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Hi, it’s Patrik Hutzel from intensivecareathome.com where we provide tailor-made solutions for long-term ventilated adults and children with tracheostomies at home and where we also provide tailor-made solutions for hospitals and intensive care units at home whilst providing quality care for long-term ventilated adults and children with tracheostomies at home. We also provide care to otherwise medically complex adults and children at home including Home BIPAP (Bilevel Positive Airway Pressure), Home CPAP (Continuous Positive Airway Pressure), home tracheostomy care when adults and children are not ventilated, also Home TPN (Total Parenteral Nutrition), home IV potassium infusions, home IV magnesium infusions as well as IV antibiotics at home. We also provide port management, central line management, PICC (Peripherally Inserted Central Catheter) line management, Hickman’s line management, as well as palliative care at home and also including ventilation weaning.

We are also providing our critical care nurses for home care to avoid emergency department readmissions. So besides keeping ICU beds empty, we also keep emergency department beds empty by sending our critical care nurses into the home for PEG (Percutaneous Endoscopic Gastrostomy) tube changes, nasogastric tube changes, tracheostomy tube changes, catheter changes, even we’ve changed casts at home and other things to keep emergency departments empty.

Today, I have an email from James who says,

“Hi Patrik,

My mom is currently in ICU, and she has been there for 46 days. We keep pushing back to the ICU to take her off all medications so she can participate in the physiotherapy and occupational therapy and the breathing trials because she is on a ventilator with tracheostomy and has been for 46 days now.

But as soon as the visiting hours are over, they tend to load her up with the medications and she’s basically back to square one until she receives dialysis which clears her system and she’s more interactive then. Within five minutes of her tracheostomy surgery, we more or less had a case manager in our room with my mom explaining that she won’t be able to get off the ventilator. That’s not what we’ve been promised before doing the tracheostomy. The tracheostomy was always meant to be a vehicle or a conduit to get her off the ventilator.

And then, they said, “We should move her towards comfort care.” We’ve convinced them to move away from comfort care because we want her to get better and she wants to get better. They have been mean and disrespectful to my wife and I ever since. Mom has made strides, but we’d rather get her transferred to home, we’ll get her weaned off the ventilator at home and pursue rehabilitation as she’s now, like I said, 46 days in ICU.

Any advice on how to approach this with the hospital she’s at now? We still only seem to be able to deal with the nursing staff, and the doctors only do their roundings early in the morning. If we do catch them to ask questions, it’s by accident as they didn’t see us sitting in the corner of mom’s room and then they try to quickly leave before we can engage them.

From, James.”

James, thank you so much for explaining your mom’s situation in so much detail. Well, clearly the intensive care team has not discussed with you what the next step is, and they just want to let her die, but they’re also trying to avoid you.

Now, there’s still many intensive care units out there who still don’t understand the Intensive Care at Home to the detail obviously that we understand it here at the intensivecareathome.com. We’ve been now in business since 2012, which is 12 years now as at the time of the recording of this podcast. Clearly, in a situation like that, your mom is much better off at home. The ICU is much better off with sending your mom home.

ICU beds cost $5,000 to $6,000 per bed day. Let me repeat that, ICU beds cost $5,000 to $6,000 per bed day, and that’s a lot of money. Intensive Care at Home costs around 50% of that. On top of that, your mom will have quality of life or quality of end of life. You and your family will have quality of life, quality of end of life because you’ll be at home, you’ll be in your own surroundings, you won’t be stuck in an ICU where it’s not noisy, there’s light all the time, people running around, other sick people, a lot of hospital bugs. If you don’t have an infection, you’ll probably get one in ICU, and going home is just the better alternative in a situation like that. It’s a no brainer as a matter of fact.

So, you’re on the right track and kudos to you that you are doing your research and look for alternatives because you’re realizing it’s simply the approach from the ICU isn’t working.

So, what we need to do next is look at the funding source, who’s going to pay for it. But the reality is, whoever is paying for the ICU bed, forks out $5,000 to $6,000 per day and would most likely have an interest to reduce that cost to approximately 50% only. Ventilation weaning and tracheostomy weaning can be done at home, rehabilitation can be done at home. Once again, we’ve shown all of that with Intensive Care at Home. You just need to have a look at our website. You just need to have a look on our case study section.

