In today’s blog post I want to talk about what led me to believe that Intensive Care At Home is possible for the right Customers. About ten years ago I was working in a Trauma Intensive Care Unit in Germany and I had already heard about a new start up health service provider, offering Home Intensive Care Nursing services for long- term ventilated Patients with Tracheostomy. I was immediately hooked by the idea, as we all know that in Intensive Care, there are those long-term ventilated Patients that are too “well” for ICU, yet because of their ventilator dependency they are too “sick” to go to a ward. Those Patients and their Families are stuck in between, so to speak. Those Patients also tend to use very scarce and expensive resources in Intensive Care, as ICU beds and highly skilled ICU staff tend to be a scarcity and therefore very expensive. Not even mentioning what it means for a Patient being in ICU 40 days and longer, being depressed, and ventilator dependent with no Quality of Life. Furthermore, the Patients Families usually put their lives on hold to be with their loved one in ICU. This in essence often means Family members not working and neglecting their Family and their professional lives, with children and elderly parents not being looked after properly! Going back to my experience in Germany, as I mentioned, I was immediately hooked by the idea and I ended up working for this start-up company, who had only started with their first Client six months prior to me joining. What I learned there and what I did in my day to day job, changed my entire outlook of what is possible, how much value we can really provide with our ICU nursing skills and with the right medical backup, when thinking outside of the box and also how much value we can provide to the health system in general, as home care nursing services tend to be more cost effective compared to hospital services, whilst freeing up valuable resources that can be used for more acute Patients who urgently need a bed in Intensive Care, whilst also focusing on Quality of Life and/or Quality of-end-of- Life in peoples homes. The first Clients I looked after in the community where either Patients out of Intensive Care(Adults and Paediatrics) who required ongoing ventilation with Tracheostomy for a variety of reasons ranging from Neuromuscular diseases to COPD, Asthma, Lung transplants, Spinal Injuries etc…. Clients and their Families alike were very grateful for the services they received as they absolutely did not want to stay in Intensive Care, as soon as the opportunity presented to go home. It also meant a huge relief for the Family not having to travel to Intensive Care every day and even though in the early days of having to adjust to 24/7 nursing care with a ‘mini ICU’ in their own homes, Families were entirely grateful for the services they received. Families also found that finally somebody understood and empathised with what they really needed in their particular situation of having a loved one long-term ventilated in Intensive Care. It took a little while to get the concept established, but for Families and their loved ones, as well as for Intensive Care Units it is now ten years down the line a “no brainer” to take a long-term ventilated Patient home, in order to improve the Clients and their Family members Quality of Life and/or Quality of-end-of-Life and also saving money and resources for the health system along the way. Moreover, looking at what we have achieved in our Clients and their Families Quality of Life is remarkable in any way.
- It is quite remarkable how Families who had a loved Family member at home who was ventilator dependent with Tracheostomy, but had no professional support, genuinely felt relieved by the level of support offered- mainly 24/7 nursing care with skilled ICU nursing staff, as opposed to be left to their own devices
- Furthermore, our ventilated Adults& Children and their Families would have never gone back to ICU if not clinically indicated and we managed to keep our readmission rate at an absolute bare minimum, thanks to a dedicated team of professionals
- Some children we managed to reintegrate back to school and kindergarten on a day to day basis, by having the right nursing skills and the right mindset to make this happen
- In most cases most Families were able to get their lives back on track in pursuing their interests, besides worrying about having a ventilated Family member at home
- In some adult cases we managed to get some adults back to work part time on a ventilator with Tracheostomy. Once again this is all about having the right mind set combined with the right level of nursing skills- think about the alternative for a minute, meaning staying in ICU for indefinite periods of time with no Quality of Life
This experience really changed my outlook of life and about Intensive Care and it is more than overdue that the current reality in Intensive Care in Australia is taken to another level by providing a genuine alternative for long-term ventilated Adults& Children in Intensive Care, by taking them home! What do you think and what is your experience with long- term ventilation in Intensive Care? Share your thoughts and leave a comment below. Cheers Patrik