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In January 2017, my brother was shot in the stomach, liver, etc., had surgery and a colostomy bag was administered for a year. In December of 2017 doctors attempted to remove the bag, three holes were torn in his stomach. After 7 additional surgeries within 3 weeks, docs could not repair the 3 holes in his stomach and decided to do a skin graft (skin from his legs) to cover the incision which had remained open for 3 weeks. Because nothing works anymore (digestive system) he has had nothing by mouth since Christmas day 2017, only IV nourishment. Yesterday docs sent him to a skilled nursing home for long-term care (supposedly for 12 to 18 months). How long can he live this way?

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I was wondering if your brother was already recieving TPN as CM suggested it. If noyhing works in his digestive system a feeding tube would be worthless. He simply could not digest anything they fed him and he would become very sick.
TPN is administered through a tube inserted into a large vien in the chest and really is no worse than having an IV put in a vine.
If he is not already recieving TPN they have to follow what is called a refeeding protocol because his body has basically been starving just on fluids. They then gradually build up the dose till he is receiving sufficient callories etc for his size.
It does sound as though his prognosis is very poor at this stage and although the TPN will actually keep him alive he is now so weakened that he can easily die from something else.
If he is able to voice his desires it is important for someone to talk to him and then follow his wishes.
It has been a year since the shooting and he may prefer not to receive further treatment.
At this time long term care is really his only option in a skilled nursing facility as he needs so much care.
Personally I would not want TPN after a year but if it was in use would not arbitrarily stop it. he may have very strong reasons to want to live as long as possible. Do what he wants, what you think he would want or failing that what you feel is best for all concerned.
You did not mention his age or other family members so it is very difficult to see the big picture.
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Behçet's Syndrome. I'm not being clever, it came up on "24 Hours in A&E" last week. It is extraordinarily rare and mostly affects people of Eastern Mediterranean extraction. I'm also not at all sure how anyone would get through three pregnancies and labours with it.

A 19 year old cannot reasonably be expected to be the primary caregiver of two other minor children. It ruins his life chances and is inadequate for their protection. Involve CPS, if they're not already on board.

These are an awful lot of misfortunes to be visited on one (even if quite a large) family, I'm very sorry for it. Do you get any support from your faith community?
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Also, ironically his wife (my sister who's 65) is in the home with him and are both in the same room together, as I requested. I was hoping they could find strength in each other. They've been married for 40 years. My sister has multiple myeloma (msp) and has been receiving chemo for the past 18 months since diagnosed. Her health is failing, as she is diabetic, 150 pounds overweight, CPD, congestive heart failure, and a host of other health issues. She has been in and out of the hospital frequently over the past year for infections such as flu, pneumonia, a broken shoulder resulting from the brittle bone (fracture) and other upper respiratory infections. She's Jehovah's Witness and refuses any blood transfusions so therefore will not have surgery on the shoulder. She was admitted again on Dec. 24th, 2017 after being non-responsive after a 6 hour chemo treatment. So.....after her discharge week before last from the hospital to the nursing home, she's been kind of in and out of her normal mental state as a result of all the medication shes on for the pain mostly from the broken shoulder. Anyways, her husband was discharged from the hospital last week after 7 attempts to removed the colostomy bag was unsuccessful, and leaving 3 holes in his stomach, which they could not repair. They are both in the same facility and they share a room. They left 2 minor granddaughters at home with their 19 year old grandson to supervise his sisters and the household. Their maternal mother (the one who's boyfriend shot her father) is mentally incapable of caring for herself, let alone her 3 children. She has something called Bechet's Syndrome and is vvery bad off. I'm just wondering what I can expect in the future for my sister and my brother-in-law. Hopefully I made the right decision by putting them in the same room. I would hate for one of them to expire while they're both so physically and mentally disabled the way they are. And if one does expire, when might that happen. I feel so unprepared. I've been helping their grand children out with almost everything fro food, bills, and moral support. I have a husband and 4 daughters myself and this is so hard of the entire family.
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Sorry no one has seen your question.
I don't know the answer, but his doctor should.

I'm so sorry for your brother's situation. How did he get shot if I may ask?
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A long, long time. Google "TPN" - total parenteral nutrition.

I can only imagine how you feel about your brother's situation. So I don't mean to be dismissive when I ask how your *brother* feels about it.

Has he, for example - is he able to? - discussed advance directives with you, or anything along those lines? Have the doctors given him a long-term prognosis?
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My brother (in-law actually) is 65 and was shot in January of 2016 and has had many surgeries since then, most of them unsuccessful. Yes, he is on TPN and has been since Dec. 26th. How long can he live on TPN? He was shot by his daughter's boyfriend as a result of my brother-in-law attempting to protect his daughters finances from the boyfriend. Sad story. The daughter left the boyfriend after the shooting but returned to him a couple weeks later. Even sadder. My brother's long-term care is said to be 12 to 18 months and I'm wondering....what then? Does anyone have anymore answers for me. How long can he actually live on TPN?
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