Raeanne and Sunny, I just want to welcome you both to the forum. You are in very difficult situations. My mother was also a life-long, practicing alcoholic (I'm a sober one for nearly 23 yrs. now.) I only lived with her for 5 yrs. of my life (my teens), so it was easier to cut off relations with her about 25 yrs. before she died. Long-term, heavy alcohol use affects the brain ("wet brain") and that is what happened to her. (Complete senility...wasn't able to give any correct information.) She ended up in a NH and died of a heart attack in a hospital.
Sunny, from what you have described TIPS really doesn't sound appropriate. Since Hospice is involved, wouldn't that be beyond what they consider "palliative" for a patient? Some of the caregivers whose loved ones have had the procedure may be able to answer that one...or Hospice, itself. Given the hepatologist has never met the patient(!!), he is giving a recommendation based on whatever he's been told or records he's seen. Unless it's a true life and death moment, IMO that's poor medical practice. Any reason the doctor hasn't met the patient?
If the care becomes too much for your families (and it seems it already is), what are the alternatives? In my city, there are 3 Hospice inpatient residences. (Hospice never turns anyone away for inability to pay.) Sunny, since Hospice is already involved, ask about residential care. Also, your uncle should qualify for Medicaid and possibly a NH. Raeanne, you could check that out, also. Sometimes the best way to get a patient into a NH is via the ER and what is called a "direct admit." I have heard doctors I worked for suggest this many times. If true nursing care is not really needed around the clock, some type of custodial care might work. The cigarette smoking, considering your uncle's mental state, is a real concern because of the risk of him starting a fire.
There is also the Meyer's Act, for alcoholics...much like the Baker Act, when a person is a danger to himself or others. In FL, the name has been changed (which escapes me right now) to include drug users. The court orders appropriate placement.
I just wanted you both to know that there are alternatives. One thing I've learned in life is not to have "tunnel vision." In any given situation, there are always options. And it never hurts to check out options, even if it's decided not to use them. These decisions are difficult to make, but as many caregivers of Alzheimer's patients can attest, it usually is just too much for them to handle at home. Given the mental status of these men, it sounds like a similar situation...especially in your case, Sunny.
If you just want to vent, that's fine, too. We all need to do that as a coping mechanism, and this is the perfect place as there are others here who can empathize and support you.
I ordinarily would suggest you start a new topic, but since I've given such a long reply, that doesn't seem appropriate.
However, if you know how to "copy and paste" your posts into a new topic, that would assure that everyone sees them.
Forum moderator - Hepatitis
"But that was yesterday, and I was a different person then."
Lewis Carroll, Alice in Wonderland