You sound very organized and prepared, but all of it is stressful for you. This was 20 years ago when my Dad fought oral SCC and finally passed away. My husband was a hospital Respiratory Therapist at the time, so he taught all family members how to suction, as well as the home care nurses/aids that were there at night. Family covered daytime hours. He went on to have a home health care business where he employed RTs to do home visits for ventilator and trach patients. Talk to local hospital social workers about discharge into home care as there will be local agencies who provide what is needed for home visits....nurse visits, PT, OT, even home doctor visits. Medicare usually covers this care as long as patient is making progress, but it varies state to state. And my personal opinion is that frequent superficial suctioning would keep the secretions from building up around the cup, as well as very regular cleaning. I hope you are there to speak with the respiratory therapists about his situation, as they will likely have the most experience and best suggestions. Best of luck to you both.