My son has been in the hospital since January 2024, starting in Detroit, MI. Can they really discharge him?

I am surprised he has been in hospitals all this time. Do you mean Rehab? You have to make it plain to the Social worker that it would be an "unsafe discharge" to return him home. That you cannot care for him and there is no money to bring in care. He will need to be transferred to Long-term care with Medicaid paying if he has no money. Do jot pick him up to take home. Once you walk out the door, he is your responsibility.

My 70 y/o father had a similar scenario occur. He has a seizure disorder. He had a seizure and hit his head pretty hard, so I took him to the ER. He was sitting in the ER room eating a sandwich while waiting to see the neurologist, and went into another seizure. He inhaled and choked on the sandwich. Thankfully, the ER responded quickly. His heart stopped (twice), he was ventilated/on life support for several days, but finally started responding to pain stimuli and came out of it (with a bit of left arm/leg weakness and slowed speech, but otherwise mentally intact). Then 2 days later, he had a stroke. They said it was a small stroke, but it had a HUGE impact. He was in the hospital for a couple months after that, in and out of ICU with various setbacks (double pneumonia, sepsis, etc.). After the hospital, he was then sent to inpatient rehab (too early, IMO - he couldn't participate) and was eventually sent to long term care. Due to the repeated TBIs, the weakness in his arms/legs, inability to speak, etc. - and depression (because he went from independent to totally dependent on others) - he had violent outbursts (amongst laughing/crying episodes). He did/said things that were totally out of character (when he could finally speak where we could understand him). He spit food on 1 nurse and kicked another nurse backwards, over the hospital table and bruised her entire arm/side. We were very lucky though, because the nurses didn't report those outbursts - even to the doctors. He was hallucinating and not making sense. He was paranoid, angry, scared and could say cruel things. He really didn't know what he was doing/saying. It has only been in the last couple months that he's really started recovering. How long was your son without oxygen? Dad was down 5 minutes, but the ER took action to preserve his brain (cooling blankets, etc.). It was only recently - when he went into permanent long term care, and he realized that he would have to live in that facility full-time, that he really started to get better. I don't know if he decided he didn't want to live/die there, or if his brain just had time to heal and put all the proverbial pieces together - but the outbursts have stopped. He very quickly started making strides, started getting function back in his arm/leg - though he still has some physical problems. He still struggles to speak. He has dysphagia. His mentation is much better though. He can remember from day-to-day, but is still sometimes forgetful. He's able to wheel himself around in his wheelchair, and can walk with a walker for short bouts of time with assistance. His left side is still weak and his arm/leg shakes when he uses it, but is much better than before. I'm working now to bring him home with me. Have they tried treating your son for depression? Does he have any suicidal ideations? I was hesitant for them to put dad on an anti-depressant, but it (and time) did wonders for him. Don't give up hope, brains CAN heal. How long was he without oxygen (if you don't mind my asking)? They told me that at this point (7 months later), his present status is probably his new functional "baseline". He sometimes acts/speaks like my father, and sometimes is more child-like.. but he's 100% better than he was before. I can't see them discharging your son home. If he cannot care for himself, and/or is a danger to himself or someone else - they are legally obligated to find safe placement. They can't release him. But if they try - do not take him home, because once you do - you're responsible. I'm so sorry you're going through this. I thought it was tough watching my father go through this nightmare - I couldn't imagine having to watch my son go through it. I wish you both wellness and I hope your son gets the care he needs.

This is incredibly sad.
What a terrible injury your son must have sustained, and clearly it had devastating effects on his emotional centers controlling his actions in his brain.
You, with all this time and experience, and with the Social Workers at these institutions telling you what is what for your Son's case and the doctor's explaining his diagnosis and prognosis, are really the expert here. I would guess that we will have little information we can give you.

Most of us on aging care are dealing with the dementias that occur with aging. While some of our elders do have troubles with controlling their emotional centers, it is medically recognized that little can be done other than finding the right drugs or "drug cocktails" to attempt to keep our loved ones somewhere between rampaging wildly through home and hallways and sitting asleep 24/7.
It just bears no resemblance to a TBI, and TBI science is so new. It wasn't until wars that gave us percussive injuries injured so many of our young men irreparably that we even recognized this as a diagnosis.

Many TBIs are notorious for very slow healing.
I wonder, and I hope, do you have any access to hospitals specializing in this care, to any of the VA (Veteran's) hospital doctors, who are the best at working with this.

I hope someone here may have some ideas for you, but in all my five or so years on this forum I haven't heard of a TBI this serious. And I know, you being the family, will have researched this out so that, as I said, YOU are the real experts. I cannot come up with a thing for you. Your son will have to be in a state where he can be cared for, where he has some control over his violent outbursts, or he will be required to have medications that medicate him below the state where he is a danger to others. As to take him home in his current state I truly cannot imagine such a thing.

I am so very sorry. This is dreadful. My heart goes out to you and I just keep hearing Dr. Laura in my head with her "Not everything can be fixed" admonition.
I hope that time is the healer here. Brain cells can recover. People do heal. This is unimaginably hard. Can you tell us how your son sustained this awful injury?

Prayers for your son and you!!