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My name is Patrik Hutzel from intensivecareathome.com, where we provide tailor-made solutions for long-term ventilated adults and children with tracheostomies, where we provide tailor-made solutions for long-term ventilated adults and children on BiPAP (Bilevel Positive Airway Pressure) and CPAP (Continuous Positive Airway Pressure), which is non-invasive ventilation. We provide tailor-made solutions for tracheostomy clients without ventilation. Tailor-made solutions for adults and children at home on cough assist machines, ventilation weaning, home TPN (Total Parenteral Nutrition), home IV (intravenous) potassium, home IV magnesium, home IV fluids, home IV antibiotic infusions, central line, PICC (Peripherally Inserted Central Catheter) line, Hickman’s line, port management at home. We provide nasogastric tube, nasojejunostomy tube, PEG (Percutaneous Endoscopic Gastrostomy) tube, PEJ (Percutaneous Endoscopic Jejunostomy) tube, suprapubic catheter, and IDC (Indwelling Catheter) management, as well as palliative care at home.

Today, I want to talk about something that frankly makes my blood boil and it should make your blood boil too.

A 67-year old motor neuron disease patient, Tony Lewis, has chosen voluntary assisted dying because he couldn’t get the funding he needed to live at home with proper support for his disease or disability. This is absolutely wrong in a first world country like Australia, and it highlights a massive gap in our aged care system. That’s literally costing lives.

Here’s what’s happened: Tony was diagnosed with MND and because he’s over 65, he does not qualify for NDIS funding. The aged care system he falls into. It simply doesn’t provide the intensive level of support that MND patients need, especially those who want to choose life prolonging, ventilation, and a tracheostomy. Think about that for a second. We’re telling people over 65 with MND, sorry, you’re too old for the disability scheme, but the aged care system can’t help you either, so good luck. That’s not a healthcare system, that’s abandonment.

Let me be crystal clear about what’s possible here. This is exactly what we do at Intensive Care at Home, and this is exactly why I started Intensive Care at Home. Tony could have been supported at home with mechanical ventilation, either non-invasive ventilation. NIV like BiPAP or CPAP or invasive ventilation with a tracheostomy. According to our evidence-based Mechanical Home Ventilation Guidelines, which have been established over 25 years ago, these are established, safe, evidence-based, and effective options for MMD patients who want to prolong their lives.

Just to give you some background, I’m a critical care nurse, I’ve worked in critical care nursing for over 25 years in 3 different countries where I spent decades in ICU as a nurse, and I’ve also spent decades now with Intensive Care at Home. We’ve looked after MND patients at home, way back when, in Germany on a ventilator with a tracheostomy, even in the early 2000s, and that’s why I started Intensive Care at Home in Australia in 2012 because I could see the gap that exists here, especially in the home ventilation. Healthcare market or disability market, you know, to help patients like Tony to prolong their lives if they choose to, so it’s not a new concept, it’s a decade old long concept, and Australia chooses to lag behind and leaves their most vulnerable exposed to committing suicide. And that needs to stop.

So, steps to get home on non-invasive ventilation:

1. Medical assessment and prescription, respiratory specialist assessment to determine non-invasive suitability and prescribe appropriate settings for BiPAP or for CPAP. Next, equipment set up BiPAP or CPAP or other non-invasive ventilation devices with backup rate, humidification system, and appropriate interfaces such as the face mask. 24-hour intensive care nurses can manage BiPAP and CPAP safely. This is exactly where aged care funding is falling short. On the other hand, you know, patients like Tony, if they choose to live, they would end up in a hospital for months or for potentially years on end, which is not what Tony wants, which is why he’s choosing to, for voluntary assisted dying.
2. Tony would need a monitoring system, oximetry, capnography when appropriate and regulatory, and regular respiratory assessments. Emergency protocols, clear escalation, escalation plans and access to, obviously 24-hour intensive care nurses at home, which is what we provide with Intensive Care at Home, and what he would also need is PEG tube, and he would need a cough assist as well.

So then let’s look at steps to get home on invasive ventilation with a tracheostomy:

1. Would be a tracheostomy formation, usually done in ICU with proper surgical technique and sizing, or at the bedside with an ICU consultant.
2. Ventilator selection, home ventilator with appropriate alarms, battery backup and emergency equipment.24-hour intensive care nursing at home, this requires registered nurses with critical care nursing experience, not standard aged care workers or support workers
3. Equipment and consumables, suction equipment, humidification, emergency tracheostomy tubes, ambubag, oxygen. Nebulizers, spare tracheostomies, tracheostomy dilator, and so forth.
4. Discharge planning, of course, coordinated approach between ICU, home intensive care, which is what we do, equipment suppliers and GP or neurologist, and of course ongoing medical oversight, regular reviews by respiratory team. ICU consultants, speech pathology and rehabilitation services, and this is what we’ve been doing from 13 years now with Intensive Care at Home, including for many NDIS funded MND clients.

