(PT & OT)to care for her, so your job(or whoever is her POA)should be to find the right nursing facility that will continue with her therapies so that perhaps one day she can return to the memory care from where she came.
An online search for 'home health care' should work, or you can go to Google maps and search for Home health that way too, to identify companies with an in-town office. You can call her prior MC and ask if they have a company they've worked with and like, and you can ask the discharge planner that's assigned to your sister at the SNF. You may also want to ask her care team if hospice is reasonable--you don't say much here about her level of functioning, but I'd refuse for them to discharge her until you have everything lined up--work with her discharge planner/social worker at the SNF.