Fil right now is in and out of consciousness. He can only indicate yes and no. He is being fed by ivs. He can’t use the entire right side of his body,
Mil reacted by making the sleep aide a true live in, She wants her husband home. This lady isnt even a cna. She has handled a Hoyer lift zero times. She is in poor health herself.
I don’t think she’s reflected on how it really takes a village to handle cases like fil, but she absolutely won’t consider a home and it sounds like she’s even resistant to rehab.
What to do?
For two years I took care of a relative who was in exactly your FIL’s shape. FIL will need rehab. They usually start it ASAP after the event, in the hospital room. They evaluate. Your MIL will get an earful. Be ready for hysterics. I’m very sorry that this has happened, and I hope he can recover some of his abilities.
Will he need a feeding tube? This is the reality I had to face when my Aunt had her catastrophic stroke, and one of the deciding factors for hospice (she was also 105 yrs old).
I agree with Fawnby that the doctor or team sitting with her to discuss his care needs and what type of in-home qualified aid he would need has to happen. Maybe this can be discussed with the current aid and maybe they'll resign or insist on other help. How can this poor aid be there 24 /7 when not even qualified or experienced or in good health?
If she manages to get him home and family sees it isn't going well, then maybe calling APS is an option...
So sorry for this distressing situation.
So sorry this has happened.
Mil arranged for the sleep aide to be there 24/7 up from evenings through early mornings. This is the one that brings the kid with her that’s not hers but kind of an informal adoption. We’ve talked with the in-laws already on the ramifications of this Indy getting residency there with this kid. We’ve talked about the fact that this Indy has gang-involved family. Indy’s family has already “filled in” by moving her bed there and coming in as a substitute when Indy went to her home country. Hopefully they were not the gang involved ones.
This time around he is a lot worse off.
You do not have to be a CNA to use a Hoyer Lift. People can be trained to use the equipment that is needed.
Your MIL may have to hire another caregiver as well as the one that is now an overnight.
Depending on the stroke is recovery/rehab a viable option?
I do hope that your FIL has a DNR or POLST.
This is really something that your husband needs to manage since it is his parents.
I get wanting to bring a spouse home. Particularly if you have been raised to care for family, "for better or worse, in sickness and in health" and all the other emotions that go with that. The thought of losing a spouse is difficult.
A Hoyer in a residential environment is almost always a two person job. Elevating this one Indy’s hours aren’t going to fix it. What’s she going to do, call on her 11-12 yo kid she brings to assist with that or alternatively the two hour diaper changes? Or will it be 81 yo mil or 72 yo sil?
I am not a cna, and had no prior medical care experience before my husband was in the same condition as your FIL. After several weeks (unsuccessful) in Rehab, then another 9 month in a skilled nursing facility, I was forced to bring my husband home and begin caring for him. I had spent nearly every day with him at the hospital, rehab, and nursing home. I watched, learned, and was even taught by the nurse how to provide the basic daily cares my husband needed. By the time he came home I was fairly proficient in diaper changes, bed-making, transfers, and using a hoyer lift properly.
I guess the point I'm trying to make is the caregiver does not necessarily need to be a cna, but she DOES need training - even informal - to learn how to properly manage this man's care needs.
I can kind of understand his wife's desire to have him back at home. We all just want our life to return to normal.
I'm not going to judge whether she should have him cared for at home, or in a skilled nursing facility. But, I hope you can convince her to have a better trained and more experienced aide to help with the home cares. Both the wife and aide should get some training. He should definitely take advantage of spending weeks in rehab, and try and get him off the IV feeding. They will not be able to do IV feeding at home! She can ask the doctor about a G-tube for feeding, and learn how to use it. (I had to do that as well for my husband for the first 2 years) She and the aide can alternate spending days in his room, if allowed, while at rehab, watching and learning how to manage his care needs. They may even be able to get some informal instruction from cna's and nurses there. That was how I learned.
This has been my only job now for 10 years. I was previously an office assistant.
I love having my husband at home with me, even with all the challenges. I currently am employed by a home health care agency, with my husband as my only client. I have to maintain CPR/First Aid certification, as well as completing several continuing education units every year.
Ill start. If he’s going home with a tube on pallative care do we just bring him back to the er if and probably when he aspirates? Then what?
If he goes on hospice, it is a matter of arranging with a new provider whether he will continue on the new antiepileptics he is on. Morphine, Ativan and Seroquel aren’t going to fix his seizure problem.
Home for comfort care is more complicated than it sounds. Ask if he could go to LTC rather than home. (Don't let MIL edit your list of questions! This is certainly a legitimate one.) If comfort care lasts only two weeks, then that's one thing, but if it goes on for six months, that's another. In the case of the latter, he'd already be in a nursing home, and MIL would not have to turn her home into one. Which is extremely awful to have to do because her home won't be a home anymore, it'll be a nursing facility, and if she's not in good health herself, the effect on her could be serious. She has no idea what she's asking for by insisting he come home.
Please let us know how it goes!
I can imagine MIL must be feeling extremely sad and frightened and hoping to “make things right” and “do her best” but I’m afraid those things will not save him.
Where is your husband in all this? You are amassing as many questions as possible for the “big meeting” but I suspect the real issue is more emotional than practical. Not “how exactly is MIL going to face the 9,254 complex care issues she will be facing” and “how can I convince her that she is not up to it” but more how are they all coming to terms with his likely imminent death. You all have my sympathies.
"Generally, CNAs cannot start, maintain, or administer medication through IVs, nor can they manage, start, or flush feeding tubes (stomach feeding), as these are restricted nursing tasks. While they can assist with oral feeding and monitor for complications, inserting tubes or giving medication via tubes is outside their scope."
CNAs are not medically trained. So here may be a good reason to place FIL in LTC. Him not swallowing is a big thing. I think my RN daughter would say, no stomach tube. Once they place it, only Hospice can remove it. He maybe transitioning. Hospice may be the only choice.
Fawnby said "She has no idea what she's asking for by insisting he come home." I had to laugh at that. Ever since Peggy has posted, her MIL has paid thousands of dollars to have her and her husband cared for. These people she hired, I think, are not even trained. So, MIL doesn't care because she will expect others to do the care. She won't be doing it.
He was comfortable throughout.
Hate to tell ya grams, there’s a million more grammas for this kid at its home. It’s real home.
Of course, aide is primed to make bank on this occasion. She has inserted herself as “family”, as MIL even told our pre-hospice meeting she saw her as family. You too can shnooker an old person for what is presently a 200k salary plus free rent and food for you and whatever relation this child is to you. His passing with the child’s “cute” presence sets it all up for MIL to request her son's rehab the upstairs suite for this wonderful tween who held his hand or catheter bag when dying, which could definitely be construed as child labor.
Aide being present for hospice and funeral period is one thing. Us having to adopt aide into the family thereafter is another.
My niece lifted catheter bags when my dad was on hospice, She was 12. It wasn’t ideal but then again she is my SISTERS CHILD. Not the child of a paid caregiver which carries profound liability,
Do you understand the difference? Do you see it at all liability wise? Emotional wise? We can’t even TALK around the aide like family as she is always there.
Aide stated she had observed fil eating a full breakfast. We had all been told he couldn’t swallow, but here he’s doing that just as the hospital has gotten the consent to just hand him off to hospice.