Hello, Thank you for this wonderful resource. Wish I would have found it sooner! I applied for the A&A for my 89 year old mother and received the approval letter in less than three months. She has Alzheimer's along with a history of falling from time to time. I moved her about ten minutes from me from out of state the end of last summer and discovered she needed more assistance than previously realized. The move added to her confusion and it took a good three to four months for her to adjust even though the independent/assisted living apartment was very similar to her prior living arrangement. The basic apartment she is in includes three meals in the dining room, weekly cleaning including changing her bed and washing the linens. They also empty the garbage and make her bed daily. In addition to that there is a company located within the building (a separate entity) that has a number of caregiving services available or residents are allowed to hire caregivers from the outside - either of which elevates the living from independent to assisted. After about three or four months of handling all caregiving myself I began using the in house caregivers to dispense her daily meds and to escort her to meals and activities. I then added shower assistance right before I applied for the A&A but had to discontinue it after a month because my mom would not cooperate and would send them away if I wasn't there. About the same time I cut back on the escorts because she was finally learning her way around. Now for the question - finally! I have a caregiver agreement drawn up by an attorney. I have been assisting with her showers, I launder her clothing, do cleaning in addition to what the home does, shop for toiletries/groceries (snacks & drinks for in her room), take care of all her financials, and take her to all appointments, church, etc. The in house caregiving company still dispenses her meds, provides some escorts, and I am trying again to have them assist with at least some of her showers. Bottom line, her caregiving is provided from three sources. The facility, the in house caregiving company, and myself. I am waiting to be appointed as her fiduciary so it sounds like I will have to do periodic accounting. My caregiving was not included in the original application. Will the VA recognize this as one of her medical expenses and as a component of her assisted living? Thank you for any advice you can provide.