She went into the ER in July 2014 with trouble breathing and disorientation and they put in a temporary trach vent. That ended up being permanent, as she was (eventually) diagnosed with ALS. For her, ALS started its work by attacking the muscles in her lungs, so her disorientation was really a matter of her lungs not being able expel all the CO2.

In any event, she was on a feeding tube from July 2014 through her death in November 2015. My dad would buy that stinking formula in bulk and feed her multiple times a day. Clogs were a big issue so keep a good eye out for those.

If you have the wherewithal, I would highly recommend bringing in a home nurse to train everyone on how to do things. You may have done that already, but if not it's something to look into.

Another thing to keep in mind is Medicare and what it does or doesn't cover. Again, if you can afford it, talking to an elder care attorney can help you in the long run. Even if it's just for an hour or two, they can point you in the right directions. Sometimes you have to fight for what you're due, unfortunately.

Physically, be prepared to watch your dad wither away. I hate to say it, but it's going to happen. You've probably already seen a bit of it, but it'll happen more. Is he bedridden? Try to move him regularly to avoid sores. Be prepared for the idea of changing him and cleaning up after him, if you haven't been involved in that yet. Especially if/when he becomes more bedridden, that takes away a lot of dignity; do your best to maintain as much as you can for him.

I'll be blunt: the next six months to a year that you expect is gonna suck. Take care of yourself, too, and find yourself someone to talk to if you're feeling overwhelmed.