Hi-I want to bring him home where he will have to have 24hr care, one in the morning, afternoon, night. He needs to be changed and cleaned, he can't walk at all. Please help me bring my dad home with his mom and 2 brothers.

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Sue, thank you for that kind compliment! My face is becoming so red it's heating the rest of me! No need to turn the furnace up for a while.
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Amazing Grace,
I'm so sorry to hear of your father's devistating stroke. As a nurse, I have cared for many stroke victims. With your dad's limitations, one caregiver is not going to be enough. In the hospital we always turn our patients with 2 nurses. Would a family member ALWAYS be available to assist the paid c/g in turning and pulling up your dad in bed? I would think your mom, in her 80's, would be too fragile to do any turning and lifting/repositioning. Are you and your brothers in good enough physical shape to assist? Also assist in diaper changes? I ask this because 39 years of nursing has ruined my neck and back. I'm 60 and get shots in my neck, back and hips for pain. He will be dead weight and unable to help.

Next thing for you to check is to see if the c/g's can do tube feedings. If not, then a family member would have to be trained to do it or you'd need a nurse. Who would crush the meds to give in the tube? C/G's can't give meds.

Hun, I know you want him home but I also know that you probably don't know the extent of his care. They are complete care.....bathing, shaving, changing diapers, feedings, oral care, changing sheets while the patient is in the bed, etc. If you want to get him up in a Gerry chair, you'll need a Hoyer lift and 2 assistants.

What if the c/g can't work the shift and the company doesn't have anyone else to send? Could the family do all the care for that shift?
This is a huge undertaking and you will be physically and mentally exhausted.
I would request that you reconsider.

GA, that is the most comprehensive post I've ever read! Bravo for such good council.
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My question, why the feeding tube? Is it because he can't eat or swallow? What put him where he is?
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Amazinggrace66, are you also taking care of your Dad's Mom and his two brothers? You wrote "Please help me bring my dad home with his mom and 2 brothers." Or was that a mis-type as your Dad's Mom would be over 100 years old. Did you mean your Mom and your 2 brothers? Just want to clarify.

You would need to hire outside care to come into the home to help. It cost my Dad $20k a month for this type of service and his care was minor compared to the help your Dad needs. Would Dad be able to budget that type of cost each month?

If such care of out of reach financially, Medicaid [which is different from Medicare] could step in, but they wouldn't bring in help nor pay for help.... they would have Dad live at a nursing home which is more cost effective for Medicaid which is paid by the taxpayers. Your Dad's care would be paid by Medicaid as long as he is in a nursing home. Plus some nursing home have rehab where Dad could get different types of therapy to help his stroke.
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Grace, it would be helpful to first become acquainted with what help is available.

1. Medicare will pay for some home care if it's scripted for by a doctor. It might be a nurse a few or more times per week, physical and/or occupational therapy, speech therapist, home health aide and social worker.

This would only be for a limited period of time, and is often prescribed after someone has been through a hospitalization and rehab, then discharged to home.

To my knowledge, it does not provide for 24/7 care.

2. Private duty care can be 24/7, is completely private pay (unless your father is a veteran) (I don't know about Medicaid), and can provide a home health aide, light duty cleaning, assistance with meal prep (I don't know about tube feeding though), and possibly some medical assistance if the particular company has either affiliations with a home health care agency or has its own limited staff of medical personnel.

PD is NOT regulated, and from my experience in trying to find one that met my standards, it's literally like the Wild West. Expect to be pushed by marketing reps, alleged nurses no longer practicing, account execs, and others who explain what that agency does.

Many are franchises; while a franchise in one area may be top notch, another in a different area can be less well run or managed.

These franchises are in a position to offer a lot but what you really get is described in the contract, which typically requires a deposit of two weeks estimated work cost, payable at signing. The advance reps don't understand contracts and frequently misrepresent situations.

It took over 4 months to find one that met my standards, but I also wouldn't accept or sign contracts w/o addressing onerous terms. Franchises don't change contracts so you either take it or leave it.

I also wanted an agency with military personnel and experience, and few had that.

3. Palliative Care. A spinoff of Medicare, it provides limited care for people with chronic conditions. Some limited medical support is available depending on the specific illnesses. It has to be scripted for by a doctor.

I think in your situation a blend of Private Duty and Palliative Care would be necessary at this point, but that also depends on your father's particular needs.

If he's in rehab now, he would need to stabilize to the point of being able to benefit from home care.

2. These kinds of rehabs are typically staged; going home directly while very incapacitated is risky for everyone and not the best route to recovery.

Before going any farther, I would have a good, thorough discussion with the doctor(s) at the facility where your father is now. You'll need to know the extend of the stroke effects, his prognosis, how much improvement can be expected, etc. Ask specifically about the care plan for him.

You should also speak with the physical, occupational and speech therapists to get the same issues addressed - i.e., feeding tube indefinitely? Speech therapy and exercises?

The therapists can also assist you in ordering assistive devices, walker, rollator, wheelchair, liquid nutrition (for the feeding tube), hospital bed, grab bars, etc. for home use.

3. Then you'll need to assess how much you can do by yourself, and how much help you'll need. Ask family members (but know their personalities to determine whether they can be relied on) whether or not they can help.

What is the situation at your house? Are you living alone? What about your father's home? Are there siblings who can be counted on? How old is your mother?

Are you working part or full time? How old are you? Do you live in a cold weather climate? (That makes a big difference in taking your father out for medical care.)

4. Some background on your father's situation would help others respond to your query. Is this his first stroke? How extensive was it? How long was he hospitalized, and how long has he been in rehab (I'm assuming that's where he is now)?

I had somewhat of an impression that you wanted specific assistance, i.e., negotiation, intervention, as you might have thought this forum was actually an entity that could intervene on your behalf. It's not. This is a forum of people with experience and interest in various caregiving applications. Posters can offer advice, but can't intervene to bring your father home.
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I would have no idea how to provide that kind of care. I might contact a home healthcare agency to inquire of their services. You'll need experts in how to properly care for him. I would imagine, it would be quite costly too.
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What exactly is it you need help with? It is only doable as long as you have very deep pockets, there is space at home to accommodate lifts, have the ability to access visiting medical care and are prepared to have strangers in the home 24/7.
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Where is your father now?

Have you talked to the senior staff members there about the possibility of bringing him home?

I'm guessing that it's your mother and two brothers who are also concerned about your Dad, rather than his. How old is your mother? Is she in good health?
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