{"id":4595,"date":"2023-05-02T16:00:54","date_gmt":"2023-05-02T06:00:54","guid":{"rendered":"https:\/\/intensivecareathome.com\/?p=4595"},"modified":"2024-01-22T15:05:11","modified_gmt":"2024-01-22T04:05:11","slug":"palliative-care-at-home-for-a-client-on-bipap-instead-of-icu-intensive-care-at-home-case-study","status":"publish","type":"post","link":"https:\/\/intensivecareathome.com\/palliative-care-at-home-for-a-client-on-bipap-instead-of-icu-intensive-care-at-home-case-study\/","title":{"rendered":"Palliative Care at Home for a Client on BIPAP Instead of ICU! INTENSIVE CARE AT HOME Case Study!"},"content":{"rendered":"<!--powerpress_player--><div class=\"powerpress_player\" id=\"powerpress_player_9627\"><!--[if lt IE 9]><script>document.createElement('audio');<\/script><![endif]-->\n<audio class=\"wp-audio-shortcode\" id=\"audio-4595-1\" preload=\"none\" style=\"width: 100%;\" controls=\"controls\"><source type=\"audio\/mpeg\" src=\"https:\/\/s3.ap-southeast-2.amazonaws.com\/intensivecareathome.com.au\/ICAH+2023\/MAY+2023\/Palliative_Care_at_Home_for_a_Clien_(getmp3.pro).mp3?_=1\" \/><a href=\"https:\/\/s3.ap-southeast-2.amazonaws.com\/intensivecareathome.com.au\/ICAH+2023\/MAY+2023\/Palliative_Care_at_Home_for_a_Clien_(getmp3.pro).mp3\">https:\/\/s3.ap-southeast-2.amazonaws.com\/intensivecareathome.com.au\/ICAH+2023\/MAY+2023\/Palliative_Care_at_Home_for_a_Clien_(getmp3.pro).mp3<\/a><\/audio><\/div><p class=\"powerpress_links powerpress_links_mp3\" style=\"margin-bottom: 1px !important;\">Podcast: <a href=\"https:\/\/s3.ap-southeast-2.amazonaws.com\/intensivecareathome.com.au\/ICAH+2023\/MAY+2023\/Palliative_Care_at_Home_for_a_Clien_(getmp3.pro).mp3\" class=\"powerpress_link_pinw\" target=\"_blank\" title=\"Play in new window\" onclick=\"return powerpress_pinw('https:\/\/intensivecareathome.com\/?powerpress_pinw=4595-podcast');\" rel=\"nofollow\">Play in new window<\/a> | <a href=\"https:\/\/s3.ap-southeast-2.amazonaws.com\/intensivecareathome.com.au\/ICAH+2023\/MAY+2023\/Palliative_Care_at_Home_for_a_Clien_(getmp3.pro).mp3\" class=\"powerpress_link_d\" title=\"Download\" rel=\"nofollow\" download=\"Palliative_Care_at_Home_for_a_Clien_(getmp3.pro).mp3\">Download<\/a><\/p><p><iframe loading=\"lazy\" title=\"Palliative Care at Home for a Client on BIPAP Instead of ICU! INTENSIVE CARE AT HOME Case Study!\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/Dz1VbRk07nw?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe><\/p>\n<p>Hi, it&#8217;s Patrik Hutzel from <strong>Intensive Care at Home<\/strong>, where we provide tailor-made solutions for long-term ventilated adults and children with <a href=\"https:\/\/intensivecarehotline.com\/tracheostomy\/\" target=\"_blank\" rel=\"noopener\"><u>tracheostomies<\/u>.<\/a> And where we also provide tailor-made solutions for hospitals and intensive care units whilst providing quality services for long-term ventilated adults and children, including <a href=\"https:\/\/intensivecarehotline.com\/non-invasive-ventilationniv\/\" target=\"_blank\" rel=\"noopener\"><u>BIPAP<\/u> <u>(bilevel positive airway pressure) <\/u><u>and <\/u><u>CPAP (continuous positive airway pressure)<\/u><u> ventilation<\/u><\/a>, including medically complex patients at home, such as seizure management, including <a href=\"https:\/\/intensivecareathome.com\/tpntotal-parenteral-nutrition-administration-picc-line-central-line-care-community\/\" target=\"_blank\" rel=\"noopener\"><u>home TPN<\/u><\/a>, as well.<\/p>\n<p>In last week&#8217;s blog, I talked about,<\/p>\n<p><a href=\"https:\/\/intensivecareathome.com\/intensive-care-at-home-now-in-the-u-s\/\" target=\"_blank\" rel=\"noopener\"><strong><u>INTENSIVE CARE AT HOME NOW IN THE U.S.<\/u><\/strong><\/a><\/p>\n<p>You can check out last week&#8217;s blog by clicking on the link below this video:<\/p>\n<p><a href=\"https:\/\/intensivecareathome.com\/intensive-care-at-home-now-in-the-u-s\/\" target=\"_blank\" rel=\"noopener\">https:\/\/intensivecareathome.com\/intensive-care-at-home-now-in-the-u-s\/<\/a><\/p>\n<p>In today\u2019s blog post, I want to talk about a case study of ours where we actually provided palliative care at home.<strong>\u00a0<\/strong><\/p>\n<p style=\"text-align: center;\"><strong>Palliative Care at Home for a Client on BIPAP Instead of ICU! INTENSIVE CARE AT HOME Case Study!