The doctors gave two alternatives, but for the Dan children there was never really any choice. Their 71-year-old father, paralyzed by a stroke, would not go to a nursing home.He would come back to his own home. The detailed technical knowledge they would need to care for him, nurses could teach them, but as one nurse noted "the main ingredient - love - was already there."
So on March 17, the lives of Connie, Lydia, John and Linda Dan, aged 14 to 28, became a perpetual relay race, built around keeping Chong Dan, who could not speak, eat or move, as comfortable as possible in their modest Silver Spring home.
The children, whose mother died five years ago, now come and go in a never-ending series of shifts - working, going to school and handing responsibility for their father's round-the-clock care to the next Dan, who will remain at home for his turn at nursing.
It was either this or a nursing home for their father, a retired restaurateur. "We canned that nursing home idea right away," 28-year-old Linda said recently.
"We couldn't have felt comfortable if he wasn't home with us," ninth-grader Connie piped in.
Resgistered nurse Marti Tinsley, who visits the family twice a week and has taught it the technical nursing skills it need, said the Dans "had to turn their personal lives inside out to care for their father literally 24 hours a day."
Doctors have told them not to expect any improvement in his condition, John said.
But the Dans and John's 27-year-old girlfriend, Betty Trent, who has joined the family to help, just shrug off what they're doing.
"It was just in our mutual interest" to do it this way, John explained with a smile.
The Dans nursing training began last March when a nurse handed Linda a hypodermic needle and an orange. She was told to practice giving the orange shots so she could properly administer insulin injections for her father's diabetes. The family also learned to feed the elder Dan through a nasal-gastric tube, to bathe him, care for his skin, exercise his arms and legs, turn him hourly to prevent bed sores, take tests to check his sugar count and handle any number of complications that could arise.
Despite the training, there still were frights in the first few weeks, like the time Dan started shaking all over and sweating while only Connie and Lydia were at home.
"We thought we had messed up his whole system," Connie said. Midnight phone calls were made between the Dan household and John's apartment, and finally,as mysteriously as it had started the shaking stopped.
A nurse later determined it was probably caused by pain, and the family was given the proper medicine to administer.
Through all this, the home care department of Holy Cross Hospital in Silver Spring, where Dan had been a patient, worked with the family. The department is set up to provide nurses, social workers and many types of therapist to homebound patients and the persons who care for them. The department is currently working with about 150 such patients and their families, according to nurse Tinsley.
But what uncommon about this family is they've accomplished so much with so little outside direction and no adult authority figure to help them," Tinsley added.
In fact, 25-year-old John, who had been living in his own apartment for about 6 years, has moved back home to take over as head of the family. His girlfriend has taken on the cooking and the cleaning duties as well as helping care for the elderly man.
Medicare pays for the cost of the nurse's visits and most of the medical equipment. The family pays for such items as Dan's special food, hospital gowns and medicine.
An intricate schedule orders the lives of the Dans, allowing time for John's job as a foreman on refrigeration and air-conditioning projects, for Linda's hours as a waitress and for Connie's days at school.
There's no such thing as a typical day in the Dan schedule, which changes to accommodate new working shifts, an illness in the family, special occassions or just someone who needs some time off.
But on recent Thursday, the day began at 5 a.m. for John, who got up turned his father from his right side to his back, gave him an insulin shot began his first feeding through a nasal tube and then left for work.
At 6 a.m. Connie arose, dressed for school, cleaned up after the feeding and sterilized the feeding bag. By 9 a.m. Betty and Linda were up, and Landa handled the 10 a.m. feeding. At noon, Betty gave Dan his bath and brushed his teeth.
Throughout the day, he was turned from his right to his left side and to his back, sugar count were taken and his arms and legs were exercised. Another feeding came at 2 p.m., this one done by Linda.
As Linda left for work at a restaurant in Georgetown, Connie was coming home from school, and she handled the 6 p.m. feeding. At 10 p.m. it was 24-year-old Lydia's turn. At midnight, Betty who had cooked and served dinner, took the elder Dan's sugar count, and Linda, home from work by 2 a.m., handled that feeding. The cycle would begin all over again at 5 a.m.
What has the Dans given up to keep their father at home in the bright blue, first-floor bedroom?
"Time," said John.
"Our own freedom," answered Linda.
"Saturday night," Lydia said with a grin.
"Sleep," said Connie.
But there have been rewards. Their father can now swallow a few teaspoonsful of grapefruit juice. He is "fighting back" when Betty exercises his legs. There are his brief attempts to speak. And in his eyes is a look of recognition that seems to say he knows his children are right theere.