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 was
COVID AND CHILDREN
You can check out last week’s question by clicking on the link here.
In this week’s episode of “YOUR QUESTIONS ANSWERED” I want to answer questions from one of my clients Janet, as part of my 1:1 consulting and advocacy service! Janet’s mom is currently in the nursing home
with a tracheostomy on a ventilator and Janet is asking about the benefits of keeping her mom in intensive care at home that in a nursing home.
Why is my Mom Better in Intensive Care at Home than in a Nursing Home?
Janet: Hello?
Patrik: Hello, it’s Patrik speaking here from Intensive Care Hotline. How are you?
Janet: I’m well and you?
Patrik: Very good, thank you. I’m just returning your call.
Janet: Thank you for returning my phone call. I greatly appreciate it.
Patrik: You’re welcome. Is this a good time or do we need to schedule another time when it’s more convenient for you?
Janet: This is a good time. I greatly appreciate it.
Patrik: So I understand your mother has a tracheostomy. Has an NG tube and is a quadriplegic. Is that correct?
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Janet: Yes.
Patrik: Right. And where is she at the moment?
Janet: She’s in the nursing home.
Patrik: Right. Okay. And how long has she been there for?
Janet: August 18th.
Patrik: 18th last month?
Janet: Yes.
Patrik: Right. And where was she prior?
Janet: At home.
Patrik: Okay. Okay.
Janet: That tracheostomy has been the devil and I read about it and I just can’t understand why they didn’t try to wean … She can breathe. She can talk. She can even eat.
Patrik: Right.
Janet: Soft foods only, but unfortunately, issues like a nightmare that has not ended. I’m gonna try to get custody of her so that I can get her to another state and be transferred there.
Patrik: Right.
Janet: I don’t know everything that has gone on. I don’t know if they’ve completed an … It’s one of those swallowing tests and endoscope to see how she can swallow. It’s a diet test. I have started doing a lot of reading and I am just trying to get it to the point to … where we can get her weaned off of it. They don’t even keep a humidifier on it. They just leave it wide open.
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Patrik: Oh my goodness.
Janet: Spread to infection. Just ignorant. Just total backwoods. Ignorant. And I did my research and I’m not even a nurse.
Patrik: Yeah. I understand. Well the problem is in a nursing facility, you don’t necessarily have skilled nurses either. That’s the problem. I would never have my family member go into a skilled nursing facility with a tracheostomy and a ventilator. Never ever. Would never do that.
Janet: Well, where would you keep the person?
Patrik: Yeah.
Janet: A quadriplegic.
Patrik: At home. With the right support like INTENSIVE CARE AT HOME.
Janet: Why at home?
Patrik: Because you can have the right support at home with Intensive Care nurses. You can bypass the nursing home by going home from ICU straight away.
Janet: What type of support?
Patrik: ICU nurses at home. A genuine and clinically relevant alternative to a long-term stay in ICU. This is the right model of support is from my experience, but just let me ask one more question, please. How long has your mom been a quadriplegic for? When did that happen?
Janet: One year.
Patrik: One year. Right. Okay, okay. To answer your question, “why should a quadriplegic with a tracheostomy and a ventilator be at home”? The reason I’m saying that confidently is that is I run and operate an in-home nursing service intensive care at home. We look after ventilated patients at home. We do that.
When we come off this call have a look at INTENSIVE CARE AT HOME website www.intensivecareathome.com
I can tell you straight away we are not in your area, but that doesn’t mean I can’t help you in terms of help you source the appropriate support structure that you need to get her back home.
Now you did mention she was at home. What changed? Why were you not able to keep her at home?
Janet: Well, unfortunately, she did not have the correct machine to balance her out. She wasn’t receiving any type of therapy. And so developed ulcers, which are aka bed sores. And unfortunately, it just turned from one situation to the next and it just went downhill. It’s been hell ever since.
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Patrik: I’m not surprised by what I’m hearing because you know, going home is great, but for somebody on a ventilator, tracheostomy, quadriplegic from my experience, you need twenty-four hour skilled nursing care at home. And by skilled, I don’t mean what they provide in a nursing facility. I mean, no disrespect to a nursing facility. It may be right … that nursing facility may be right for some people, but certainly not for somebody on a
ventilator with a tracheostomy as you would know by now. Your mom needs specialised care. Right?
Janet: Correct.
Patrik: But I also agree with you that given that this only happened from one year, they probably haven’t maximised all options to wean ventilation. To wean tracheostomy. If you know … I assume that’s all still very early days.
Where is the injury? Is it C-1? Is it C-2, do you know what I’m talking about there?
Janet: She had a stroke, which means she didn’t have a spinal cord injury.
Patrik: Oh.
Janet: It was a cerebral stroke.
Patrik: Oh, I see. Okay. Is she moving at all?
Janet: She’s able to blink her eyes. Move. Talk. I mean move her head back and forth and she is starting to show some signs of movement in her body, but I’m not sure if that’s body spasms, but I have not seen it where it spasms. I have noticed that her feet move and she’s able to squeeze her hand.
Patrik: Right. When you hold her hand and you ask her to squeeze your hand, is she doing that?
Janet: Yes, she is able to do that.
Patrik: Okay. On both hands?
Janet: No, just one side.
Patrik: One side.
Janet: For right now.
