Hello everybody and first of all, I want to wish you and your Families a very happy and healthy new year 2013! I hope you had a well deserved and good Christmas break and you are refreshed to start a great new year!
I also want to thank each and everyone who has been following INTENSIVE CARE AT HOME’s blog for the last six months. The visitors to our website have increased massively over the last few months and have now reached the 500 people mark and I am very proud of that achievement to say the least. It also goes to show that the ICU community and Health Services in Australia in general are not oblivious to the need for new and innovative services, that not only provide massive value and Quality of Life/ Quality of-end-of-Life to long-term ventilated Adults& Children with Tracheostomy and their Families, but also provide value to Public and Private Hospitals and Intensive Care Units in particular, by saving money and resources that can be used for more acutely sick Patients in need of a Critical Care bed.
I also want to thank all the people that I have met in the last six months, who helped and supported me getting INTENSIVE CARE AT HOME’s idea out into the ICU community and opened doors along the way. It has been a very exciting and very interesting journey thus far and as some of you know by now, I enjoy talking to and meeting new people!
In this week’s blog I want to talk about 10 compelling reasons to look for options outside of Intensive Care for long-term mechanically ventilated Adults& Children with Tracheostomy and their Families. Feel free to add on any reasons that you think I may have forgotten below in our comments section.
Let’s dive into it
1. Quality of Life and/or Quality of-end-of-Life outside of Intensive Care in somebody’s own home and familiar environment, where they can feel at home and where they and their Families can feel at ease, where they can relax and where they can have control
2. Getting Families lives back on track, rather than spending days and nights in Intensive Care whilst their loved one is long-term ventilated with Tracheostomy in Intensive Care. Families often put their lives ‘on hold’ when their loved one is in Intensive Care. Putting their lives ‘on hold’ often means neglecting their Families, whether it is children or elderly parents or anybody else within the Family. And far too often, some Family members with professional lives and careers are unable to work whilst their loved one is in Intensive Care on a ventilator and that very often leaves people taking paid and often unpaid leave, in order to spend time with their loved one in Intensive Care. This very often leaves Families in financial stress, in a situation where financial worries do not help the overall situation of having a loved one in Intensive Care!
3. Depression. Pretty much any long-term ventilated Adult& Child in Intensive Care with Tracheostomy gets depressed, usually at the day 60 mark. That’s probably no surprise to anybody who has worked in Intensive Care and has dealt with long- term ventilated Adults& Children with Tracheostomy. For the readers who haven’t worked in ICU, Long-term ventilation in Intensive Care leaves Patients with no or very little Quality of Life in an environment that is sterile, busy, noisy and it leaves Patients with no dignity, privacy and limited choices. My experience has shown me that despite the challenges of long-term ventilation with Tracheostomy, taking a long-term ventilated Adult or Child out of Intensive Care, makes such a massive difference to their and their Families well- being that taking long-term ventilated Adults& Children out of Intensive Care is a must and a no-brainer!
4. Avoiding and preventing Hospital and Intensive Care acquired Infections. I am very certain that Health professionals in Intensive Care(mainly nurses and doctors) have seen long-term ventilated Adults& Children with Tracheostomy in Intensive Care with Hospital acquired infections along their road to recovery. Hospital acquired infections either prolong the Patients recovery unnecessarily or sometimes those infections can also be lethal and also add on to the already massive bill of a prolonged ICU stay. Furthermore, a usually already depressed long-term ventilated Adult or Child in Intensive Care with Tracheostomy does not need an infection on top of all the other issues they are dealing with.
5. Giving health consumers, their Families and Hospitals/ Intensive Care Units a choice. This is something that I can’t stress enough. I strongly believe that any Industry should be creating choice for their Customers or Consumers. The Health Industry is such a highly regulated Industry, that choice for the Health Consumer is very often not an option. This is for a number of reasons, including Health professionals not offering alternative services in niche markets. But the Health Industry should, like any other Industry, create choice and alternatives for their consumers!
6. Stamina. Long-term ventilated Adults& Children with Tracheostomy and their Families not only get depressed, they also very often lose stamina along their stay in Intensive Care, for a number of reasons, including depression, lack of Quality of Life, lack of privacy and dignity and so on. Once again, just like with getting depressed in a hospital environment, stamina comes back once long-term ventilated Adults& Children are in a friendlier home environment, surrounded by their loved ones. This is something I have seen over and over again, that every time a long-term ventilated Adults or Child is given the opportunity to go home, their and their Families well being improves massively, just by being at home.
7. Cost reduction and cost effectiveness. Intensive Care is one of the most expensive specialities in the Health Care Industry and little has been done to improve its inefficiencies, whilst also providing real and tangible benefits to long-term ventilated Adults& Children and their Families, by providing them with something they really want and they really need! In case you haven’t heard me saying it, and ICU bed costs $ 3,000- 5,000 per bed day and Intensive Home Care Nursing is more cost effective and it gets long-term ventilated Adults& Children out of a sterile hospital environment, where Quality of Life can be restored.
8. Effective Resource Management. Resource management is another area with room for improvement for Intensive Care Units and for Hospitals. What if a long-term ventilated Adult or Child keeps occupying a bed for 50 days or more in an Intensive Care Unit. What about all the Hospital waiting lists, whether it be medical or surgical or Patients not getting in ICU beds within four hours from Emergency Departments? By freeing up beds in ICU everybody wins, the long-term ventilated Adults and Children and their Families, as well as the Hospitals and their future Patients.
9. Home before Hospital. This one should be a ‘no-brainer’ too. Hospital care has its unquestioned place. But there are times and there are Health consumers where Hospital Care is detrimental to their recovery or to their and their Families Quality of Life. We should as a society, explore any possible option in order to reallocate resources towards home care based models, as is the case in Europe and many other parts in the developed world, rather than focus only on Hospital care. As somebody said to me the other day:”Hospitals are designed for Health professionals, not for Patients…”
10. Nurses and Doctors can do it. I do strongly believe that Intensive Home Care is the future model for long-term ventilated Adults& Children with Tracheostomy and their Families. I also believe that we as health professionals should not underestimate our ability to provide services that are not fitting the norm, but are extremely valuable and provide tangible benefits. When the first Intensive Home Care Nursing service providers came up in Germany in the late 1990’s, a lot of people were against changing care models, changing their thinking and changing their paradigms. Nearly 15 years later, it is unquestioned that the best and the only place for a long-term ventilated Adult or Child with Tracheostomy is Home.
Please share your views and also add on to the list if you feel like anything is missing. Cheers.