Something’s gotta give and something’s gonna give (water dam style). There’s a lot happening here and it sounds like you need to call a doctor, social services, 211, for an HHA, or a few of them, in your area. Maybe your family can combine funds to pay out of pocket (private pay HHA), until your grandpa is approved. Depending on what hours grandpa needs help with, or what’s approved, you may have 8am-8pm shifts, where one aide works Mon-Thu and one work Fri-Sun (or one weekend and one weekday HHA) and then dad and bro can take the overnight shift if grandpa sleeps through the night with a Depends (adult disposable brief), a urinal, or a commode nearby.
The alternatives are home hospice care (but he may not qualify yet), respite care (help for primary family caregivers who are burnt out), a nursing home, or assisted living (which he may lack the independence for).
If you go with a HHA from an agency (via LTC coverage for your dad) the nurse will evaluate how many hours your grandpa can get, at the very least a split shift is needed, likely more. Split shift is like 4 hours in the morning and 4 hours in the evening but likely he needs much more or should get more within a year. Is he walking still? The nurse will also oversee the HHA’s in case something serious comes up. The nurse can also order special equipment to help you and the aide like a commode.
You’re at serious risk of a mental, physical burnout if you try and do everything alone. And if you’re not aware of body mechanics that HHA’s learn you can suffer a serious debilitating back injury that will leave the rest of your family without you. Can you be the manager and not the laborer? And then labor only during emergencies when the HHA calls out or something? Someone needs to manage.
I doubt you, or any sane person, can take care of dad, mom, grandpa, your 3 year old, your family, your farm duties, your home duties, your husband time, and work, without burning out. And with a 3 year old I think they need to have access to a car eventually so you likely can’t move down permanently.
If there’s no approval for a HHA, hire an experienced, confident, certified HHA for a a month or so to get a routine in. Try and stress a routine, just like children have routines that they thrive in (once a man twice a child they say). Especially if he’s “a handful”. Have a routine with a few allowances on bad days. Do not get used to lifting anyone, if he falls, keep him comfortable and call 911. Learn from the HHA how to move a body without lifting (or watch YouTube videos for HHA’s). Spinal cord injury care videos also show how to move a body properly and with proper body mechanics and without damaging your back.
Please try and be patient and spend as much time as you can advocating for grandpa, insurance companies are know for saying no first and then asking questions later (or not even) so you may have to work with the doctor for a sign-off and keep advocating and appealing any denial of LTC coverage. Grandpa has earned it at his age. Please also get a plan and be prepared to politely put your foot down as 3rd parties are only interested in their own things. Good luck.
(PS: Typing on a crappy mobile so please excuse any typos, will try and edit later on my computer)