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My dad and I were in an accident several months ago. My dad suffered a traumatic brain injuries that have left him a functional paraplegic and he has some cognitive disabilities. My dad is headed to an inpatient rehab for a few weeks to see if they can train him to get himself in and out of a wheelchair and be able to care for himself. It’s a bit of a long shot considering the hemorrhage he suffered on his brainstem, that essentially left him unable to move his legs much and not be able to tell if he has to go to the bathroom.



after months of in-and-out of ICU care, into an LTACH, and back into general care, we finally got him accepted into a rehab. He’s doing exceptionally well despite his injuries. He’s able to eat on his own and entertain himself. The biggest concern is if he will be able to come home and if my sisters and I will be able to care for him effectively.



I know the horror stories about nursing homes and since we lost my mom just a year ago, it’s hard to imagine sending him dad to a skilled nursing facility. I want to do right by my dad, I just don’t know what to do. I’d love some advice or just to hear about your experiences. Thank you in advance

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If at all possible, try to get your dad home.
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LoopyLoo Sep 2023
Cover, If she takes him home, will you help her? Or pay for people to help?
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I say that either he improves to the extent that he comes home functionally able to care for himself or he doesn't come home at all, you are far too young to give up your present and future life to prop him up.

You asked for experiences - there is a family I know whose mother has a chronic, debilitating disease and at a young age the kids were expected to help dad with her care needs. This has been going on for over a decade now with no end in sight - one child has never been able to create a life for themselves and the other has many emotional scars, both are so screwed up
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anonymous1732518 Sep 2023
This situation is different.

What if the accident was the fault of someone else or the OP?

What then?
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You’re not professionals. With his difficulties, which may get better for a while and then get worse, he needs professional care.

Never ever take someone in such bad condition into your home. His care will consume your life. Your household and all relationships in it will change, and not for the better. You have no idea how long it will last, and once he’s there, it will be next to impossible to get him out.

Skilled nursing facilities are just that. Some are better than others. Choose carefully.
The facility will provide a social life, trained help for the difficult tasks he faces, prepared food and people to hang out with.
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anonymous1732518 Sep 2023
In a perfect world your last paragraph sounds wonderful, but there also could be understaffing, bickering among employees, lousy food, and talking about residents, just to name a few.

By the way, heard the Activities Director at the facility I'm at, quit.
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It will be hard if he does come home, but if that is what you all want then by all means try. If he does, you will need help coming in, you cannot do this on your own. . If he can no longer work, apply for Medicaid. Just get some outside help in.

I'm sure you know this already, but if the accident was the fault of others, seek the advice of an attorney.
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The horror stories of trying to care for a paraplegic parent with cognitive and incontinence issues in home far outweigh the horror stories one may hear about nursing homes. There are people (on this forum especially) who will insist how horrible SNFs are, yet those people are not in the position you are in. Unless you have extensive medical training, you're in no position to care for your father at home. Research good SNFs in your area before passing generalized judgment on "all" of them being terrible. They aren't.

My condolences on the loss of your mom.

Best of luck with a difficult situation.
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I have no doubt of your good heart and good intentions, but I have serious doubt about your understanding what it is to do 24/7 hour care for someone, no matter the love and good intentions. It is almost impossible, and if you read Forum for any amount of time you will see the losses of family, health, job, mind and even loss of the love of the person you are attempting to help.

I spent my life as a RN. I knew at once that I would never be capable of this kind of care 24/7 no matter the amount of love I had for the person involved.

I hope that you and your sister do not attempt this. Do the best you can, given his assets, to find your Dad adequate and kind care. Meanwhile, while he is in rehab, make a point of staying with your Dad for an entire 12 hours so you understand clearly what I am saying to you.
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caylaistrying Sep 2023
Hi, thank you for your advice! It’s been a hard pill to swallow over the last few weeks realizing how much care my dad receives. I’m at the hospital with him everyday for the whole day, and I often participate in his changings and turns. It’s extremely difficult but it’s something we’ve been considering. My family and I were the caregivers of our mom when she came home from the hospital because her cancer caused her to lose mobility
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It will be an unmitigated disaster to even attempt to care for him at home, and will ruin both your life and your relationship with him. He is in far too bad health for that.

Send him to the facility where he belongs.
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From your profile:

"I am a 23 year old caregiver to my father after we were in an accident. I’m a grad student and now the guardian of my littlest sister. "

Your Dad is 45. I'm so sorry for what this accident has done to your young lives.