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

In your situation, James, we can set up home care just like we’ve done for all of our clients, dozens of clients over the years and the service that we provide is evidence based. You can have a look on our section at intensivecareathome.com, the Mechanical Home Ventilation Guidelines which are evidence-based. All of our staff have a minimum of two years critical care nursing experience. As a matter of fact, we’re employing hundreds of years of critical care nursing experience in the community, and I think it’s unmatched by any other service provider. We are the only service provider in Australia in 2024 that has achieved third party accreditation for Intensive Care at Home.

Everything can be organized for home care, James, just by setting up the home properly doesn’t necessarily need renovations; often doesn’t, sometimes it does in rare situations. Furthermore, we help create the team of the right nurses for home care, you will see a very different approach at home compared to a hospital environment.

Like I mentioned, we’re also sending our critical care nurses into the home or into a residential age care to keep emergency departments empty and avoid emergency department presentations. We have done that successfully in the past for the Western Sydney Local Area Health District, the in-touch program there.

If you’re at home already and you’re ventilated with a tracheostomy or if you’re ventilated on BIPAP, CPAP, or you have a tracheostomy, you’re not ventilated and you realize you need more help and you need intensive care nurses instead of other supports you have, you’re actually on the right track because people have died at home on ventilation, tracheostomy, even without ventilation and tracheostomy because they’ve been looked after by support workers or by family members and that’s not evidence-based, and that is really really dangerous. We know of many cases that have died at home because they didn’t have the intensive care nurse for a tracheostomy. At the end of the day, it’s an unstable airway and if patients go back to hospital, they often go back into ICU. So, the same level of care is needed at home. Once again, that’s evidence based. Have a look at our section, the Mechanical Home Ventilation Guidelines.

We are also providing Level 2 and Level 3 NDIS Support Coordination. If you want to know more about a Level 2 and Level 3 NDIS Support Coordination, please reach out to us as well. I’ve actually done an interview with Amanda, our NDIS support coordinator and I will link below it in this video.

If you’re a NDIS support coordinator working for another organization and you’re looking for nursing care for your participants, please reach out to us as well. We’re also providing NDIS specialist nursing assessments and we’re providing nursing assessments for any other funding body or organization if you need them, especially when it comes to very complex ventilated and tracheostomy clients in the community or in ICU and in hospitals.

If you’re a NDIS support coordinator struggling with getting nursing care for your participants, please reach out to us as well. Once again, we have been successfully involved in the advocacy for our clients for nursing care at home from Day 1. That also is applicable if you’re a family member or a patient who can’t get nursing care through the NDIS, please reach out to us.

If you are a critical care nurse and you’re looking for a career change, we want to hear from you as well. If you have worked in critical care for a minimum of two years and you ideally have completed a postgraduate critical care and nursing qualification, we want to hear from you. We currently have jobs in Sydney, Melbourne, Brisbane, Albury, Wodonga, Bendigo, as well as in Warragul in Victoria. We want to hear from you and also in Brisbane.

Please keep in mind we’re looking for critical care nurses that want to complement our team. We want to hire staff that give us regular availabilities because that is what our clients want. Our clients want regular staff that’s why we can provide a tailor-made solution for our clients and their families, and that is what we are providing.

If you’re an intensive care specialist or ICU consultant, and you want to be part of our exciting mission and journey, we are currently expanding our medical team as well. We want to hear from you.

If you are working in ICU as an ICU consultant, intensive care specialist, we could help you empty your ICU beds with long-term patients. They are much better off at home and your ICU is much better off with having them at home and staying at home.

If you’re a hospital executive watching this, we also want to hear from you. Once again, we can help you eliminate bed blocks in ICU, ED, and respiratory wards.

Once again, our website is intensivecareathome.com. Call us on one of the numbers on the top of our website or send us an email to info@intensivecareathome.com.

If you’re in the U.S. or in the U.K. or in Canada, please reach out to us. We can help you there privately.

If you like my YouTube videos, subscribe to my YouTube channel for regular updates for families with Intensive Care at Home. Click the like button, click the notification bell, comment below what you want to see next, what questions and insights you have from this video, and share the video with your friends and families.

I also do a weekly YouTube live where I answer your questions live on the show and you get notification for the YouTube live if you’re a subscriber to my YouTube channel or a subscriber to our email newsletter at intensivecareathome.com. Go there and subscribe now!

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.