<\/strong><\/p>\n<p style=\"text-align: center;\"><strong> <img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-4596\" src=\"https:\/\/intensivecareathome.com\/wp-content\/uploads\/2023\/05\/2_Palliative-Care-at-Home-for-a-Client-on-BIPAP-Instead-of-ICU-INTENSIVE-CARE-AT-HOME-Case-Stud-300x206.png\" alt=\"\" width=\"300\" height=\"206\" srcset=\"https:\/\/intensivecareathome.com\/wp-content\/uploads\/2023\/05\/2_Palliative-Care-at-Home-for-a-Client-on-BIPAP-Instead-of-ICU-INTENSIVE-CARE-AT-HOME-Case-Stud-300x206.png 300w, https:\/\/intensivecareathome.com\/wp-content\/uploads\/2023\/05\/2_Palliative-Care-at-Home-for-a-Client-on-BIPAP-Instead-of-ICU-INTENSIVE-CARE-AT-HOME-Case-Stud.png 333w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/strong><\/p>\n<p><strong>\u00a0<\/strong>Hi, it&#8217;s Patrik Hutzel from <strong>Intensive Care at Home<\/strong>, where we provide tailor-made solutions for long-term ventilated adults and children with <a href=\"https:\/\/intensivecarehotline.com\/tracheostomy\/\" target=\"_blank\" rel=\"noopener\"><u>tracheostomies<\/u>.<\/a> And where we also provide tailor-made solutions for hospitals and intensive care units whilst providing quality services for long-term ventilated adults and children, including <a href=\"https:\/\/intensivecarehotline.com\/non-invasive-ventilationniv\/\" target=\"_blank\" rel=\"noopener\"><u>BIPAP<\/u> <u>(bilevel positive airway pressure) <\/u><u>and <\/u><u>CPAP (continuous positive airway pressure)<\/u><u> ventilation<\/u><\/a>, including medically complex patients at home, such as seizure management, including <a href=\"https:\/\/intensivecareathome.com\/tpntotal-parenteral-nutrition-administration-picc-line-central-line-care-community\/\" target=\"_blank\" rel=\"noopener\"><u>home TPN<\/u><\/a>, as well.<\/p>\n<p>So, in today&#8217;s video, I want to talk about a case study of ours where we actually provided palliative care at home for a gentleman in his early 70s last year. Now, I&#8217;ll quickly talk about the gentleman&#8217;s history, and then gentleman&#8217;s premedical history, and then also why he needed <strong>Intensive Care at Home<\/strong> services.<\/p>\n<p>So, he had a longstanding history of cancer. Initially, he was diagnosed with bowel cancer in the early 2000s. He had a colostomy back for that. Eventually, the bowel cancer spread into the lungs. He had lung metastasis. He also had a history of pancreatitis. He had blocked right ear with tinnitus. The right side of his diaphragm was paralyzed. He had a total knee replacement. He also had an upper left lobectomy as part of the metastatic lung cancer. And eventually, he was BIPAP dependent, initially only overnight. But then, as the lung cancer progressed, he was BIPAP dependent, 24 hours a day.<\/p>\n<p>As part of his diaphragm paralyzed, he had phrenic nerve palsy. And as I said, eventually, he was BIPAP dependent at 24 hours a day. Initially, he might have been able to take the BIPAP off for about five minutes when he was in the shower. But then as time progressed, we ended up having him in the shower even with BIPAP on, but he was still mobile. The last few weeks, he was no longer mobile. We were basically providing palliative care for about three or four months at home last year. The alternative for this man would&#8217;ve been to be in intensive care with his BIPAP dependency, also oxygen dependency. We had an oxygen concentrator at home to supplement with oxygen when needed.<\/p>\n<p>Obviously, the referral was made to us, and I&#8217;ll just read out the referral from the specialist, \u201cChronic respiratory failure requiring ventilation life support, 24 hours per day, 365 days per year. Home care required by <strong>Intensive Care at Home<\/strong> with ICU trained nurses, ventilation, mobilization, stomach care, and all nursing care.\u201d<\/p>\n<p>And also, what&#8217;s important here to understand as well is, we are providing home care according to best practice and evidence-based guidelines. We are providing those care services according to the <a href=\"https:\/\/intensivecareathome.com\/mechanical-home-ventilation-guidelines\/\" target=\"_blank\" rel=\"noopener\"><u>mechanical home ventilation guidelines<\/u><\/a>\u00a0that you can read on our website at <strong>intensivecareathome.com<\/strong>. The mechanical home ventilation guidelines are evidence-based. Services such as <strong>Intensive Care at Home<\/strong> have been around in Europe, particularly in Germany since the late 1990s. And all the evidence is there that <strong>Intensive Care at Home<\/strong> can be provided safely if there are intensive care nurses available, 24 hours a day, with a minimum of two years hospital ICU or pediatric ICU experience. And that&#8217;s exactly what we are providing at <strong>Intensive Care at Home<\/strong>.