need guidance

>>> Please offer comments, thoughts, advice................ Thank you

I will tell you most rehabs and skilled care units are all about the $$$ They will keep someone on med A until they tank. Some of the staff will tow that party line and others will be more honest.

Everyone travels down a different path, no one can tell you with any certainty how long the road will be. It is time for you to talk to your husband about end of life care. You need to discuss LTC and homecare and decide right now which way your family will need to go . If at home who will be with him when he needs 24 hour care? Can you afford to pay for help? Who will perform that basic care? Can your husband perform incontinence care for his dad? Can you? Are you prepared to take FMLA to do it, especially knowing the FMLA could expire long before his death.

It's a difficult discussion to have but you do need to start it with your husband asap.

Thank you for responding and your support. I did discuss with my husband tonight the need for him to have a serious discussion with his Dad, while he is still mentally competent. I actually read him your exact response ktwlpn, and it helped facilitate our conversation. Luckily, I am not working yet, so I can offer him care when needed. My husband is going to ask him on Friday about his wishes and how he wants to proceed when discharged. This is more challenging for him (husband) cause his family never really "talked" openly about things like this. And we are only in our mid-thirties, and have 3 kids under 8! But, as my husband and I agreed, it is better to be prepared and know his wishes rather than guess. He seemed a bit more spacey and confused today, but still answers questions appropriately.

They did a portable Chest Xray yesterday at the rehab facility and it showed lower left lobe infiltrate. He does have some chest pain when sneezing, coughing etc in addition to his other aches and pains now. They are treating the finding as pneumonia (I know lung mets is possible), and treating with yet another ATB. So, now I am wondering if the confusion is related to his advanced liver mets or the infection, or both? Either way, we just don't want to see him undergo anymore agony, and I pray he does not become septic or need admitted to the hospital again. For him, being in the hospital is the horrific.

My husband is going to ask about his current care plan during his meeting and individually to the nurse, case manager, and therapist about the progress or futility of his "rehab." I just home they are honest with us, and don't just follow protocol or their job descriptions........

Went through this with my FIL as well, minus the extensive heart issues. Liver mets, he was treated but it was not successful. I believe it actually increased his decline. He went from cognitively impaired, to completely lucid one day, then he completely got lost in his mind. My husband did not have that talk. Today, we still cannot find important items and documents. There was a language barrier for me; my comprehension was not good enough for a serious talk. Hopefully, they address these issues so they can spend time, however long and hopefully it's longer than anyone thought, just enjoying the sounds, smells, visions of the living person.

BTW, if your FIL agrees, start hospice care. He can even do it at home. For some reason, nobody likes to talk about this with families. Only one primary care DR. who was filling in even mentioned it to us.

ahhh...I think you are already getting prepared.....my hope for you is that someone (not necessarily you) has the conversation with him about his wishes. It is not an easy conversation, but ever so important. I suspect he is aware as well.

((Hugs))

Several things came to mind -

First, please take care of yourself. You have the best wishes of many who will read your post.

Secondly, since your husband has siblings, please, PLEASE, get them on board. Even if they may not fully understand or agree, at least there will not be any surprises. Things can get VERY, VERY ugly at the end. I am hoping that your husband (and YOU) have the legal, official documented POA/HCP power. One official person is crucial for definitive (and authorized) decision-making.

Thirdly, I urge you (and your husband) to be realistic. This will become extremely difficult as the time winds down when more & more care becomes necessary. Your FIL will most likely want to be at home; your husband will want to honor that decision also. Likely that will also be the desire of other extended family. At this time, you are willing to be there for him. Will that be his home or yours? This will make a huge difference.

But the likelihood and expectation is that because you are the official family 'healthcare person' you may fall into the trap of being the only person to be there to do it all by yourself. If your FIL remains at home, his care will be extensive. You will need HELP. You cannot be expected to be the sole caregiver 24/7, and that is what freq becomes the expected end result. The unrealistic expectation may become that you will dedicate your life to his care. You CANNOT. You will need your husband's support & understanding so that you can lead some life of your own. Down the road, home care decisions for assist, hospice, NH placement, financial expenditures, etc will be necessary so it is imperative that your husband have the right legal authority to act.

And I reiterate a point from another respondent - make sure you know where are all the documents. Finances, insurances, titles to home & car, prearranged cemetery plot, military, safety deposit, valuable collections like stamps or coins, a will, DNR/POLST (get one now if not already), etc. Any outstanding debts?

To your good luck (LUCK is NOT a good word here, but I can't think of another better word to use, sorry), your FIL has all the right professionals providing his medical care. You, yourself, seem to have the understanding, knowledge and desire to be there for his life's end journey. But the reality is that things may not work out as all wish. Time, family, assistance and money will dictate things that you may already be sensing as possible difficulties down the road.

I speak from experience about long-term caring for ill relatives. Not an easy road to travel and one I wouldn't wish on my worst enemy.

The recent care of your MIL may have already prepared you for some of these activities, so I don't mean to hit you over the head with info you already know or have addressed.

There's a lot of things for you to address quickly. Again, good wishes for you.