The real problem here is that aged care funding cannot handle the funding needs for MND patients whilst they’re paying hundreds of thousands if not millions of dollars a year for ICU beds. But I’ll explain that in more detail in a minute, and it really makes me furious that the aged care system is designed for elderly people who need help with daily living activities, showering, dressing, meal preparation, that’s important work, of course, but it’s not intensive care. MND patients who choose ventilation need 24-hour intensive care nurses at home, so that either non-invasive ventilation such as BiPAP or CPAP or invasive ventilation with a tracheostomy can be managed.

It also then needs 24/7 monitoring and support, specialized equipment and consumables, ICU consultant or respiratory physician oversight 24-hour intensive care nursing, and the current aged care funding model for the community, it simply doesn’t cover this level of care. It’s like asking a general practitioner to perform open heart surgery. They’re both doctors, but they’re not the same thing. In the meantime, if an MND patient chooses to go back into hospital and goes into ICU, it’s costing the taxpayer $5,000 to $10,000 per bed day, whereas home care with Intensive Care at Home would cost approximately 50% of that. So, it’s a no brainer and a win-win situation.

So, what needs to change right now, we need urgent aged care reform that includes a special category for high acuity, intensive homecare. Recognize that some aged care recipients need intensive level support at home, not just assistance with daily living. We need funding parity. If a 64-year-old with MND can get NDIS funding for 24/7 ventilation and tracheostomy support, why can’t a 67-year-old? Age should not be a death sentence and age should not be a discriminating factor because that’s what it is. It’s discriminating against patients with a certain age.

Next, respiratory support packages, dedicated funding streams for home mechanical ventilation, including tracheostomy that cover the true cost, specialized home care nursing, equipment, consumables, and medical oversight, and of course, 24-hour intensive care nursing.

The right to choose life, every MND patient should have the genuine choice to pursue life prolonging treatment at home, if they want to not be financially forced towards voluntary assisted dying. Instead of having the right to choose voluntary assisted dying, they need the right to choose life. That’s a no-brainer.

How can we create a law to choose voluntary assisted dying, but we can’t choose a law for life. Because this is about dignity and choice, I absolutely support voluntary assisted dying as an option for people who choose, and I am a big believer in freedom of choice, but it should be a genuine choice, not the only option left after the system has failed, Tony.

Tony Lewis should have been able to choose life with ventilation at home if that’s what he wanted. The fact that funding constraints pushed him towards voluntary assisted dying instead is a systemic failure that we should all be ashamed of.

The research evidence shows home mechanical ventilation with Intensive Care at Home works. We’ve supported hundreds of patients at home on ventilation with a tracheostomy, including those with MND. The clinical expertise exists, the technology exists, the intellectual property exists because we created it. What’s missing is the political will to fund it properly for people over the age of 65.

Now if this makes you angry too, and it should, here’s what you can do, contact your local MP and demand urgent aged care reform that includes Intensive Care at Home options.

Share this post so more people understand what’s happening, support organizations advocating for MND patients’ rights to choose life prolonging treatment, and if you or a loved one is facing this situation right now, whether you’re dealing with MND, COPD (Chronic Obstructive Pulmonary Disease), neuromuscular disease, or any condition requiring ventilation with or without a tracheostomy, don’t accept you’re too old for support as an answer.

Call us at intensivecareathome.com today.

We’ll help you navigate the system, explore every funding option, and advocate for the care you deserve.

This is literally what we do every single day.

Contact us at intensivecareathome.com, subscribe to my YouTube channel here, click the like button, click the notification bell, and share this video, far and wide, because remember choosing life should never be a luxury only available to those under 65.

Every person, regardless of their age, deserves the right to quality Intensive Care at Home if they need it and want it.

Until next time, this is Patrik Hutzel, reminding you that with the right support, Intensive Care at Home is possible regardless of your age.

 

With all of that said, with Intensive Care at Home, we are currently sending our critical care nurses into the home 24 hours a day. Therefore, we are providing a genuine alternative to long-term stay in intensive care for:

• Ventilation
• Tracheostomy
• Home BiPAP (Bilevel Positive Airway Pressure) and CPAP (Continuous Positive Airway Pressure)
• Tracheostomy care without ventilation
• Home TPN (Total Parenteral Nutrition)
• Home IV potassium
• Home IV magnesium
• Home IV antibiotics
• Home IV fluids

We’re providing:

• Cough assist management at home
• Ventilation weaning management at home
• central line, PICC (Peripherally Inserted Central Catheter) line, Hickman’s line as well as port management at home
• nasogastric tube, nasojejunostomy tube, PEG (Percutaneous Endoscopic Gastrostomy), PEJ (Percutaneous Endoscopic Jejunostomy) tube management at home
• IDC (Indwelling Catheter) and SPC (Suprapubic Catheter) management at home
• 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 Health District’s In Touch program, saving approximately $2,000 per patient that we keep at home instead of them going into an emergency department.

