Family member in ICU, need some insight please.

71M, 6ft, 350lbs, white, cellulitis infection in his L lower leg. He was alert and oriented. Went to the ED via squad 4/3 around 7pm. CHF, diabetes, kidney failure (stage 3), Afib, hypertension. Currently he is on oxygen 2L, insulin, a blood pressure med, eliquis, dopamine, propofol. (im unsure of the doses, he may be on more medication but im unsure). Not a current drinker, smoker or user of recreational drugs.

Family member lives alone. He refuses any help with personal care. He has not seen a dr in over a year(He has been offered help from family and friends but always has an excuse to not go, and just doesnt want to deal with doctors, and never has liked to deal with them). He was sick at home, fever, chills, leg swollen and had an odor. His family finally talked him into going to the hospital. He went in via squad. He was unable to stand on his own or pivot to the gurney. (He has had very poor mobility, and very bad knees for a long time).

By the next day he was admitted and in a room, getting treatment for cellulitis. PT evaluated him and tried to have him stand and walk. He couldn't do either. He did comply with the staff and do some core PT for a little over 10 minutes. PT recommended him go to an inpatient facility to do PT and get stronger to be able to return home. He immediately said no to the nursing home. Said he can walk and asked family to bring in his walker. (I think he has been in denial about his health for some time. He only had a small amount of independence left and his mind. And he wanted to hold onto that for as long as he could)

Some family talked to him and he finally agreed to go to inpatient therapy, but only for 30 days. He was very attainment on only being there short term. Paperwork was started, he was accepted to a nursing home.

Later that evening things turned for the worst. He began to breathe very rapidly, became confused. He couldn't do simple tasks asked by the staff. The saff moved him to PCU. There they put him in a bi-pap, in hopes it would help his breathing. It didnt help him.

Thats when they moved him to the ICU, put him on a ventilator, and sedated him. (so this is early wednesday morning, I believe around 3am)

I got the call Thursday morning that this happened overnight. He was a full code at this time. (we have tried previously to talk to him about POA and a living will, he never wanted to talk about it). He has only 1 son, so he is the voice for the family member currently.

The doctors explained to us when we got there thursday morning, that he is very sick. They talked to us about code status. He is on the propofol, lactated ringers and dopamine. The resident explained to us, the dopamine is supporting his BP and pulse , and that without that, he wouldn't make it. We ended up changing him to a DNRCC.
He has a kidney specialist, cardiologist, critical care dr, hospitalist and resident as his team.

Wednesday morning he had an echo- it showed left side weakness, right side pumping as it should (This was the same as it had been many years ago). They took cultures from his lungs, and blood. All have came back with no bacteria infection so far. His blood work showed he was acidotic. Bloodwork also showed he would be considered stage 4 kidney failure. On a CT scan, they they found a soft lump on his left hip full of infection. They talked about getting a consult with OR to see about draining it, or what they could do about that. (Ive yet to hear an update on that). One dr that had seen him on the other floor came to talk to us. He said he thought maybe he was full of mucus and that may have caused the rapid breathing, and a blockage which made him retain CO2. This same dr wanted to look into doing a procedure to go in and clear out all of the mucus in his lungs. He also mentioned wanting to do a CT scan with dye- to look at his chest and brain. But he explained, doing so would further injure his kidney function so they weren't leaning to far into that.
Throughout Wednesday, they played with the dopamine. They tried stopping it completely, and just lowering it. Both ways, the family members blood pressure and pulse would tank. So we would end back on it everytime. The nurse told us the cardiologist was thinking the he was having a firing issue with his heart- saying he recommends putting a pacemaker in. He said the pacemaker would act as the dopamine and support the BP and pulse. This was sort of shocking to us, as previously the other doctor had told us, after 48 hours, there wouldn't be much that they can do in terms of helping him further. (However I know at this point its still early on. They were doing all the tests they could to figure out why this happened and how to fix it)

Thursday morning. They stopped the sedation and dopamine to see how he would react. He was able to be off those drugs for 2 hours. We had got to the hospital at the end of that time frame. When we got there we talked to the family member, held his hand. The nurse and I asked him to squeeze our hands-no response. He was full of mucus so they suctined him a lot. His O2 dropped to the 70s, they called respiratory in. They suctioned him more aggressively. They noted a large ball of mucus and wanted to go in and scrape the mucus out of his lungs. The dr agreed. They put him back on full sedation and dopamine at this time. After that procedure his O2 went back up and he seemed comfortable.

We then spoke to the critical care dr after that. We wanted to get his insight on the pacemaker and see if we could get on the same page. We asked if he recommends this, and if our family member would be a good candidate. We explained how he lived at home prior, and that we were concerned with how his life would look like after the pacemaker. He said everyone would be a candidate for a pacemaker, however with his conditions and how he lived non compliantly, and all of the health conditions he has, he would not be a good candidate. He said our family member would likely be bedridden the rest of his life, wouldn't be able to go home, and would need 24/7 care.

This is all such a shock to my husband and I. Especially since it happened so quickly. I guess I am just looking for other advice or any insight. My husband is very strongly wanting to make decisions based off of what the family member would want. The family member has been very clear in the past about never wanting to live in a nursing home. Since he was barley holding onto what little independence he had left, I think he would be very upset if we not only put him into a nursing home, but if he had to live there with no mobility. I do not see him having the will to do PT after all of this. Being on the vent takes so much out of a healthy person, and he was far from that. He would not only need PT on his legs, but his core and arms too, basically everywhere from my understanding.

My husband keeps thinking, what if I make the wrong decision? He wishes the family member would come out of sedation long enough to say what he wants done, however, he realizes this will likely not happen.

I think what he is leaning into is, not do the pacemaker, let the staff wean him off the sedation & vent, and start palliative/comfort care measures. (this is also something the dr that had seen him on the previous floor had recommended.)

Im trying to support my husband and our family as much as I can. This is so mentally exhausting, I cant imagine how my husband feels. This family member has been in my life for many many years. I love him to death and look at him as a father figure in a way. If you have any advice on how I can better support my husband I am all ears.
If you have read this far, thank you so much. I really appreciate you for that alone.