Patrik: Okay. Right. That’s good news. Because now that you’re also telling me that your mother is not a quadriplegic, there could well be chance to wean ventilation and the tracheostomy. How many hours a day is your mother on the ventilator? Twenty four hours or what’s the situation there?
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Janet: She doesn’t have a humidifier. She only has a tracheostomy and technically, they have inserted a cuff tracheostomy, so she is not even on a humidifier. They didn’t even attach a humidifier to the end of her outer cannula or the tracheostomy. Now, my question is this, since this is a cerebral stroke, does that mean that she’s also mentally incapacitated as well? Is that possible?
Patrik: Well, you have mentioned to me a minute ago that your mother is talking. Is that correct?
Janet: Yes.
Patrik: And when she’s saying things to you, do they make sense? Is she making sense when she’s talking?
Janet: Yes.
Patrik: Okay. Doesn’t that answer your question?
Janet: Yes. Well, unfortunately, an ignorant doctor stated that she’s mentally incapacitated. I did not agree with that. We just had a court hearing yesterday. That’s a big fat … They’re contradicting yourself.
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Patrik: Absolutely.
Janet: And I’m a freakin’ paralegal. That already was a red flag to me right then and there.
Patrik: Does that mean you have lost guardianship of your mother? I didn’t get that part. You mentioned court. Did you lose guardianship for your mother? Is there somebody else in charge now?
Janet: Yes. And she was MPOA. I didn’t have her guardianship. My mother’s sister did her power of attorney.
Patrik: Right.
Janet: And when she had the stroke, she was in her care.
Patrik: Right.
Janet: Yes, she did lose custody of her.
Patrik: Oh my goodness, that’s terrible. That’s terrible.
Janet: Yes, like I said, it’s been hell on earth for the past year and it just has not gone well.
Patrik: Right.
Janet: They’ll come and take everything and just push you out. You’re poor number one. You don’t have anything. You’re a person of colour, that’s it.
Patrik: My goodness, I’m so sorry to hear that. I’m really sorry. That’s your…
Janet: Yeah it’s-
Patrik: Experience.
Janet: Yeah, it’s been terrible. I try to … Unfortunately, my mom’s sister didn’t have the education to ask questions like I did and become more involved and she was locked up. Now may I ask, originally, where are you from? What is your-
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Patrik: I can tell you a little bit about my background, I’m an intensive care nurse by background, right? I have worked in intensive care for 20 years.
I own and operate a home care service INTENSIVE CARE AT HOME and we’re looking ventilated patients at home or tracheostomized patients at home, you know, even if they’re not ventilated, which sounds like if you were here, I know we could help you very quickly. Right? We get funding for our service. It’s a mix of funding that we get through government, through health insurances, all of that.
We also look after medically complex patients that are not ventilated but have unstable airways and we either take them home from ICU/PICU or we make sure they don’t go back to ICU/PICU from home because we send highly skilled ICU/PICU nurses into the home.
We can definitely help you with going forward is to look at is there is a chance to wean your mother off the tracheostomy. That’s something I can definitely help you with, even from a distance because we’ve got lots of experience with it.
Janet: Perfect.
Patrik: Besides getting the 1:1 consulting, have you also subscribed to our free email newsletter?
Janet: Yes, I did. And I have viewed the entire web site. It’s really a good website and offers a lot of help!
Patrik: The good news about INTENSIVE CARE AT HOME is that it
a) Improves the quality of life for your Mom and for you as a family when you have 24/7 ICU/PICU nurses coming to your home
b) It helps health insurances and other funding bodies to reduce the cost of an ICU bed by 50%
c) It frees up in-demand and scarce ICU beds
d) It prolongs life because most long-term ventilated patients in LTAC (215) or nursing homes die because they don’t have the skills that a specialized service like INTENSIVE CARE AT HOME has.
Janet: That’s interesting, thank you.
Patrik: You can look up more information about INTENSIVE CARE AT HOME here.
https://intensivecareathome.com
Janet: Wonderful. Glad to hear. And so, how long have you been in business like your business that you run INTENSIVE CARE AT HOME?
Patrik: We’ve been in business for about six years, but I’ll tell you a little bit more about that. As you can hear, I speak with an accent. English is not my first language. I was born in Germany and in Germany, intensive care at home services are everywhere. It’s massive. It’s huge.
Janet: Really?
Patrik: Twenty years ago, I helped set up the first service for intensive care in home in Germany. Then during my travels, I worked in England. Then when I came to Australia, I realised there is no intensive care at home. I couldn’t believe it.
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Janet: When are you going to set up a place in the United States?
Patrik: Eventually. I can tell you that we are in the middle of doing that. We have put a US phone number on our web site for intensive care at home and I can tell you the phone is ringing. So we’re not in a position to provide the service yet, but we know the interest is there. So we’re not in a position to do that yet but we’ll launch soon. But we know there is a growing demand. We know that. The English speaking world whether it’s the United
States, the UK, whether it’s Australia, they are far behind when it comes to intensive care at home. They’re thirty years behind. It’s been happening in some countries in Europe for the last twenty, thirty years.
Janet: Thank you very much and I appreciate it.
Patrik: You’re very welcome. Look out for the email. You should get it in the next half an hour.
Janet: Thank you. Have a good day.
Patrik: Thank you so much. Take care. Bye bye.
Kind regards,
Patrik
