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 question from our readers and the question last week was
My husband had open heart surgery with complications! He’s not “waking up”, he needs 100% of oxygen and now he’s
bleeding from the stomach, I’m so scared, help! (PART 5)
You can check out last week’s episode by clicking on the link here.
In this week’s episode of “YOUR QUESTIONS
ANSWERED“, I want to answer another frequently asked question from our readers
What is the quality of life after a tracheostomy?
This is another great question we get
rather frequently from our readers at INTENSIVECAREHOTLINE.COM and I do want to shed some light on this question today.
I probably should ask a different question to begin with to set the frame.
Is there quality of life in Intensive Care?
The answer is no, therefore let’s look at some explanations and let’s look at the
bigger picture.
One of the biggest frustrations for families in Intensive Care is simply that they don’t know if a tracheostomy is the right thing to do if their critically ill loved one is on a breathing tube and a ventilator and can’t be weaned off it.
From my experience Intensive Care Units can be very quick to either
- wanting to do a tracheostomy and then send their Patients off to Long-term acute care (LTAC) if you are living in the USA. This often serves an Intensive Care Unit because they can free up a precious, expensive, scarce and “in-demand” Intensive Care bed, without actually maximizing and optimizing
chances to get your critically ill loved one off the ventilator and the breathing tube in the first place. Getting your critically ill loved one off the ventilator and the breathing tube should always be the goal. Most Intensive Care teams are not explaining this to you and are often trying to “sell” to you either a tracheostomy as the gold standard without trying to maximize and optimize chances to get your critically ill loved one off the ventilator and the breathing tube in the first place.
- If they don’t offer a tracheostomy, they often want to “sell” you and your family on a “withdrawal of treatment” or on a “withdrawal of life support” as being “in the best interest” for your critically ill loved one
- If you are in countries like the UK,
Ireland, Australia, New Zealand or South Africa, a tracheostomy should ideally lead to weaning off the ventilator in Intensive Care. The challenge in those countries is often that there is a delay in suggesting and/or performing a tracheostomy
- A delay in offering and/or performing a tracheostomy can also be used to again try and “sell” you and your family on a “withdrawal of treatment” or on a “withdrawal of life support” as being “in the best interest” for your critically ill loved one
This is really important for you and your family to understand before I explain to you if there is quality of life with a tracheostomy.
I can’t stress enough how important it is for you and your family to read
between the lines whenever the Intensive Care team is telling you something.
Here are also some links to articles/videos when to do a tracheostomy in the first place.
If your loved one has a tracheostomy already, you may wonder how long it might take to get off the ventilator and the
tracheostomy and you will find the answer to that here
Generally speaking, quality of life after a tracheostomy is improved in Intensive Care, because the need for sedation and induced coma is often minimized and/or excluded.
You may also be curious about why I should be the one answering this question for you.
In case you are wondering, after nearly 20 years
Intensive Care Nursing 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 in Intensive Care for over 5 years I can assure that I’ve seen enough Patients in Intensive Care getting a tracheostomy.
I have also worked in the community with many long-term Intensive Care Patients (adults & children) on ventilators with tracheostomies
as part of INTENSIVE CARE AT HOME.
Furthermore, now in my professional 1:1 counselling, consulting and
advocacy service here at INTENSIVECAREHOTLINE.COM I speak to families in Intensive Care all over the world every day!
I know their questions, I know their frustrations and I know how to get results for them!
Once a tracheostomy has been done, it’s also much easier to wean your critically ill loved one off the ventilator and again, that improves quality of life as well. In some
instances it can also improve quality of end of life too.
What a tracheostomy is also doing is it buys your critically ill loved one time, especially when Intensive Care teams and Intensive Care doctors are negative.
Especially if there is talk about a “one way” extubation”.
What does a “one way extubation” mean? (Extubation = removal of the breathing tube)
A “one way extubation” means that the
doctors/ Intensive Care teams are planning to take your critically ill loved one off the ventilator and the breathing tube and they won’t be putting it back in.
It’s a “sink and swim” approach and it doesn’t do Patients and their families justice.
Those “one way extubations” are often set up to let people fail and it’s another way for Intensive Care teams to empty their ICU beds by letting
Patients die without having tried a tracheostomy.
Again, a tracheostomy will buy your critically ill loved one time and it often buys them as much time as they need to recover in their own time.
It’s often time that Intensive Care Units are not prepared to give to their Patients.
They once again frame it around your critically ill loved
one not having any “future quality of life”. This is very short sighted and doesn’t take into consideration the time it takes to recover after a critical illness.
Therefore, a tracheostomy on the one hand should not be rushed, but on the other hand it should always be offered, it’s as simple as that.
The biggest problem however is that 99% of the families of critically ill Patients in
Intensive Care don’t question, they make no informed decisions, they have no peace of mind, no control, no power and no influence.
You are one step ahead of the 99% already because you are here and you are doing your own research and you are questioning.
If your critically ill loved one can be weaned off the ventilator but can’t have the tracheostomy removed they should definitely be in a
position to leave Intensive Care.
But even if they can’t be weaned off the ventilator there is light at the end of the tunnel.
A ventilator and a tracheostomy is still enabling many Patients to go home instead of staying in Intensive Care, Long-term acute care and/or nursing home.
The way this is possible is by taking Patients home with a
service INTENSIVE CARE AT HOME.
INTENSIVE CARE AT HOME is a genuine alternative to a long-term stay in Intensive Care and it literally improves the quality of life for any
ventilated/tracheostomised Patient overnight.
Imagine your loved one is stuck in Intensive Care and your family spends day and night in Intensive Care, INTENSIVE CARE AT
HOME offers like a “dream come true” experience.
Therefore the answer is, “yes” there is quality of life for anybody on a ventilator and/or tracheostomy.
