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!
In the last
blog I talked about
5
things the Intensive Care team hasn’t told you when your critically ill loved one is dying!
You can check out the last blog by clicking on the link here.
In this week’s blog I want to talk
about
Do Intensive Care Units have a "one size fits all" approach to dying in ICU?
Before I get into today's topic I want to share a quote with you that I wrote on today’s topic!
When critically ill Patients in Intensive Care approach their end of life, most Intensive Care Units and most Intensive Care teams have a standard approach to death and dying.
They usually say things like "we've tried everything that we
could..." or they say things like "any further medical treatment is futile..."
Whilst all of the above may well be true, the approach to dying in Intensive Care still leaves little room to give people choice and actually gives people what they want!
Research and surveys have revealed that 75% of the population in first world countries- if
given a choice- want to die at home.
The reality however reveals that less than 15% of the population actually do die at home...
Therefore, Intensive Care services as well as other health services are failing to deliver what the vast majority of people actually want in end of life situations.
Most Intensive Care Units all over the world have a standard "one size fits all approach" when it comes to end of life situations in Intensive Care.
Once critically ill Patients in Intensive Care are approaching their end of life, ICU's follow certain policies and procedures to aid critically ill Patients
dying.http://intensivecareathome.com.au/services
This "one size fits all" approach leaves little to no room to give critically ill Patients and their families what they want but is rather a reflection of current realities in Intensive Care.
A much better approach to end of life in Intensive Care is to listen to people and offer them end of
life situations on their terms, follow people's wishes and give them the opportunity to die at home. Thankfully, services like INTENSIVE CARE AT HOME are making this possible now, creating win-win situations for all stakeholders!
Let's get into today's topic.
I can’t tell you how often I’ve heard families in Intensive Care saying “it would be so much nicer to have our loved one die at home instead of in Intensive Care”.
When critically ill Patients die in Intensive Care, ICU’s tend to have a “one size fits all” approach!
It means that once a
critically ill Patient’s life can’t be saved, the Intensive Care team uses a standard approach by ceasing treatment and/or life support and using sedatives such as Midazolam(Versed) and Opiates(pain killers) such as Morphine or Fentanyl to aid a critically ill Patient going from life to death.
That’s virtually the “one size fits all” standard approach offered in Intensive Care.
It goes totally against
what more than 75% of the population wants, which is to die at home…
Albert Einstein once famously said
“A problem can never be solved by thinking about it at the same level it was created”.
Having people die in Intensive Care even though Patients and their families want to die at home means that the problem can’t be solved on an Intensive
Care level.
It needs to be solved on a different level.
What do I mean by that?
Well, Intensive Care is a volatile, dynamic, stressful, political, hierarchical and non-family friendly environment!
Death and dying are usually very private matters that should be managed by families and not
by health professionals.
Health professionals should be there to aid and facilitate the process of dying in a manner that is conducive to the wishes of a critically ill Patient and their family.
And again, those wishes are crystal clear according to research and surveys that more than 75% of the population in first world countries want to die at home and yet, less than 15% of people actually
do die at home…
Therefore there is a big mismatch in delivering people on what they want during a very important time in people’s and their families lives.
Related article/video:
All Intensive Care has to offer is a “one size fits all” approach to death in Intensive
Care.
That approach is usually a result of failing to listen to people and it’s a result of Intensive Care teams “knowing it all” and “knowing of what’s best”!
It’s also a result of being ignorant to what’s happening in the real world…
What do I mean by that and why should I be the one telling you about
this?
Look, 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 seen my fair share of people dying in Intensive Care and I know that this “one size fits all approach” in Intensive Care has failed.
I also talk to families in Intensive Care every day of the week with my 1:1 counselling and consulting service here at INTENSIVECAREHOTLINE.COM
I therefore have a
very good understanding of what people want and what they are thinking.
I have also worked with many critically ill Patients and their families in a home Intensive Care environment, therefore I really have a good
understanding of what people, want, what they need and I do have an understanding of what’s possible in the real world…
I also have intimate knowledge of what goes on in an Intensive Care Unit and I know exactly what’s happening “BEHIND THE SCENES” in Intensive Care!
Recommended:
The “one size fits all” approach of Intensive Care teams when Patients are dying has failed on a moral, ethical, cultural, religious and spiritual level…
It’s also failing on a level that creates “win-win” situations….
What do I mean by
that?
A “win-win” situation is a situation where all parties benefit in a situation!
Let’s look at the interests of all parties in an end of life situation in Intensive Care
- Families in Intensive Care want to mostly have end of life situations on their terms in their own homes. At the end of the day they
want to make informed decisions, they want to have peace of mind, control, power and influence
- Families also want to have a sense of meaning and belonging that they can find in a home care environment and not in an Intensive Care environment
- Intensive Care Units want to have access to beds, staff,
equipment and other resources in Intensive Care and they want to maximize their revenue, it’s as simple as that…
- A bed in Intensive Care costs around $5,000 per bed day, therefore health funding agencies have an interest in keeping their costs down in such a high cost environment like Intensive Care
In order to meet all needs of the
stakeholders when Patients are inevitably approaching their end of life Intensive Care one doesn’t have to be too creative to come up with a solution that provides everybody with a win.
Especially when in some situations Patients are dying over many weeks and sometimes many months in Intensive Care… often on life support such as mechanical ventilation with tracheostomy
…
Therefore INTENSIVE CARE AT HOME is providing a win-win situation for all stakeholders.
INTENSIVE CARE AT HOME enables critically ill Patients and their families
to
- Be in an environment of their choosing, where they can be in control
- Give them peace of mind, control, power and influence
- Meets their individual cultural, religious, spiritual and family needs in a home care environment, removed from a sterile and depressing Intensive Care environment
- Have an end of life situation on their
terms and not on the ICU team’s terms
But a service like INTENSIVE CARE AT HOME also gives Intensive Care Units what they want by
- Giving ICU’s the ability to discharge their critically ill Patients earlier and freeing up their precious, “in-demand” and expensive Intensive Care beds
- Admitting other critically ill Patients
- Free up other resources such as beds, equipment and staff
- Maximizing their revenue by having a higher throughput of critically ill Patients
And last
but not least a service like INTENSIVE CARE AT HOME is giving health funding agencies the ability to save costs by
- Reducing the cost of an Intensive Care bed to around 50% in a home
care environment
- Supporting Patients, their families and Intensive Care Units by focusing on their needs
INTENSIVE CARE AT HOME is a proven and evidence based concept and it’s a concept widely accepted since it was introduced in the late 1990’s in Europe.