Because of your age, I think finding your Dad a reputable facility for him will be the best thing for everyone. My MIL is in LTC (on Medicaid) in an excellent facility. Go on Nextdoor.com and ask your community for recommendations. If your Dad qualifies for LTC, he may also qualify for Medicaid to pay for it.

In a good facility he will feel more independent and have more opportunities for social activities and interactions. My MIL gets taken out on a pontoon boat (in her wheelchair) goes to outings, participates in activities, etc. It is a long-established faith-based facility that happens to be very close to our house. Good places do exist. Get recommendations.

I wish you clarity, wisdom and peace in your heart as you and your whole family go on this journey (((hugs)))
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anonymous1732518 Sep 2023
That's the sad part. Imagine living in a facility for 30 or more years.
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You are only 23 and in the middle of your studies. I don’t know your financial situation but I hope your fathers care is covered by insurance it is important for you to finish your studies for your future job prospects. You have a younger sister to help as well. I hope you have the security of living in the family home. You must consider your future life and prospects. Your father needs care by those who are available 24/7. I would think that there will be the availability for your father to come home for visits and short stays. I guarantee he would not want you to destroy your life to look after him full time
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Caring for him at home is the worst thing for all involved. Your dad has complex mental and physical issues that need way more than an average person can give. We tend to think love will be enough to keep going and sustain us through rough times… it isn’t.

Unless you are an RN, PT, and psychiatrist all rolled into one, and can survive on no sleep, and do this for years… you are not qualified to take this on.

Listen to the people here who know of what they speak!

I promise there are nice, caring facilities out there.

But I fear you have already decided to take him home and do it all yourselves.
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olddude Sep 2023
Exactly. You bring him home and you will regret it after about 2 days.

This isn't a Lifetime movie. This is real life. You are not going to be able to solve his problems by just loving him a little more.
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I am so very sorry the accident happened. It has changed your family in big & permanent ways.

Dad is still in rehab, so the journey is still very fresh. The shape of the next pathway is not clear yet.

Hopefully Dad keeps improving as the days go by. Keep having care update meetings with key staff, OT, PT, Dr (or ask for this). Social Workers can help family plan & assist with options once a discharge date from rehab is closer.

You will find that 'recovery' doesn’t really mean 'return to as before'.
Recovery is more a concept - towards a new life or 'new normal'.

When thinking about providing hands-on care, consider these to start;
* what does Dad want?
* how much can you realistically do?
* how much can your sister realistically do?
* timeframe - it will be ongoing
* there are many ways to show love - hands-on care is not the only one
- supported care homes differ widely
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This is so tragic. I suggest you find a good facility close by you so that you can visit often and on at least some visits stay for several hours. Eat with him, take along activities to share (puzzles, card games, music, photos of things you've been doing, etc.) Take him out to whatever type of courtyard they have, wherever his wheelchair will go so he sees things other than the facility. The main thing I can't stand about nursing homes is the people just sitting there, falling asleep in their wheelchairs or being ignored in their rooms. Some of that might happen to him, but all in all he'll be better off there than at home with all the care he'll need. It will exhaust you and he needs you to be strong and happy. He may need much more physical therapy than medicare allows. You can appeal to keep him on PT longer if you feel he can improve. He can still get more PT when moved to long term care and might learn to transfer himself, which will really help him. I wish you well with all this.
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anonymous1732518 Sep 2023
At some NHs, some residents fall asleep in front of the TV.
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Can we please dispense with the whole, "all nursing homes are horrible" nonsense. That is just a steaming pile of crap, and it needs to end right now. Some NH are bad, but the vast majority are good. My mother is in an AL facility, and quite frankly, when the time comes, I wouldn't be against staying there myself.

This reputation that all NH are horrible is the exact reason why so many kids ruin their lives by insisting on taking care of their parents themselves.
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MACinCT Sep 2023
The real horror story is if he is taken home and family has this 24 hour care and no ability to earn a living. Sisters can enter this with the best of intensions and things fall apart and the caregivers get sick
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I think you need to talk to the physical therapist. At your age and now caring for your sister, I don't see you being able to care for a person with your fathers problems. You need to get a job to secure your future and your sister's. You cannot hold a job and care for someone who cannot care for himself. You also need a good Social Worker to help you deal with the paperwork and decisions needed for Dad.
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SnoopyLove Sep 2023
Exactly. How is the social worker at the facility advising them? Also, a minor child (OP’s sister, I assume, is under eighteen) is involved in this very sad situation. The OP needs to stay in school and work and her little sister needs to be in school and allowed to be a kid/teenager. Neither can or should become the hands-on, full time caregivers to their father. It will torpedo their lives.
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