Ok guys/girls. I do understand that no medical advice can be given here but I am looking for a clearer explanation of each of these areas as I have only a few weeks to help my dad decide what to do.
The hospital Social Workers are not very helpful. The doctor came in the room, asked my dad what his wishes were if he again had trouble breathing. My dad told him that he didn't want the trach ever again. The doctor replied, "Well ok then. We'll discharge you home on hospice and give you Roxanol until you die." And with fear and trepidation in his eyes, my dad stated "Well, I think I have a few good weeks left in me.". Uggggg.
Dad was in a rollover tractor accident in March. He has spent most of these past months in ICU with multiple bone fractures, and burns and all the complications involved. At this point, he is down to 137 pounds, with a GT, still with the hole from his trach healing, a GT to drainage, a JT for feeding, Stage IV decube to his coccyx and remains NPO. He does love his therapist at the Skilled Care Facility but the nurses are way overworked and cannot be in his room to suction him as needed (he is back in the hospital after one of the nurses/aides gave him a glass of water, he began coughing so hard that he vomited and aspirated GT feeding and reopened the stoma from his trach.)
Anyhooooo, he wants to go home. It has been months. I want to help him do just that and will be quitting my job here in another state and moving to his state to help with his recovery. We are having ramps and rails put in and will ensure that all the equipment he needs will be available but I am not sure at this point which of the above would help him the most.
He is now able to speak above a whisper and can have ice chips. He does get up to the w/c to wash his face, brush his teeth and shave. He needs assist to transfer to the w/c or commode. He does NOT want to die and has good cognition.
The hospital obviously as noted above is pushing for him to go home with Hospice but I feel that once he gets back home with his wife, his dog, his chair, the lake and birds, he will finally begin to heal. Especially if he has someone right there to assist him and ahem, push him to go further. Plus, the only thing he doesn't want is to be intubated, but he does want to be given CPR if needed.
That being said, I am a realist. He was very critically ill and is severly emaciated and weak (he used to work out 4-6 hours every day, after all these months, he still cannot stand by himself). He did get gastroparesis from the rapid IV infusion after the burns and his stomach is slow in responding. He has virtually only gained 0.6 ounces...due to???? Letting his GT run empty too many times? Shutting it off and forgetting it? Yes these things have happened, and is yet more reason to get him home. More reason to believe he can actually heal there, and yet? Still we don't know. But I'd like to give him that chance. If nothing else, to go home for Christmas and be surrounded by help and love.
Sigh, I've run on. I do apologize. So, he has Medicaid with a supplemental insurance. I would appreciate anyone with general knowledge with the above 3 options to help out a fellow tired nurse :))) Any guidance to where I can begin would be most helpful!