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Today’s article is about, “Quick Tip For Families In Intensive Care: ICU Wants To Send My Dad To LTAC (Long Term Acute Care) With Ventilation & Tracheostomy Without My Consent! Can They Do That?”

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Quick Tip For Families In Intensive Care: ICU Wants To Send My Dad To LTAC (Long Term Acute Care) With Ventilation & Tracheostomy Without My Consent! Can They Do That?
 

Hi, it’s Patrik Hutzel from intensivecarehotline.com with another quick tip for families in intensive care.

So today’s tip is about an email from Annette who says,

Hi Patrik,

I would love some help or any information regarding an ICU, trying to discharge my father from ICU while he’s still on the ventilator with a tracheostomy from a TBI (Traumatic Brain Injury). They want to move him to an LTAC facility and I want to know on what grounds I have to keep him in ICU.

That’s a great question and it is a question that is very specific to our viewers in the United States because, in other countries, LTAC don’t exist. So let’s just quickly talk about LTAC. LTAC stands for Long Term Acute Care facility or long-term acute care hospital even. And the title of those LTAC is actually very misleading because, from our experience, they are nothing more than a better version of a nursing home, and imagine they want to send ICU patients to LTACs.

And again, LTACs are not even the better version of a nursing home from our experience. So, there are numerous, numerous red flags and risks for your father to go to LTAC. And here is what often leads to that, when patients can’t come off the ventilator in ICU. I should say when they can’t come off the ventilator that quick enough, what the ICU deems is quick enough. They are suggesting to families, “Well, we need to do a tracheostomy and the PEG (Percutaneous Endoscopic Gastrostomy) tube”, and then they can send the ICU patients out to LTAC.

So, it’s very, very dangerous, especially since I have worked in ICU in three different countries and in other English-speaking countries, LTACs don’t exist and patients get weaned off the ventilator and ICU and that’s where they should get weaned off the ventilator. Not going to an LTAC where all of a sudden the nurse-to-patient ratio goes from 1:1 to 1:10. And technically those patients still need ICU. It’s very, very scary, it’s very dangerous and patients have died and because of the lack of care and treatment, those patients are getting in LTAC.

Now we have helped dozens if not hundreds of families over the years to stay in ICU and get the best care and treatment there rather than going into LTAC right. Now, the first step that you need to do or that you should have done, it sounds like your dad already has the tracheostomy. When you or other family members have given consent to a tracheostomy, you might have skipped one step and the step you might have skipped is, have you looked for and asked whether the intensive care team has done everything beyond the shadow of a doubt to avoid the tracheostomy and get your dad off the ventilator and the breathing tube in the first place.

Now, I can’t answer that question for you. However, I’ve done many, many videos about this topic. I’ve done one video, the title of “How to wean a critically ill patient off the ventilator and the breathing tube?.” I encourage you to watch that or read the transcript, because the biggest challenge for families in intensive care is that they don’t know what they don’t know. They don’t know what to look for. They don’t know what questions to ask. They don’t know their rights and they don’t know how to manage doctors and nurses in intensive care. They have no idea.

And I’m not suggesting that your dad may not have needed a tracheostomy. I simply don’t know. So, we now know he’s got a tracheostomy. The other question that I have is, does your dad have a PEG tube or a G tube? It’s known as a gastrostomy tube because if he does chances are higher than with a PEG and a tracheostomy. He will go to LTAC.

Now, chances are that if your dad only has a tracheostomy and no PEG tube that he won’t go to an LTAC because most of the time will not take patients without it, the PEG tube. If your dad has a tracheostomy and the nasogastric tube, chances are very high that he won’t go to an LTAC. That should tell you everything that you need to know about LTAC. If they can’t look after a nasogastric tube that should tell you everything you need to know about the skill set that an LTAC has, it’s actually very poor right now.

