VentWorld
help me to help my dad

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July 19, 2006, 07:40 AM
kentsgram
help me to help my dad
i live in ohio. my dad had surgery in march for his heart and arteries in the neck. he was a heavy smoker for 60 years. thus he had to be trached and is now vent dependent.
he is now in a facility and hour away, and it's horrilbe there. i promissed him i'd never put him in a home, and i need help in trying to get him to my house for home health care.
is it possible? he is tube fed, on a ventilater, he's 74 yrs old. his weight is 116 lbs and he's fading fast. has had several bouts with pneumonia. if he's going to die, i want it to be in my home, surrounded by the people who love him, not in some strange place.
he used to be as sharp as a tack, now he's confused, has short term memory. he's been moved from one hospital to the next, at least 6 times in the last 5 months.
the last time he was moved, he wanted to wait until my mother got there. she's been dead for over 25 yrs.
he has deteriated so much in 5 months. sometimes he doesn't know me, other times he's right on the money.
i'll have plenty of help, i have 2 brothers, that practicaly live at the hospital, and my sister in law across the street is a rn and does home health care.
does insurance help pay?
any advise, would help me so much
July 20, 2006, 06:47 PM
GaryMefford
Kentsgram,

Our heart goes out to your father, you and your family. The circumstances you describe your father as going through are far too common. It sounds like he has faced many challenges, but with your very supportive family right there with him. I will offer what advice I can, based on my experience, hoping it will assist you and your family in some way. Each circumstance, facility, and state's regulations are different, and what I offer may not fully apply to those you face, but I will offer you what I can.

First, I commend you and your family for the support you have provided your father through these many challenges. The long term facilities in which I have practiced have always worked for the patient with their's and their family's goals as the primary driving factor. From what you say it is easy to see that one of your goals for your father is to be able to provide care for him at home. Another is to have him at home with those he loves if and when his time come if that is possible. It is with these two primary goals in mind that I will frame my advice.

It is very important who is making the decisions that are going to be honored by the care team. If your father doesn't have an assigned medical power of attorney it will fall to a member of the immediate family. This will usually be a spouse, oldest child, or child designated by the siblings, or some other similar arrangement.

It is also very important that your father's physician hears these primary goals from first, this decision maker, but also from the rest of the family. Please realize there might be very good reasons that your father may not be a candidate for being cared for in your home. His doctor should be able to help you to understand this if it is the case. He must be essentially stable medically. From what you say you can put together a team of family and caring support people more than adequate to provide the time required to care for him.

Case Management or Social Services are available for all patients in my experience at long term care and long term acute facilities. I suggest you and your family ask for a family meeting which can be coordinated with Case Management or Social Services. They should be able to assemble the team from the facility and explore with you the challenges you face and offer advice.

A homecare equipment provider will have to be located and you and the group who will be caring for your father will have to be trained on all of his medical care processes.

As far as what insurance or Medicare will cover, you should be able to get that information in the family meeting or at least some advice on how to find out.

Don't underestimate the challenges, but if you and your family are willing to face them it is possible to care for ventilator dependent people at home. Hopefully your father is able to improve. Sometimes the home environment even contributes to this. In any case our best to your father, you and your family.
July 21, 2006, 08:05 AM
<kentsgram>
my sil has done alot of phone calling for me and has set-up some agencys for me to call.
i've learned medicare will pay 80% and his secondary insurance after that.
everyone in the family is on board with me, if no more can be done to get him strong and off that machine, then we want him home to give him comfort care.
i am the oldest, and everyone is in agreement with me.
dad did not have a living will or poa.
he was such a procrastinator. he only added my name to his bank accounts the day before surgery!
mom died over 25 yrs ago, and he never probated the will, so her name is still on the house.
thank god i talked him into adding my uncles name to my grandmothers accounts, (she died 6 months ago) as he was in charge of settling her estate, and he won't be able to do that now.
even though i don't care for the place he's in, and it is a long drive, they are doing more for him than anyone else has is the last 4 months. they called me to see what his life was like before, his interests and hobbies, clubs he belonged to.
they told me they were bringing in puppies to let the patients hold, and just that alone, made my day.
he hasn't had that kind of stimulation in a long time. they are also going to try to see if he can eat and drink. nobody has tried that in 3 months.
this place is his last chance for any rehabilitation, and i have to let them try. if it's not going to happen, i'm bringing him home.
wish me luck.
August 03, 2006, 07:30 PM
josepht
I can wish you luck, but I will also say a prayer! You all sound like wonderful people! Not many families choose to take the high road like your family has.