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In one of my previous videos I talked about, “Can my 39-year-old daughter go home with Intensive Care at Home with an uncuffed tracheostomy and dialysis after stroke?” You can go and check out that blog post by clicking on the link below this video in the written version of this blog.

In today’s blog post, I want to talk about the essential questions you can ask the discharge planner, ICU team case manager, but also us as a service provider in the community when exploring the option of bringing your daughter or your loved one home with uncuffed tracheostomy and dialysis.

My name is Patrik Hutzel from intensivecareathome.com, and I will bring today’s video to you. So, without further ado, let’s look at the list of essential questions that need to be asked.

Number one, medical stability and readiness. Is your loved one considered medically stable enough for discharge to Intensive Care at Home? Does your loved one require any ventilation support, or is your loved one breathing fully on their own through the tracheostomy? What are the risks of airway obstruction or aspiration with your loved one’s current tracheostomy status? Those are very important questions to ask for you as a family, of course. But there are also important questions to ask as a service provider in the community to understand what are the exact needs of a patient that goes home with Intensive Care at Home.

Next, tracheostomy management at home. What type of suction equipment, humidification and oxygen, if any, will be needed at home? What happens during emergency tracheostomy care and suctioning, which is again our skill here at Intensive Care at Home to manage that? How often will a doctor visit, for example?

We provide 24-hour nursing care, and you will need 24-hour nursing care for someone with a tracheostomy, and that is evidence-based, by the way. It’s documented in the Mechanical Home Ventilation Guidelines that you can read up on our website at intensivecareathome.com. So, you can’t really negotiate on having less than 24-hour intensive care nurses at home for someone on a tracheostomy, cuffed or uncuffed, because it’s an artificial airway. It’s an unstable airway, and that’s the bottom line.

Next, who will handle tracheostomy changes and routine tracheostomy tube maintenance? Once again, we can do that at home, but it is still a very important question to ask.

Next, dialysis at home. What type of dialysis is your loved one on? Peritoneal dialysis or hemodialysis? Can that be done safely at home? Have there been incidents where blood pressure dropped to a dangerously low level? How can that be managed at home? We need to look at that.

Also, for peritoneal dialysis, that can be safely done with nurses. But if it’s hemodialysis, does it need to be done as an outpatient at a dialysis center, for example? What happens if there are complications during home dialysis? How can that be managed?

Obviously 24-hour care is not only recommended, it’s also needed with intensive care nurses. Like I said, that’s evidence-based as per Mechanical Home Ventilation Guidelines.

Can a registered nurse with intensive care nursing experience be available 24/7? Again, that’s what we are the specialists on. We provide 24-hour rosters for intensive care patients at home that are medically stable but need tracheostomy, ventilation management, or BIPAP (Bi-level Positive Airway Pressure), CPAP (Continuous Positive Airway Pressure) management, I’ll come to the services that we provide in more detail later in this video.

Will Intensive Care at Home be coordinating this level of care? Who will be the primary contact, of course, at Intensive Care at Home? Will insurance such as Medicare, NDIS (National Disability Insurance Scheme), TAC (Transport Accident Commission), iCare, DVA (Department of Veteran Affairs), private health insurance hospitals cover equipment, supplies, and staffing for Intensive Care at Home?

What equipment will be needed and delivered to the home? Hospital bed, suction machine, oxygen, spare tracheostomies, Air Vivas, oxygen concentrators, oxygen cylinders, for example? Is the home care environment suitable? Or does it need modifications, i.e., power backup rams, space for equipment, bathroom, etc?

Ongoing monitoring. What signs should you watch for in terms of that situation that require immediate medical or nursing attention? Again, that’s what we are there for, from Intensive Care at Home and our highly qualified ICU nurses.

Is there a hospital or a doctor overseeing the service at home? Again, we can provide that with our own intensivist. Will your loved one have regular follow-up appointments as an inpatient or outpatient? And how will transport be arranged?

So, with Intensive Care at Home, we are currently sending our ICU and critical care nurses into the home, 24 hours a day. We are providing the following:

• Genuine alternative to a long-term stay in intensive care/ long-term acute care
• Home care services for ventilated adults & children with tracheostomies
• Tracheostomy care
• Home care services for patients on non-invasive ventilation – Home BIPAP (Bilevel Positive Airway Pressure), Home CPAP (Continuous Positive Airway Pressure) 
• Home TPN (Total Parenteral Nutrition)
• Home IV potassium and home IV magnesium infusions, IV fluids, and IV antibiotics
• Provides central line management, PICC (Peripherally Inserted Central Catheter) line management, Hickman’s line management, as well as port management at home.
• Provides nasogastric tube  and PEG (Percutaneous Endoscopic Gastrostomy) tube management at home
• Palliative care services at home
• Use cough assist machines for our clients for airway clearance

We are also sending our critical care nurses into the home for emergency department bypass services. We have done so successfully as part of the Western Sydney Local Area Health District, their in-touch program, saving approximately $2,000 per patient that we keep at home, instead of them going to the emergency department.

That also means we’re in a position to cut the cost of an intensive care bed by around 50%. An intensive care bed costs between $5,000 to $6,000 per bed day. Our services cost between $2,500 to $3,000 per day and we’re freeing up the most sought-after bed in the hospital, which is the ICU bed. But most importantly, we’re improving the quality of life for patients and their families, which is a win-win situation for all stakeholders. Of course, quality of life at home is much improved surrounded by families.

