Entitlement to a Higher A&A Allowance Under 38 U.S.C. 1114(r)(2)

Has anyone ever received the R-2 rating?? I cannot understand the criteria that must be met in order for a Veteran to receive this rating as it is so confusing, so anyone that has received either the R-1 or R-2 rating could you please elaborate what is needed to receive this rate. I am receiving Aid and Attendance at the "L" level and have applied for Entitlement to a higher A&A rating. Is this a temporary rating in that you are awarded this rate temporarily or while you are not in a nursing home or hospital?? I know I don't have anyone to help take care of me anymore and need someone to help me in every way. I am unable to stand or walk so I have loss of use of my legs. I don't have any strength in my hands or arms, I have loss of bladder control, diabetic neuropathy with very painful feet and legs among a host of other documented problems. Now I have come to find out I have a heart condition that can be rated as service connection. Does the veteran need to ask for an R-1 or R-2 rate or is that something that is decided by the RO in their decision. The money would definately help pay for someone to come in everyday that is most of all qualified. As it stands now I have no one except a lady that has stolen my pain medication in the past.
Any insights??