Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM, where we instantly improve
the lives for Families of critically ill Patients in Intensive Care, so that you can make informed decisions, have PEACE OF MIND, real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care!
This is another episode of “YOUR QUESTIONS ANSWERED“ and in last week’s episode I answered another frequently asked question from our readers and the question last week was
My 79 year old sister has had seizures and she’s now in ICU! She’s not waking up and she’s having a tracheostomy! Can she improve?
You can check out the answer to last week’s question by clicking on the link here.
In this week’s episode of “YOUR QUESTIONS ANSWERED” I want to answer another frequently asked question that we get from our readers and the questions this week is
How long can a critically ill Patient stay on life support?
So today’s question is another one of those questions that we get quite frequently from our readers at INTENSIVECAREHOTLINE.COM
It’s also one of those questions that families in Intensive Care tend to shy away from asking the Intensive Care team directly because it
can be too confronting…
So first off, let’s look at some definitions here and I want to clarify what life support is in Intensive Care.
Life support in Intensive Care usually involves the following
- Cardiopulmonary resuscitation
- Total parenteral nutrition/TPN (=Intravenous nutrition)
Therefore it’s quite a wide range and the most important ones are really Mechanical ventilation with a breathing tube (endotracheal tube) or with a tracheostomy, as well as mechanical ventilation with mask/BIPAP ventilation.
Other very important life support mechanisms in Intensive Care are
- Dialysis for acute or chronic kidney failure
- ECMO for heart or lung failure
- Inotropes/ Vasopressors for hypotension (=low blood pressure)
- Vasodilators for hypertension (=high blood pressure)
- Defibrillation and cardiopulmonary resuscitation
They are the most important and also most common mechanisms of life support in Intensive Care and other mechanisms of life support such as TPN(=intravenous nutrition), PEG or nasogastric(NG) feeding tube or Urinary catheter are almost always a subordinate form of life support compared to the most common and also most important forms of life support such as mechanical ventilation,
Dialysis, ECMO, Inotropes/Vasopressors and/or Vasodilators.
Therefore the focus of life support in Intensive Care is really all about mechanical ventilation, Dialysis, ECMO, Inotropes/Vasopressors, Defibrillation, Cardiopulmonary resuscitation(CPR) and Artificial pacemakers.
That’s what’s most commonly being referred to as life support in Intensive Care/ Critical
Care.
And because so many families in Intensive Care want to know about it, it’s also a hot topic with many unknowns and many grey areas!
So why should I be the one telling you all about how long a critically ill Patient should be on life support for?
Well, after nearly 20 years Intensive Care nursing experience in three different
countries where I literally worked with thousands of critically ill Patients and their families and where I also worked as a Nurse Unit Manager for more than 5 years, I have learned many things in Intensive Care that I know most families of critically ill Patients in Intensive Care want to know about.
I also constantly counsel and consult families in Intensive Care through my 1:1 counselling and consulting service here at INTENSIVECAREHOTLINE.COM.
Therefore I work with and have been working with families of critically ill Patients in Intensive Care for a very long time and I know what questions they have.
If families in Intensive Care want to know about
How long can a critically ill Patient stay on life support?
The answer to this question is particularly important if your critically ill loved one is either
because those are the situations where your critically ill loved one may be in a situation where they need
life support for a long time to come.
Therefore the answer to our original question is crucial and it can literally be a “life or death” answer.
The answer is not what you think it is!
Now first off, before we dive deeper, the answer is not what you think it is. You may expect me to come up with some timeframes and length
of time a critically ill Patient can stay on life support.
Again, that may be part of the answer but more importantly the answer to the question
How long can a critically ill Patient stay on life support?
is an answer that heavily depends on your and your family’s mindset!
If you and your family are like 99% of the families of critically ill Patients in Intensive Care and you believe everything the Intensive Care team is telling you or even worse, if you feel intimidated by their “perceived” power and their “perceived” authority, you’ll probably buy into the time-frame thinking and the limited mindset thinking of the Intensive Care team.
Therefore the answer is not what you think it
is.
The answer is really dependent on what you want and what you feel is right for your critically ill loved one!