With Intensive Care at Home, we are currently operating all around Australia in all major capital cities as well as in all regional and rural areas. We’re an NDIS (National Disability Insurance Scheme) approved service provider all around Australia, TAC (Transport Accident Commission) and WorkSafe in Victoria, iCare in New South Wales, NIISQ (National Injury Insurance Scheme in Queensland), as well as the Department of Veteran Affairs (DVA) all around Australia. Our clients and we, as a provider, have also received funding through public hospitals, private health funds, as well as departments of health.

We are currently the only service provider in Australia that has achieved third-party accreditation for Intensive Care at Home nursing in 2025. We have been achieving this level of accreditation since 2012. No other service provider has achieved this high level of accreditation in the community and has created more intellectual property for Intensive Care at Home nursing than we have. This puts us in a position to employ hundreds of years of critical care nursing experience combined in the community. No other service provider in 2025 employs a higher skill level in the community than we do, which enables us to look after the highest acuity adults and children in the community in Australia safely.

If you’re at home already and you’re watching this, or if you’re stuck in an ICU, or if you’re going to hospital and ED (emergency department) all the time, and you realize that you don’t have the right level of support, I’ll give you another tangible and real-world example today, very similar to the one I gave you a minute ago.

One of our first clients when we first got started over 10 years ago, was a client who was at home initially on a ventilator with a tracheostomy with a support worker model 24/7. Of course, support workers are dangerous and negligent. Having support workers looking after a client at home on a ventilator with a tracheostomy is like flying the airplane with the cabin crew instead of the pilot because anyone on a ventilator with a tracheostomy is at very high risk of medical emergencies 24/7 or even at high risk of dying if they don’t have a team of critical care nurses looking after them 24/7. This is actually evidence-based and it’s documented in our Mechanical Home Ventilation Guidelines that you can find on our website at intensivecareathome.com.

Think about it, in an intensive care unit in a hospital, you wouldn’t have support workers looking after a critical care patient on a ventilator with a tracheostomy. So, why would anyone in their right mind would do that in a home care environment in the community?

So, this client found out about us eventually and the ICU that he went back to all the time also knew about us and eventually reached out to us. We were proving our concept with this client very fast. When we worked with the client, we sent him intensive care nurses, 24 hours a day. He never, ever went back into ICU ever again and we were proving our concept there very fast.

We can do the same for you if you’re not safe at home which includes the advocacy for funding that goes along with it. We have always successfully advocated for our clients. Otherwise, we would not be in business. The same is applicable for those stuck in an ICU, similar to our case study today, or going back to ED all the time, so what you’re looking for? Reach out to us, we’ll make it happen for you as well. We can take you through the right steps including NDIS or other funding bodies, and the advocacy that needs to go along with it.

Which is also why we are providing Level 2 and Level 3 NDIS Support Coordination. We have a team of NDIS Support Coordinators, and they have a wealth of knowledge. I’ve done an interview with Amanda Riches, one of our NDIS Support Coordinators, and I’ll put a link to an interview with Amanda in the written version of this blog. We’re also providing TAC case management and WorkSafe case management in Victoria with Lucy McCotter.

If you’re an NDIS Support Coordinator or a case manager from another organization watching this, and you’re looking for nursing care for your participants, please reach out to us as well. If you’re looking for funding for nursing care for your participants, and you don’t know how to go about it and what evidence to provide, I encourage you to reach out to us as well. We will help you with the right level of funding and with the right level of advocacy. We’re also providing NDIS specialist nursing assessments done by critical care nurses with a legal nurse consulting background.

If you are a critical care nurse and you’re looking for a career change, and you want to join a very progressive, dynamic, high-performing team of critical care nurses in the community, we are employing hundreds of years of critical care nursing experience combined. If you are looking for a career change, we’re currently hiring for jobs for critical care nurses in Melbourne, Sydney, Brisbane, in Albury, Wodonga, in Bendigo, in Geelong, and in Warragul in Victoria. If you have worked in critical care nursing for a minimum of 2 years pediatric ICU, ED, and you have already completed a postgraduate critical care nursing qualification, we will be delighted hearing from you.

I have a disclaimer, because we are offering a tailor-made solution for our clients, which includes regular staff, our clients also do want the same staff coming over and over again because they are very vulnerable and very special, and that’s why we need regular staff. So, if you’re looking for agency work where you can come and go, this will not be the right fit for you. We are looking for consistency and our clients are looking for consistency. So please, only apply with us if you can give us regular and consistent availabilities for shifts and if you’re really keen on building relationships with us and with our clients.

If you are an intensive care specialist or an ED specialist, we also want to hear from you. We’re currently expanding our medical team as well.  We can also help you eliminate your bed blocks in your ICU and in your ED for your long-term patients, or for your regularly readmitting patients with our critical care nursing team at home. We’re here to help you take the pressure off your ICU and ED beds. In most cases, you won’t even pay for it. Even if you do pay for it, it is much more cost-effective than what you’re paying for in ICU and ED, and you get the same level of care.

If you’re a hospital executive watching this and you have bed blocks in your ICU, ED, and respiratory wards, home TPN, please reach out to us as well. We can help you eliminate your bed blocks very fast.

If you’re in the U.S. or in the U.K. and you’re watching this and you need help, we want to hear from you as well. We can help you there privately with one-on-one consulting and with hiring nurses privately.

Once again, our website is intensivecareathome.com. Call us on one of the numbers on the top of our website or simply send us an email to [email protected].

If you like my videos, subscribe to my YouTube channel for regular updates for families with Intensive Care at Home and intensive care, click the like button, click the notification bell, share the video with your friends and families, and comment below what you think about this video or what you want to see next.

Thank you so much for watching.

This is Patrik Hutzel from intensivecareathome.com and I will talk to you in a few days.

Take care.