That also means we’re in a position to cut the cost of an ICU bed by around 50%. An intensive care bed costs between $5,000 to $10,000 per bed day depending on location. Intensive Care at Home costs approximately 50% of that, and we’re freeing up the most sought-after bed in the hospital, which is the ICU bed. Most importantly, we’re improving the quality of life for patients and their families, which is a win-win situation for all stakeholders.

Our Coverage and Accreditation

With Intensive Care at Home, we’re currently operating all around Australia, in all major capital cities, as well as in all regional and rural areas. We are an NDIS approved service provider all around Australia, TAC (Transport Accident Commission) and WorkSafe in Victoria as well as the Department of Veterans Affairs all around Australia.

We’re also ISO 9001:2015 accredited. Our clients and we as a service 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 nursing in 2025. We have been achieving this high level of accreditation since 2012. No other provider in Australia has achieved the Intensive Care at Home level of accreditation in the community and has created more intellectual property when it comes to 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. And that enables us to look after the highest acuity adults and children in the community in Australia safely.

If You Need Help

If you’re at home already and you’re watching this or you’re stuck in an ICU and you realize that you don’t have the right level of support, I can give you many examples where we helped clients with funding, how we advocate for funding. We had to advocate successfully for funding from our first case study to many other case studies where we had to advocate successfully for funding with the right evidence of course because it is crystal clear that disability support workers for example or registered nurses without ICU experience cannot look after ventilated clients at home whether adults or children with or without a tracheostomy and it’s simply dangerous and negligent.

There are plenty of examples where clients with support worker models or even RN (registered nurse) models without ICU experience have died at home and I have evidence to back up everything that I’m saying here because it’s a bit like flying the airplane with a cabin crew instead of the pilot and it could simply be deadly.

This can be avoided by having simply 24-hour critical care nurses at home because our clients are at high risk of medical emergencies or worse without critical care nurses 24 hours. This is actually also evidence-based in the community and is documented in our evidence-based Mechanical Home Ventilation Guidelines on our website at intensivecareathome.com.

Think about it: in an intensive care unit in a hospital, you wouldn’t have support workers or general registered nurses looking 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 where there are fewer resources?

Clients that have found us have been at home long-term predictably and permanently with critical care nurses. Their alternative would have been to either die or stay in ICU long-term, and our clients don’t go back to ICU. They stay at home permanently and predictably and the insurance bodies save half of the cost of an ICU. But it’s a win-win situation all around.

We can do the same for you if you’re stuck in ICU or if you’re not safe at home, which includes the advocacy for funding and the network that goes along with it. We have always successfully advocated for our clients or we have the network to successfully advocate for you and for your family member, otherwise we wouldn’t be in business. The same again is applicable for those stuck in an ICU which is similar to many of our, if not most of our cases.

Our Support Coordination Services

This is also why we are providing Level 2 and Level 3 NDIS support coordination. We have a team of experienced NDIS support coordinators, and they have a wealth of knowledge. 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 or a social worker from another organization or a hospital 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 how to advocate for it, what evidence to provide, I encourage you to reach out to us as well. We have the network to make that happen. 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.

Join Our Team

If you are a critical care nurse and you’re looking for a career change and you want to join a very progressive, dynamic, successful, 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’re looking for a career change, we’re currently hiring for jobs for critical care nurses in Melbourne, Sydney, Brisbane, Albury-Wodonga, Bendigo, Geelong, Warragul, and also in Wyelangta in Victoria.

If you have worked in critical care nursing for a minimum of two years, adult ICU, pediatric ICU, ED and you have already completed a postgraduate critical care nursing qualification, we will be absolutely delighted hearing from you.

I have a disclaimer though: Because we are offering tailor-made solutions for our clients which includes regular staff, our clients do also want the same staff coming over and over again because they are so vulnerable and so special. That’s why we need regular, reliable staff.

If you’re looking for agency work where you can come and go, this will not be the right fit for you. We’re 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 you’re really keen on building relationships with us and with our clients. Reliability is also a must.

For Medical Professionals and Healthcare Executives

If you’re 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 to 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 so much more cost-effective than what you’re paying for in ICU and ED settings, and you get the same level of care and simply more patient and family satisfaction because you also want to partner with your consumers.

If you are a hospital executive watching this, we can help you free up your ICU and ED beds.

International Support

If you’re in the U.S. or in the UK 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, click the like button, 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, and share this video with anyone who has a family member in intensive care long-term or needs to see this.

Thank you so much for watching.

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

Take care for now.