<\/p>\n<p>As a matter of fact, we are employing hundreds of years of intensive care nursing experience in the community. I don&#8217;t think that any other service provider can match that. We bring so many experienced ICU nurses into the community and basically replicating an ICU bed in the community, and we take pressure off the healthcare system by bringing the intensive care skills into someone&#8217;s home, keeping intensive care beds empty.<\/p>\n<p>So, coming back to our case study, obviously, the client had the desire not to be readmitted back to ICU, had the desire to spend whatever time he had left at home. And we enabled that for him and for his wife as well. It was very important for them to have quality time at home. It was very important for them to spend whatever time they had left in the comfort of their own home. Would&#8217;ve been literally a nightmare for both of them to have this gentleman readmitted back to ICU and not have the quality palliative care at home.<\/p>\n<p>So, we then started a 24-hour nursing roster at home with our <strong>Intensive Care at Home<\/strong> nurses, with our ICU trained nurses, and made sure that this gentleman has all the quality care at home that he needed to spend his last few months at home, in the comfort of his own home with his wife, and his kids were visiting. And it was a really good experience for everyone involved. And I do believe by the time he passed, he was very much at peace, and his wife was at peace that at least he didn&#8217;t have to go back to hospital.<\/p>\n<p>Pain was fairly well controlled. We were working very closely with local palliative care service here in Melbourne. And making sure that his pain was well controlled that all of his needs were taken care of. And as, unfortunately, the cancer progressed, even with the ongoing BIPAP, he could no longer be ventilated appropriately. And then, he passed away eventually, but he passed away with comfort and with dignity and which is very important.<\/p>\n<p>Everyone that&#8217;s worked in ICU or everyone that God forbid, lost a family member in ICU knows that ICUs are not the right place for end-of-life situations. It&#8217;s often rushed, it&#8217;s often hastened because ICUs are under pressure. They need the beds, they need the staff. Whereas, in the comfort of their own home, it&#8217;s a very different approach. It&#8217;s a much more gentle approach. It&#8217;s a holistic approach. It&#8217;s a family-centered approach, which I believe makes all the difference to someone&#8217;s quality of end of life.<\/p>\n<p>They&#8217;re not shoved patients in ICU or often shoved into a corner or they&#8217;re in a dark room, whereas in someone&#8217;s home, the home can be set up nicely for someone to pass away nicely at home, and it&#8217;s also a much better experience for the health professionals, for our nurses, and for the doctors because the reality is we&#8217;ve all been in end of life situations in intensive care that haven&#8217;t gone well because there&#8217;s often so much pressure. At home, it&#8217;s at the client&#8217;s pace, it&#8217;s at the family&#8217;s pace. It&#8217;s not at the ICU team&#8217;s pace. It&#8217;s at the family&#8217;s pace, at the patient&#8217;s, at the client&#8217;s pace, which is very important. People want choice, they want freedom, and they want to do what&#8217;s right for them. And that&#8217;s exactly what we can provide here at <strong>Intensive Care at Home<\/strong>.<\/p>\n<p>And again, we have saved the healthcare system probably hundreds of thousands of dollars by providing an intensive care bed in the home rather than using an intensive care bed in a public or in a private hospital that costs five to $6,000 per bed day and we&#8217;ve kept that bed empty so that patients from emergency departments, from the operating room, can go into intensive care, so it&#8217;s a win-win altogether.<\/p>\n<p>And it was sad as it was to palliate this gentleman, it was a good experience for everyone because that&#8217;s what the patient wanted, it was their wish, and wishes need to be respected. Especially since with <strong>Intensive Care at Home<\/strong>, it provides a win-win situation for everyone, including the hospitals and the funding bodies, because otherwise they would&#8217;ve paid for an ICU, but which would&#8217;ve been doubled the cost.<\/p>\n<p>So, I hope that illustrates another case study for <strong>Intensive Care at Home<\/strong>.