How in the world do I add being a caregiver to my parents? I don’t know what to do!

Realistically this could be happening to your parents whether they had children or did not. If they did not have children there would be no expectation that a child step in and handle things. If you lived in another country you could not do all these things that you mention.

My point is that you need to make it clear that you love them and that you are so sorry for what they are going through, but that you cannot be the caregiver. Trying to do this would break you and do them very little good thereby.

Placement is almost a certainty. Stop now with making this YOUR problem. It is (sadly) their problem so that your question now for your Dad is "What are your plans?" And YOU cannot be the answer as in "YOU are the plan". You are going to have to toughen up to protect yourself AND them. They now need care. You cannot do it, and it is not your responsibility to do it.

I am so sorry for this dire diagnosis. This is a tragedy. But it is not something you are able to nor qualified to "fix".

You don’t. Why would you even think you have the capacity to take care of two more people?

You don't manage it because it's not possible with your own family and their needs. I think you already know this though.

Considering that both of them need a lot of care, I don't think that even moving a live-in caregiver with them will be enough. Taking on both of their needs is too much for one person, even a professional.

Now is the time for serious plans to be made. Like your parents being moved into AL and an private aide hired to handle doctor's appoitments and lab tests.
AL is probably the best bet for them.

Skip the outside help with household chores and go directly to the assisted living option.

You won’t have the time or energy to manage all their illnesses plus the people you hire to come to their house. At assisted living you immediately get help with everything. It takes much of it off your shoulders.

You must make it clear to your parents that it’s the only way.

I agree with another poster. There is no eventually, it is now. Talk to your father about managed care for the two of them. Make sure he understands that you are not part of the solution. You cannot take on any more than what you are doing now, even for a little while. You are willing to assist getting to the next stage but you are NOT the next stage.

Your first priority is your children and your self. This is not selfish, just realistic. I suggest you imagine what they would do if they were alone, without an adult child. They would find a solution. Tell them you are willing to coordinate their care but cannot personally provide daily care. This is not a selfish position, rather a loving and realistic offer to help.

I'm sorry that such illness is now part of your lives.

A needs assessment or appointment with a social worker may uncover your folks needs, their wishes & start the ball rolling towards a care plan. Care services to their home may be possible & enough now or for a time. If not enough, assisted living may be needed sooner rather than later.

I am sorry to hear this, however, with 3 children you will not be able to handle this, there is no way.

My suggestion would be to place both of them. Where my mother and step-mother are, the doctor comes in weekly, for other appointments they are taken back & forth at a nominal charge,

There will someone with them 24/7, do something before it becomes an emergency situation.

Sending support your way.

Respectfully, you *do* know what to do, you just dread telling your parents and dealing with the fallout. I don't blame you. But you must tell them no. If I were in your shoes I would approach your parents under the assumption that they are rational, loving people (giving them the benefit of the doubt -- many parents are not). From this perspective, I would have a planned discussion with them as to why you won't be providing more care to them: the existing extra burden of your profoundly disabled child plus 3 others means there is 0 time and energy left at the end of each day to add any more to your plate. Then you present what you think your parents' options are: based on their means, what it would cost for them to hire enough help for each day/need; transportation options; house upkeep labor and costs; etc. This lump number can then be compared to the cost (and benefits) of transitioning to IL then AL, in a continuum of care community. FYI the only "benefit" of staying in their home with the amount of problems they have is that it "feels comfortable" to them. There are no other real benefits because managing the affairs of 2 more people and house will be a big undertaking. Then there's always the risk that when they get to the point of really needing to be transitioned, they won't cooperate. Make the goal to get them in there sooner rather than later. Take vidoes of some candidate facilities to show them they aren't dirty, depressing, scary, etc. Also, your parents have probably spent their entire lives having YOU as their retirement plan. I'm an only with a surly single Mom. I've had to make it blatantly and abundantly clear that the trigger for her to go into AL is when she is no longer safe in her home OR I'm overwhelmed. I've videoed her agreeing to this. My hubs and I have 2 other LOs we are PoA for, besides her. Your parents may be shocked, angry, depressed, all the above at the suggestion of a facility. Your job is to remain cool like Spock and just give them the cold, hard facts. It doesn't mean you don't love them. But if they think they can add their care burden to your already big one, then what does that say about their love for you? Do they *want* you to burn out and then not be able to care for your own family, not to mention they themselves? This is the hard truth they need to come to grips with if they are reasonable people. FYI I often wield guilt like a sword, when appropriate, because sometimes putting things in perspective like this is the only way to get people to think through what they are asking. Stay strong. They will get over the shock of having their expectation turned into a disappointment -- but it will only be temporary. Your own spouse and kids come first, no matter what. Defend that boundary like a lioness. Again, it doesn't mean you don't love your parents. They had their entire lives to ponder and plan reasonably for their elder years, even facing unforeseen problems like PD and liver disease. Aging throws a lot of crap at a lot of elders. Few are spared. Don't feel guilty. Your situation is stressful and grief-invoking. But do not feel guilty about not being able to provide their hands-on daily care. It is what it is. I wish you clarity, courage, wisdom and peace in your heart as you have the necessary conversations with your parents.

You don’t. You can’t possibly take this on. The first step is to cut yourself some slack and give yourself permission to NOT take this on. It’s not like you have the resources to do it and are just refusing to do it. Then you need to find a social worker who will help you navigate getting them the care they need. Either at home or in a facility.