If you feel like your critically ill loved one has a chance of recovery given more time on life support then you should be asking for it in no uncertain terms!
99% of the families of critically ill Patients in Intensive Care
make no informed decisions, have no peace of mind, no control, no power and no influence.
Given that you are here, there is a very good chance that you are trying to get into the 1% bracket of the very few families of critically ill Patients in Intensive Care who make informed decisions, get peace of mind, control, power and influence.
Given that you are here, you are most likely looking
beyond the Intensive Care team’s standard responses towards families which are almost always a result of what’s happening “BEHIND THE SCENES” in Intensive Care.
What’s happening “BEHIND THE SCENES” in Intensive Care tends to be so powerful that it almost always impacts on how the Intensive Care team answers the question of
How long can a critically ill Patient stay on life support?
Therefore, the positioning of your critically ill loved one’s diagnosis, their prognosis as well as the care and the treatment offered or not
offered by the Intensive Care team is indirectly giving you the answers about this crucial question from the Intensive Care team’s perspective…
Therefore the Intensive Care team’s answer to this question is heavily influenced by hospital and Intensive Care Unit management, by the culture within the ICU and by their massive need to stay in control of the meaning of the situation…
And that’s
not your perspective…
You and your family truly have the best interest of your critically ill loved one at heart…
You and your family also want to stay in control of the meaning of the situation…
Related
The Intensive Care team truly has the Intensive Care Unit’s best interest at heart and that may or may not include your critically ill loved one’s “best
interest”.
More often than not, Intensive Care teams or position “limiting life support” or “withdrawal of treatment” as being “in the best interest” for your critically ill loved one.
Related:
They are in essence saying that they are not prepared to prolong life on life support.
Now, I can tell you that I have seen many many critically ill Patients being on life support for a
very long time.
What’s a long time? Definitely many weeks, definitely many months and in some cases many years if not decades.
It really all comes down to your mindset and how prepared you are to stand up for what you want.
Obviously there are situations where no fancy equipment, no fancy surgery and no fancy drugs can save a
life…
However there are many cases where the right negotiation strategies, the right insider knowledge, the right positioning of your critically ill loved one’s diagnosis, their prognosis as well as their care and their treatment will give you every bargaining tool you need to keep your critically ill loved one on life support for longer than the Intensive Care would want them to.
Related article/videos:
Intensive Care teams often limit their thinking in what is possible around the availability of resources, including emotional resources.
What do I mean by that?
To prolong and preserve live, as well as giving your critically ill loved one the best shot at a meaningful recovery also takes emotional resources and many
Intensive Care Units are not prepared to invest the emotional as well physical and financial resources.
Intensive Care Units and Intensive Care teams often frame and position a potential recovery of your critically ill loved one as a recovery that wouldn’t guarantee “quality of life” for your critically ill loved one in the future.
I call BS on all of that.
You can’t measure quality of life and in some instances quality of end of life. It’s a term that especially in Intensive Care is being misused and used out of context.
Quality of life is subjective and everybody’s goal for quality of life is different.
Very few people in Intensive Care know what quality of life ex-ICU Patients live 6 months after being in Intensive
Care, there are very few statistics. The bottom line is that people are alive and want to live…
In light of the fact that people tend to stay on life support for longer and longer and especially with services like INTENSIVE CARE AT HOME being readily available, extending life
support in a meaningful setting is also bringing quality of life to Patients and their families.
A service like INTENSIVE CARE AT HOME offers a genuine alternative to a long-term stay for adults& children on life support, mainly needing mechanical ventilation with
tracheostomies.
Especially in this day and age where families in Intensive Care are getting more and more educated and are getting more and more savvy to get what they want by challenging the Intensive Care team’s “perceived” power and their “perceived” authority.
Therefore the answer to
How long can a critically ill Patient stay
on life support?
is an answer that lies within you and it’s an answer that is way more dependent on your mindset, on what you think is possible, rather than waiting for an “expert” Intensive Care team to tell you what’s “in the best interest” for you, your family and for your critically ill loved.
Decide for yourself and you’ll reap the rewards!
