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Hi, it’s Patrik Hutzel, from INTENSIVE CARE AT HOME, where we provide tailor made solutions for long term ventilated adults and children with tracheostomy by improving their quality of life and where we also provide tailor made solutions to hospitals and intensive care units to save money and resources by providing quality care.

In last week’s blog, I answered another question from one of our readers where the reader asked

My husband is in ICU for four months, can he go home with intensive care at home?

You can check out last week’s question by clicking on the link here.

In today’s video question, I want to focus on another question from one of our readers.

Mandy says

My husband has been in ICU since January 2020. with pneumonia and a stroke he’s got a tracheostomy and he can’t come off the ventilator. We are stuck. Can we go home with intensive care at home?

So here is what Mandy writes.

Hi Patrik,

My 63 year old husband went into ICU earlier this year with a severe pneumonia.

He then suffered from a stroke a couple of weeks after being admitted into ICU.

Since he suffered from the stroke, he ended up with a tracheostomy, and he’s been in ICU since the sixth of January.

He’s slowly weaning off the ventilator but has poor muscle movement due to all the medicines he was given.

I would like to bring him home with intensive care at home.

He is already getting severely depressed, he’s not being able to talk right now as he can only manage a couple of hours here and there to stay off the ventilator.

Me and my children are spending day and night in ICU in order to be with my husband and he’s not making any progress at all. The ICU team says it’ll be very difficult for him to come off the ventilator. And they say that it might be best if we let nature take its course and let him die.

We don’t agree with that at all, because we know he wants to live.

We can accept if he can’t be weaned off the ventilator and the tracheostomy but we can’t accept him staying in a sterile ICU environment.

What are our options to go hime with intensive care at home?

Mandy

Hi Mandy,

Well, thank you Mandy, for writing in and for sharing your situation.

I can totally understand your situation as most of our clients journey started somewhat similar.

I have worked in intensive care for 20 years and I have seen situations like your husband over and over again. And obviously now with what we’re doing with intensive care at home, it does make a lot of sense to get your husband home as quickly as possible.

And not only is it going to be better for your husband to leave ICU as you pointed out to leave the sterile intensive care environment.

You know, it’ll also be better for, you know, his quality of life, of course, he’ll go back into a more natural day and night rhythm because as you would have seen by now in ICU, there’s never any peace and quiet, he probably would have a disturbed day and night rhythm by now.

He probably also has ICU, psychosis and ICU delirium on top of the stroke.

Now, the other thing is, obviously, with your and your children’s situation, you know, you are spending day and night in intensive care.

And I’m sure it impacts on your whole life, you probably can’t work if you were working before, I would imagine it impacts on your children’s life.

And I can only understand that you and your children want to be with your husband 24 hours a day. That’s how important your husband is, of course, and you know, we understand that perfectly well.

So now let’s look at what are your options?

The good news is that you do have options.

You’re saying that he can’t be weaned off the ventilator at the moment and he’s struggling with that.

We don’t know whether we can wean him off the ventilator at home or not, but we can certainly keep trying.

Now keep in mind, you know, in a depressing and sterile ICU environment, I believe it’s not the right environment anyway, to focus on weaning.

At home it will be so much easier and also so much more patient and family friendly because your husband will be in the comfort of his own home.

We are sending intensive care nurses into the home 24 hours a day, 7 days a week, 365 days per year to focus on what is best for your husband and for you as a family and we can also focus on the weaning, we can focus on mobilising your husband, we can organise a physiotherapist coming into your home, occupational therapists, speech therapists, social worker etc…

If your husband can stay off the ventilator for a little bit longer, maybe he can start with speech therapy, you know, and that’s when you need to need to speak therapists as well, but the bottom line is this, you know, your options are to leave intensive care and go home with intensive care at home.

As soon as everything is organized, we can focus on getting all the equipment organized, that your husband will need, we can focus on getting a 24 hour nursing roster together with intensive care nurses that are basically bringing the ICU into your home, to provide an intensive care substitution service for your husband and for yourself that gets you out of the rut being stuck in intensive care.

Now, the next question in a situation like that is obviously how can you obtain funding for our service?

I know you are in in Melbourne in Australia, and especially now in Australia with the NDIS now it’s one of several avenues to access 24 hour funding for intensive care at home.

Department of Health has funded our service in the past as well. Another option is that our service can come in under a hospital in the home (HITH) type of service because you have to look at this from an intensive care perspective as well.

As you would know by now intensive care units are incredibly busy.

And with winter coming up, they’re only going to be much busier. And you don’t want your husband being exposed to all sorts of infections in intensive care either.

The longer he stays in intensive care, the higher the risk, he will end up with another pneumonia or he’ll end up with another infection and that could kill him.

Let’s face it, at home the infection risk is so much lower because he’s in his own environment. He’s not exposed to any other serious bugs that he is exposed to in ICU.

We are all about creating a win-win situation for everyone and therefore what’s in it for the ICU as well with our service, which will help you as well.

So an ICU bed costs around $5,000 to $6,000 per bed day.

And that is a significant expense, you know, intensive care beds are the most expensive beds in a hospital.

With your husband being stuck in intensive care long term, the ICU is suggesting to you that your husband should die.

Why should he die if he wants to live, especially with a service like ours, being so readily available nowadays.

So, the question is, is not so much, what does the ICU want, the question for you is what do you and your husband want and what we offer, ICU wants as well because we can help them free up their ICU beds.

And as I said before, ICU beds are in high demand. And as you know, elective surgery gets cancelled all the time in hospitals because of limited ICU bed availability.

Some ICU patients have to be referred to other hospitals because there are no ICU beds available because long-term ventilated patients like your husband are “blocking” ICU beds.

So what we’re providing really is a win win situation for everyone. We get your husband home, he can improve his quality of life, we help you to leave ICU as well.

We improve your quality of life, we free up an ICU bed that costs $5,000 to $6,000 per bed day.

And we can provide an intensive care substitution service in the home for about half of the cost. So again, it’s all about creating that win win situation everybody wants.

And again, on top of all of that your husband is in an environment where there’s much less risk for an infection.

So thank you for watching this video and I hope Mandy this helps, you know where we are.

If you have a loved one in intensive care with long term ventilation, and tracheostomy needs or any other medical complexities, you should also contact tacked on one of the numbers on the top of our website, or just simply send me an email to [email protected]

And if you are an intensive care nurse or a pediatric intensive care nurse and you’re looking to get out of the craziness of an intensive care unit and work for us in a much nicer and more holistic and client centric family environment, you should contact us as well and should check out our career section on our website here

https://intensivecareathome.com/careers/

We currently have vacancies for experienced ICU and pediatric ICU nurses in Melbourne, on the Mornington peninsula, in the northern suburbs in Melbourne and also in Sunbury. So really all across the Melbourne metropolitan area, including country Victoria, and you can escape the hustle and bustle of intensive care and work in a much nicer and much more family friendly and holistic environment.

You can also have a look at our service section where we detail exactly how we deliver services or tailor made services I should say for our patients and their families. But also for hospitals in intensive care units.

https://intensivecareathome.com/services/

We have also been part of the Royal Melbourne health accelerator program in the past for innovative health care companies. Thank you so much for tuning into this week’s vlog and I’ll talk to you in a few days. This is Patrik Hutzel from intensive care at home.