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Hi all. My FIL has been hospitalized since 12/10, he had 2 liters fluid removed from his lungs, then his blood pressure was really low. Anyway on Saturday they put in a feeding tube because he is having trouble swallowing and is malnurished. So the hospital is saying they are going to keep him another 2 weeks to make sure the tube is working and he’s getting nutrition and then they will send him to rehab for 2 weeks for physical therapy and then he’ll be sent home. does this sound right? And what kind of care will he need with a feeding tube? Will he need a visiting nurse? Or will a family member have to be trained on how to use it? Honestly he hasn’t been taking care of himself since he moved out here this summer. He was malnourished when he was hospitalized on 12/6 so he hasn’t been eating for some time now. He lives with my BIL, he helps them out financially and I really don’t think either of them realize that someone is going to have to work the feeding tube, someone will have to administer the food as well as try to unclog the line at times. Is it realistic for him to come home with a feeding tube? Even if he could afford a caregiver, he wouldn’t hire one. I don’t know if he will qualify for IHSS and even if he does, then there is the matter of finding a qualified caregiver. Wondering what your experiences are with feeding tubes & patients at home? Is it a lot of work? Requires a lot of training?

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My brother-in-law came home with a feeding tube and we still feed him enterally. The Nursing home nurse taught my husband how to feed my brother-in-law with the tube and we had a home health nurse come in every week or so for a while. It is not hard to do but it is tiresome having to feed someone every four or five waking hours. One of my friends' brother had throat cancer and could not swallow after surgery and treatment and he was able to feed himself. You have to flush the tubing before and after the food and also watch the area and put barrier around it where the tube goes in the stomach. The disc on top sometimes irritates it. Unfortunately, licensing regs in this state prevent an CNA from feeding someone so it is difficult to hire someone who can do it while you are out if longer than the time in between feedings. I hope this helps.
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worriedinCali Jan 2019
Thank you. This information helps a lot! I think it’s clear my FIL can’t come home with a feeding tube, there is no one who can administer his feeds during the day. And he won’t take care of the area and put a barrier there. He’s got a chest tube now, I found out today. So coming home is not an option at this point.
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Yes the family will be trained on how to use the tube at home. I speak specifically about a PEG tube. NG tubes are seldom if ever used for long term feeding - they are just too unreliable.
First, Calm down. It’s going to be ok. He won’t be sent home until the family is taught how to do it. I’ve seen many PEG tube patients in home care. It’s not that hard to learn once you’ve become comfortable with it. The nutrition comes in premeasured cans with the formula specific to the person’s nutritional needs. I never had to mix anything; just gently roll the can to make sure it’s well distributed. It is ordered and delivered monthly in cases.
Care of the insertion site is pretty easy as well once it’s healed. Mild soap and water will do the trick. Sometimes the tube is sutured in, sometimes not.
Feedings are usually given in boluses meaning amounts of 150-250cc each time. 1 oz = 30cc so 240cc = 1 cup. You are taught to flush the tube with water before and after to assure the tube is patent.
If the person is independent they are taught to do it themselves.
Someone will have to learn - can FIL be taught? Let your BIL learn how to do it. If I were you, I would not. You have enough to take care of.
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While he is in rehab inform them that because of everyone working and you raising small children there is no one home who can care for him. That it had already been discussed that maybe it was time for a NH because he wasn't able to care for himself anymore.

How long has he lived in the US? If over, I think it is, 5 years he maybe able to get Medicaid.
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worriedinCali Dec 2018
Well it’s going to have to be my BIL that does all that. My FIL was born and raised in the US, he just moved to California 5 months ago. He’s got medi-cal insurance already but don’t know if he can get IHSS. He exceeds the $1242 monthly income limit.
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"My husband said something the other day about him coming to live with us and putting him on IHSS but I don’t know if he would qualify for IHSS because of income guidelines and he would be moving to a different county."

Once BIL and SIL see how life with a feeding tube goes, they won't want to do it anymore. So, even though they don't want to lose his monetary help, they will probably be glad to foist FIL off on you.

DO NOT even go out to help with the feeding tube during the day if FIL is at BIL's. You will have "mission creep" before you know it. It will be the logical next step to have FIL come live with you, since you will know how to take care of him.

You are correct in that YOUR young family comes first. Do not even let FIL move in on a "temporary" basis (which could quickly become permanent). Be VERY FIRM on YOUR boundaries regarding YOUR involvement and YOUR home life, and let the siblings decide as they may what to do about/with FIL.
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Thank you both. The feeding tube is in his stomach. My husband says it’s not permanent but my BILs wife is saying he’ll be coming home with it. He’s not taking care of himself so he’ll be dependent on my BIL and his wife to set up his feeds I guess. He can’t do it himself. I am not sure why the tube is temporary, he’s been having difficulty swallowing for 8 months now! He went to the ER via ambulance last April because he had food stuck in his throat. And my BILs wife says he hasn’t been feeding himself, he’s home alone all day and doesn’t fix himself anything to eat. My husband told his siblings he thought their dad needed to be in a nursing home (because his kids all work full time and have young children and none of them can take on the roll over caregiver). But in talking to my BILs wife, I think they are expecting to bring him home but....i’ll Just say it. They are money motivated. They moved him out here to help pay the mortgage on their new house. If he doesn’t go back there, they lose his money. My husband said something the other day about him coming to live with us and putting him on IHSS but I don’t know if he would qualify for IHSS because of income guidelines and he would be moving to a different county. He’s only been a CA residence for 5 months as well. I really do NOT want to be his caregiver which is what my husband suggested. I don’t know anything about feeding tubes other than they can get clogged and someone has to administer the food. I also have no desire to look after a grown adult when I’m busy raising young children. Not sorry about that either. I don’t have it in me. And I feel strongly that my kids have to come first, especially after what we have all been through with my MIL this year. My kids just watched her dying for 3 months. So I think he’ll be going back to my BILs house, so hopefully BIL and his wife learn how to use the feeding tube.
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Hello WorriedinCali, Both of my parents had feed tubes for different reasons. My father has had one for over a decade now due to a rare GI disorder. It’s a little difficult for me to answer some of your questions because there are different types of feeding tubes and different ways to administer liquid foods. Some may be easy than others for people to catch on to. In short, your loved one should be educated on how to work the tube and get assistance. The rehab facility can arrange that with a visiting nurse service once your loved one is released.
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OctoberAngels Dec 2018
I was about to say the same thing. My son often has one during times of GI distress and inability to digest correctly. At first I assumed it would always be the same type and was surprised when a different one was placed. I agree, and I asked to be taught while he was still in the hospital so it was more comfortable to do once home. It seems to take home health 2 days to catch up once discharged. Good point Redbird1.
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There are a few questions for you.
Is this a permanent tube or are there plans to remove it?
Is this a tube that has been placed in the stomach or is this a NG tube (nasal gastric)?
If it is to remain when he is sent home the family will have to learn how to mix up the nutritional food. they will have to learn how to feed, how much and over what period of time. And they will have to learn how to maintain the tube(cleaning and clearing)
It can be managed at home with few problems. If there are questions the time to ask is prior to leaving the hospital or rehab and ask that each person that may be involved in feeding him be trained in each aspect of the procedure from mixing up the food to administering it and cleaning and clearing the tube.
If there are any problems help would be a phone call away and with a feeding tube there would rarely be a life threatening emergency if something were to happen. (Unlike a malfunctioning oxygen or dialysis machine.)
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