The other thing that we’ve seen over and over again is that patients go to LTAC and then they bounce back to ICU within less than 24-48 hours and they often bounce back to another ICU because the discharging ICU no longer has any beds available. So therefore your dad here is at risk of going from the ICU to LTAC bouncing back into another ICU. That means he’s in three different places within sort of 48-72 hours. That is not what a critically ill patient needs.

A critically ill patient needs consistency, need the same people around them, who can get to know them, who can help them recover. That’s less likely to happen if you’re bouncing from place to place again. That is insanity. Now how to stop it?

Let’s get to the meat of it, how to stop it? Well, ask for the hospital discharge policy.  And you will actually see that in the hospital discharge policy, it will say something along the lines of that, your loved one can’t go anywhere without you or your loved one’s consent needs to be mutually agreed on.

Now, there are exceptions to the rule, something like, if someone is ready to be discharged from a hospital cause they’re well and they’re walking around, they’re healthy. You can’t dispute that, but that’s not the case for your dad. Your dad is critically ill. That’s number one.

Number two, you need a second opinion. When we look at medical records, we’re often finding that families in intensive care, are not even told half of the story. And we are often finding that when it comes to dispute situations, whether someone should go to LTAC or not, we often find well, going to LTAC would actually be really, really dangerous. And here are the reasons why your loved one and your dad in this situation and it needs to stay in ICU.

So it’s very simple really, I’d say 9 out of 10 patients are not ready to go to LTAC, especially if you’re getting a second opinion. And that’s what we do here at intensivecarehotline.com. We are consulting and advocating for families in intensive care, including giving a second opinion, and helping you with a dispute process. That’s what you need to do here. Take responsibility for anything that happens, take responsibility for any outcomes and you will see the world’s your oyster. You have taken the first step by reaching out. But the reality is you will only get the outcomes that you want if you take full responsibility for the outcomes.

Now, I hope that helps Annette.

We have a membership for families of critically ill patients in intensive care at intensivecarehotline.com. If you click on the membership link or if you are going to intensivecaresupport.org directly. In the membership, you have access to me and my team 24 hours a day in the membership area and via email and we answer all questions intensive care related.

I also offer one on one consulting and advocacy for families in intensive care over the phone, Skype, Zoom, WhatsApp, whichever medium works best for you. And I talk to you and your families directly. I talked to intensive care teams directly and I asked all the questions that you haven’t even considered asking but must be asked when you have a loved one in intensive care so that you make informed decisions, and have peace of mind, control, power and influence.

I have worked in critical care for over 20 years in three different countries where I also worked as a nurse manager for over five years in intensive care. And I’ve been consulting and advocating for families in intensive care for over 10 years now, here at intensivecarehotline.com. Have a look at our testimonial section and have a look at our podcast section where we interviewed clients and I can say without any hint of exaggeration that we have saved lives for our clients. And when they were absolutely lost, we came to the rescue. Saved lives through our consulting and advocacy, through giving a second opinion by educating our families and our clients about their rights. And because you actually do have rights, you just don’t know it yet.

Now, I also represent you in family meetings with the intensive care team so that you don’t get walked all over. Again, you need to know what to say in a family meeting. You need to know what questions to ask. You also need to understand if you should even go in a family meeting in the first place.

Now, we also offer medical record reviews in real-time so that you can get a second opinion in real-time. We also offer medical record reviews after intensive care if you have unanswered questions, if you need closure or if you are simply suspecting medical negligence.

Thank you so much for watching. And all of that you get at intensivecarehotline.com. Call us on one of the numbers on the top of our website or send us an email to support@intensivecarehotline.com with your questions.

Thank you so much for watching.

If you like my videos, subscribe to my YouTube channel for regular updates for families in intensive care. Click the like button, click the notification bell, share the video with your friends and families and comment below what you want to see next or what questions and insights you have.

I also do a YouTube live once a week where you can ask questions on the YouTube live.

Thanks for watching.

This is Patrik Hutzel from intensivecarehotline.com, and I will talk to you in a few days.

Take care for now.

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