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Can a patient with motor neurone disease on continuous BIPAP and nasogastric tube, have a tracheostomy and PEG tube can go home with Intensive Care at Home? If you want to know the answer to that question, stay tuned. I would break this down for you today.
My name is Patrik Hutzel from intensivecareathome.com. Now, a question that we got recently from a client was, “Can my husband, who is on continuous BIPAP for motor neurone disease, have a tracheostomy and also can he have a PEG (Percutaneous Endoscopic Gastrostomy) tube?” Now, from our perspective, clearly, yes. I’ll tell you why. We have a number of clients in the community that are at home with motor neurone disease and the tracheostomy, and they’re living their best lives, and they want to live.
Now, it turns out that currently in the state of Victoria, in Australia, where I am, that the Motor Neurone Disease Association in Victoria stopped advocating for their clients, and big shout out to my friends there. Clearly, that is what we are seeing, and someone has to advocate for those MND clients, and that’s what we are doing here at Intensive Care at Home. We’re not shy in advocating for our clients, whereas MND Victoria seems to advocate for palliative care for patients that want to live, and that is ethically and morally wrong.
I do believe that MND Victoria has lost their moral and ethical compass. I do believe I can confidently say that because I have worked with Intensive Care at Home in Germany 25 years ago, and we were looking after motor neurone disease patients with tracheostomies there and then.
So, Motor Neurone Disease Victoria Association, wake up, you’re 30 years behind. If you choose to stay 30 years behind, that’s fine. You got to wake up to what’s actually happening in the real world. Better 30 years later than not at all.
We have certainly woken up to what’s happening, and we’ve been advocating for our MND clients from Day 1 successfully, of course, otherwise we wouldn’t be in business, and I wouldn’t be making these videos.
So, what needs to happen? Well, clearly what needs to happen is the patient needs to have a tracheostomy to live their life. This gentleman has a young family, clearly wants to live, his wife wants him to live, his kids want him to live, he wants to live. So, what’s the point in not advocating for a tracheostomy here? Is MND Victoria seeing those patients as a burden, as a cost factor?
The interesting part that I can also see with MND Victoria is, I can’t see any nurses there or any clinicians there that are making decisions or that have experience in intensive care or in the community like we have here at Intensive Care at Home. I can’t see any clinicians that have significant experience.
I also can’t see any videos from them. I can’t see any public statements from them, maybe they’re hiding behind their computers, or I don’t know. It would be nice to hear, get a statement from MND Victoria but obviously they’re not speaking up. They’re just speaking up behind closed doors and are not advocating for patients and their families.
Just to give you some examples as well, we have an MND client that has been living at home since 2019 with a tracheostomy and a ventilator with 24-hour NDIS funded nursing care, because he needs critical care nurses, 24 hours a day, and that’s where we come in with Intensive Care at Home, and that is much more cost-effective than an intensive care bed, which is what the alternative would be for this man.
Another client that we were looking after was Justin Yerbury, quite a public figure in the Wollongong and Sydney area in New South Wales. He also had a tracheostomy with MND, and he lived at home with a tracheostomy for a number of years as well, as was his wish.
So, for any MND association to say it’s not possible or it’s not funded is complete and utter nonsense. So, wake up, guys, face reality, and make use of the NDIS, who has been supporting these clients.
We will fight for this client too here. We are in the process of helping them with nursing care. Of course, we will advocate for them just like we do for any other clients. We will do that with specialized NDIS nursing assessments, but also with NDIS Support Coordination.
We have our own NDIS Support Coordinators, so does MND Victoria, but we also know now from experience that we know two clients now with MND who have pitched their NDIS Support Coordinators from MND Victoria because they’re simply not advocating, and they don’t even know what they’re doing, and I’m not mincing my words here.
If you need help for anything advocacy related or nursing related for MND (motor neurone disease), please reach out to us. We’re here to help and we’re here to support.
So, with all of that said, with Intensive Care at Home, we are sending our critical care nurses into the home, 24 hours a day. Therefore, we are providing a genuine alternative to a long-term stay in intensive care for ventilation, tracheostomy, Home BIPAP (Bilevel Positive Airway Pressure), Home CPAP (Continuous Positive Airway Pressure), ventilation without tracheostomy, tracheostomy without ventilation, Home TPN (Total Parenteral Nutrition), home IV potassium infusions, and home IV magnesium infusions. We’re also providing ventilation weaning at home. We’re also providing central line management, PICC (Peripherally Inserted Central Catheter) line management, Hickman’s line management, as well as port-a-cath management for home TPN, but also for IV infusions. We’re also providing nasogastric tube management, PEG tube management at home, as well as palliative care services at home.
We’re 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 going to the emergency department, and we’re actively making sure that there are empty beds in an emergency department for the patients that most need to be in the emergency department.
We’re also in a position to cut the cost of an intensive care bed by around 50%. An intensive care bed costs around $5,000 to $6,000 per bed day. Our services costs around 50% of that and we’re freeing up the most sought-after bed in the hospital, which is the intensive care bed. Most importantly, we’re improving the quality of life for patients and their families. So, it’s a win-win situation for stakeholders.
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 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 the only service provider in Australia that has achieved third-party accreditation for Intensive Care at Home in 2025. We have been achieving this level of accreditation since 2012. No other 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. That 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 stuck in an ICU bed or your family member is stuck in an ICU bed, especially if you’re long-term ventilated with tracheostomy, if you’re at home already and you’re watching this, and you realize that you want to go home or that you don’t have the right level of support if you are at home, I’ll give you some tangible examples of how we can turn situations around for you. One of our first clients over 10 years ago was a client who was at home on a ventilator with a tracheostomy with a support worker model 24/7. Of course, support workers cannot look after clients at home on a ventilator with a tracheostomy, full stop. That 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 or dying if they don’t have critical care nurses looking after them 24/7.
This is evidence-based, and it’s documented in the Mechanical Home Ventilation Guidelines that you can find on our website. Think about it, in intensive care in a hospital, you wouldn’t have support workers to look after a critical care patient on a ventilator with a tracheostomy. So, why would anyone in their right mind do that in a home care environment?
So eventually, this client found out about us. We were proving our concept with this client very quickly. 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, 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.
This is also why we are providing Level 2 and Level 3 NDIS Support Coordination. We have a team of designated and dedicated 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 we’ll put a link to an interview with Amanda in the written version of this blog below the video. 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 can 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, and 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 the postgraduate critical care nursing qualification. We will be delighted hearing from you.
I have a disclaimer though, because we are offering a tailor-made solution for our clients, which includes regular staff and regular teams, our clients do want the same staff coming over and over again, because they are so vulnerable and so 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 availability for shifts and only 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 EDs 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 for, 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, respiratory wards, please reach out to us as well. We can help you there 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 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].
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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 for now.