my step-father refuses to send my mother to day care or have any services in home. My mother has Alzheimer's and he keeps claiming he can take better care of her, than the professionals. She is getting injured, and is at risk for harming herself or him.
You will not find a Medicare agency to provide personal care/attendant services for your mother unless a physician first orders skilled services.
Medicare only pays for intermittent skilled home care (physical therapy, occupational therapy, etc.) and while skilled services are being delivered some intermittent personal care may be provided (e.g., bathing twice per week). Physician orders typically do not run more than 30 or 60 days so this is not a solution.
If your parents do not have funds to pay for care, contact their local Area Agency on Aging (search this phrase followed by the name of your county) and ask them to do an intake. They will help them apply for any pubic benefits they may be entitled to and help identify appropriate services.
Be careful contacting Protective Services. The result (mom being removed from the home) may not be what you anticipated or desire. Better to let a professional social worker (from the above mentioned agency) have a go with dad first.
Being a spouse does not automatically gives you a right over your spouse. When my mom was still alive, she was bedridden and completely in a vegetative state. She could not move at all, nor blink at you, etc... Several times when we took her to the clinic and the ER, my father (who had legal guardianship but never presented his papers) was forced to sit in the waiting room while the medical staff attended my mom...sometimes without even anyone asking us why she was brought in. They treated mom for something else and not the severe bedsores on her back and butt. That's when I realized that being a spouse is nothing if you don't have POA/medical POA. With our hospital, they prefer the POA and not the Guardianship paper. I read the Guardianship paper. And it does give my father authority over my mom's medical issues.
Guvna, it's like what Ralph Robbins said. Medicare will only cover Temporary any home care issues but it must meet certain criterias. Whenever one of my parents left the hospital after an extended stay, they would get the home health nurse visits for up to a certain time period (6 weeks???) They will come for an hour, do any sponge bathing, vital checks, physical therapy, etc.... It's really only temporary - a couple of weeks.
Thank you for the detailed answer! I've heard that some life insurances can be used to pay for part-time attendants also.