Is moving my husband home after his stroke a good idea, or will he lose all the progress he made in the nursing facility?

7 answers | Last updated: Sep 14, 2017
A fellow caregiver asked...

My 73 year old husband had a stroke in Feb of this year. He was in ICU for 3 weeks and went to a nursing facility for rehab. Insurance has ran out so far as room and board, he has state medicaid, but the therapy is almost at a standstill. He has a stomach feeding tube. Supposedly temporary as soon as his swallow strength is good, he will be able to eat. He is totally dependent on a wheelchair and non-ambulatory. He wants to come home and I want him to, I have 2 sons and a daughter to help at home. My question is how do I know that this is the right move without causing him to go backward instead of progressing as much as he has in the past 5 months? Am I being scared for no reason? What if he isn't happy at home not being able to do for himself as he has always done? Any suggestions?

Expert Answers

James Castle, M.D. is a neurologist at NorthShore University HealthSystem (affiliated with The University of Chicago) and an expert on strokes.

If he really wants to come home, he probably has a good reason (i.e., he is not getting along with the staff and other residents at the nursing home). I would try your best to help him with this. The easiest way to go about doing this is to ask his physical and occupational therapists how much assistance he would need at home (24 hour nursing care, daytime nursing care, etc.) and work with the social worker either at his current nursing home or at the hospital wher his primary care doctor works, to help arrange such coverage. Please don't overly burden yourself with managing his 24/7 needs - this, in my experience, only leads to severe burn-out and resentment.

If the above is not a feasible option, then consider moving him into a different nursing facility. There are often many different options in every region, and you might find one that fits his needs much better than his current situation.

Good luck!!

Community Answers

Ash4456 answered...

Every situation is different but I would certainly consider bringing him home.

My 73-Yr-old (now 76) husband had a massive stroke in October 2008, spent 8 weeks in ICU and 100 days in a nursing home/rehab. I brought him home as soon as Medicare ran out since we do not qualify for Medicaid and cannot afford a nursing home.

My husband is dependent on a wheelchair, must be lifted to transfer, he can now eat but could not for many months -- it sounds much like your situation. He has 2 grown children but they moved on with their lives once the chronic nature of his illness became apparent and I take care of him all by myself.

He improved as soon as he got home. It was the best thing we could have done for him and I will care for him here all his life unless something happens to me. One nurse told me she can see I am doing a good job because he is so happy.

It's not easy though, and Dr Castle is right -- I have gone through burnout, depression, injury, despair -- and come out the other end. I now know why I am doing this and am ok with my life. It's worth it but don't think it will be easy. If you can't do it, a good nursing home is an honorable option. That's not so easy either!

I hope things go well for you and your family. Good luck.

A fellow caregiver answered...

Your husband is 73 which tells me you are more than likely about 65 or older. I don't know your health problems. You did say you have 2 sons and a daughter to help. With that said. It is possible you could bring him home. However, With him in a wheelchair full time you will have your hands full. Can you lift on him? I mean life him from the wheelchair to the toilet? Then back to the wheelchair? If you cannot do just this one simple thing then you have a problem already. Sure he can wear a diaper (if he will) then of course he will have to wear that diaper (dirty) till someome (son or daughter) can come over to help change him. Can you get him in or out of a bath tub or do you have a way of bathing him in the bed? These are important questions you need to ask yourself before making this decision.

I like you had to make a decision like this. It is not an easy one to make. You want him home. He wants to come home. However, is this where he will get the very best of care? What will happen to him if you get sick. Is there someone that can come in and take care of him 24/7 should you get sick? Do you have this type of backup? Really?

Just because, you have two sons and a daughter to help how much help will they be. They have families too! Yes I am sure, they would be glad to help as much as they can but, how much is that really? Be honest in answering these questions before, making your mind up. Once you decide to bring him home it might not be easy to get him back into a care facility again. Right now you can have him moved to a different place that he might like better if only till he gets better and much stronger. Most states or places have a long waiting list to get someone in a care facility from a persons home. I would check on that before, I took him out of the place he is in now.

Just a few things to think on in making the right decision.

talk it over with your sons and daughter about these questions also.

Ash4456 answered...

Good points made by the previous Anonymous poster. I am more than 20 yrs younger than my husband, I have no health issues and he is not a big or heavy man. If her were 6'4" and 200 lbs it would have been very different.

Finances are another big consideration. We had retirement savings so I could stop working -- there will be nothing left for my "retirement" but nursing home costs would have stripped us of all our assets anyway and I would have been working and commuting to pay the nursing home. If he is eligible for medicaid and you have a job, a nursing home might make more financial sense.

As for help, you know your kids, but my husband's kids adored their father and were always going to be there for him... We haven't seen them in 18 months and they call maybe once every couple of months. Better be sure you can do it alone.

It's a difficult decision, and all this conflicting advice is probably not much help. Good luck. I hope he gets better

Weezer 43 answered...

I see all these points. Both my sons live at home with me, my daughter is right next door. The staff at the nursing home is very understanding about him wanting to come home. They are going to do a training program for the kids to help transfer him from bed to chair to bathroom and etc. Nursing is going to instruct my daughter on the feeding tube. I am a CNA/CMA so this is not exactly new to me. We have kids in other states with families of their own. Yes I am 67 years old, I do have health problems. For both of my sons, we are their family. Neither is married and both live at home. My daughter living next door, has children, but they are grown and away from home. Everyday he asks me to take him home. We are waiting on getting the ramps for the wheelchair done and the finances to do it. I have talked to a home health agency that will help and they also offer respite care so I can get away for a day a month. Right now, he is getting ice chips to help with the swallowing exercises. He is getting stronger on his swallow tests, but not quite enough for food. He has a catheter, however, he can say when he needs to use the restroom. I don't know that he will come home with the catheter, right now he has a UTI and they are treating it with antibiotics. I think when the session of meds is done, I will have them take the catheter out since he has had it since day 1 of his stroke. So far as bowel control goes, with the feeding tube he has a lot of diahrrea. However, he knows when he is dirty. He can transfer with the right leg and one of the boys is home 24/7. I am not blind to suggestions or help. Any and all of these comments are very helpful because it lets me see how others have handled the same or similiar situations. Thanks all suggestions are helpful

A fellow caregiver answered...

With all you just wrote and the answers you gave to all the questions I posted. By all means. BRING HIM HOME! GOD BLESS YOU!

Weezer 43 answered...

Thank you so much for all the input. I feel better with different opinions and people who have been there before. I don't expect it to be all roses without the thorns, but I am a firm believer that Jesus will provide and that He has us in His hands. We have prayed lots and lots and had some miracles along the way. I believe in Miracles wholeheartedly. I feel this was a miracle in finding caring people to interact with. Thank all of you so much. We are counting the days. 26 to go. Getting housework done, carpets cleaned, furniture moved and things situated for his comfort. Once again, thank you so much.