<\/p>\n<p>If you are in a similar situation for palliative care or if you have a loved one in intensive care, ventilated with the tracheostomy and also as I\u2019ve just explained today, BIPAP, CPAP, what still needs loved one, or you still need to be stuck in intensive care because you think there are no other options. Think twice. There are options. You just contact us at <strong>intensivecareathome.com<\/strong>.<\/p>\n<p>We are currently operating all around Australia. But you should also contact us if you&#8217;re in the U.S., we can help you in the U.S. as well. But we are operating in Australia and all major capital cities, including regional and remote areas. We are a TAC (Transport Accident Commission), DVA (Department of Veteran Affairs), and <a href=\"https:\/\/intensivecareathome.com\/how-can-you-as-a-family-obtain-funding-for-intensive-care-at-home\/\" target=\"_blank\" rel=\"noopener\"><u>NDIS (National Disability Insurance Scheme) approved funding<\/u><\/a>\u00a0nursing service provider. We receive funding through those organizations. You should contact us if you are not sure how to go about funding. We can help you with all of that.<\/p>\n<p>Or if you&#8217;re looking for home TPN solutions, you should contact us as well at <strong>intensivecareathome.com<\/strong>. Call us on one of the numbers on the top of our website or send us an email to <strong>info@intensivecareathome.com<\/strong>.<\/p>\n<p>Also, if you are a critical care nurse and you&#8217;re looking for work, if you have a minimum of two years ICU, pediatric ICU experience, ideally with a critical care qualification, you should contact us as well. We currently have work in Melbourne, Sydney, and Brisbane, but also in other major capital cities. Please contact us as well, and if you&#8217;re an intensive care specialist watching this, you should contact us as well. We&#8217;re trying to expand our medical team.<\/p>\n<p>And if you&#8217;re an intensive care specialist watching this and you have long-term ventilated patients in your unit, please contact us as well. We can help you manage your exit blocks or bed blocks.<\/p>\n<p>Now, you should also <a href=\"https:\/\/intensivecarehotline.com\/intensivecaresupport-org-membership\/\" target=\"_blank\" rel=\"noopener\"><strong><u>check out our membership for families in intensive care at intensivecaresupport.org<\/u><\/strong><\/a>. There, you have access to me and my team, and we answer all questions, intensive care and <strong>Intensive Care at Home<\/strong> related in a membership area, and via email.<\/p>\n<p>If you need a <a href=\"https:\/\/intensivecarehotline.thrivecart.com\/review-of-medical-records\/\" target=\"_blank\" rel=\"noopener\"><strong><u>medical record review<\/u><\/strong><\/a>\u00a0for your loved one in intensive care, or if you need an NDIS nursing assessment, you should contact us as well. We can help you with either.<\/p>\n<p>Subscribe to my <a href=\"https:\/\/www.youtube.com\/channel\/UCFMAw7gyY0cJxrDSTCYIEYA\" target=\"_blank\" rel=\"noopener\"><strong><u>YouTube channel<\/u><\/strong><\/a>\u00a0for regular updates for families in intensive care and <strong>intensivecarehome.com<\/strong>, share the video with your friends and families, click the like button, click the notification bell, and comment below what you want to see next, what questions and insights you have, whether you agree with palliative care at home, as opposed to intensive care.<\/p>\n<p>I want to thank you for watching.<\/p>\n<p>This is Patrik Hutzel from <strong>intensivecareathome.com<\/strong> and I will talk to you in a few days.<\/p>\n<p>Take care.<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>(getmp3.pro).mp3Podcast: Play in new window | Download Hi, it&#8217;s Patrik Hutzel from Intensive Care at Home, where we provide tailor-made<a class=\"read-more\" href=\"\">Continue Reading <i class=\"fa fa-angle-double-right\" aria-hidden=\"true\"><\/i><\/a><\/p>\n","protected":false},"author":5,"featured_media":4596,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_genesis_hide_title":false,"_genesis_hide_breadcrumbs":false,"_genesis_hide_singular_image":false,"_genesis_hide_footer_widgets":false,"_genesis_custom_body_class":"","_genesis_custom_post_class":"","_genesis_layout":"","footnotes":""},"categories":[2,7],"tags":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v22.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Palliative Care at Home for a Client on BIPAP Instead of ICU! 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