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But I don't think your dad being a vet would help your mom in this case. I could be wrong.
As Garden said, Medicare should pay for limited at home care, but mainly short visits, (checkups, baths, etc). I found that by the time you hired out for too much at home care, you would be better off, economically anyway, going to an assisted living or even SNF if needed for a while.
I think the SW is wrong. Don't take her word on post rehab home care.
Also, contact TRICARE; I don't know for sure what it covers in home care, but it's worth a call.
I would start calling locally for in-home care service. She'll need bed transfers, probably shower and toilet assistance too. I believe it is common for costs to run between $20-$25 per hour. If your mom doesn't have enough saved up, then perhaps look into getting her signed onto Medicaid.
I am so very saddened that elder care in this country (US) isn't better. I believe it is due to there not being enough money in it, it is not glamorous, and nobody gets to be the hero in the end or save anyone. I feel like we are largely left on our own.
Medicare will cover home care, but it's not extensive. For us, it's been a nurse a few times a week, PT and OT 3 times a week, an aide weekly (if desired) and a social worker (usually once or twice).
It's definitely not a high level of care.
Private duty could provide more care, from up to 3 - 4 hours at a time, but it's completely out of pocket and in my experience it's difficult to find a reliable agency.
The rehab staff, specifically the social worker, should have notified you more than one day before discharge. In my experience, it's typically about a week before.
I'd enlist their help, ASAP, and ask if they can help file an application for Medicaid. If not, and if you can afford an elder law attorney, do some really quick research and find one who's handled Medicaid applications and get one filed.
If worse comes to worse and for the time being you have to rely on home care, make it clear that the visits need to be spaced so that the therapists and nurse can be there when your mother needs help the most, on HER schedule, not theirs. They'll object, but don't back down.
What's your situation? Can you be there for the first visits to establish parameters?
HomeHealthCare can assist you in many ways - ask mom's physician to order HomeHealth right away too.