In last months Newsletter I have talked about why some Patients and their
\nfamilies suffer dramatically within Intensive Care, due to the lack of specialised
\nIntensive Home Care Nursing Services for long-term ventilated Customers with
\nTracheostomy and their Families.
\nIn this issue of our Newsletter I want to talk about Quality of Life for our
\nCustomers and their families.
\nTo dive right into the topic, Quality of Life is something that is very subjective to
\nthe individual and people have different perceptions and different ideas of what
\nis important to them and what is important to their Quality of Life.
\nQuality of Life is a term that is very often used within the Intensive Care
\nenvironment, as health outcomes and recoveries of people in Intensive Care
\nvary and are looked upon of what the Quality of Life might be in the future for
\nsomeone who is critically ill in Intensive Care- should they survive their ordeal in
\nIntensive Care.
\nWhilst the multidisciplinary team in Intensive Care is usually so caught up and
\nbusy attending to the vital needs of the Patients in Intensive Care, we very often
\nforget to ask some fundamental questions regarding the outcome of a Patients
\nrecovery. The Patient might survive the Critical Phase in Intensive Care only to
\nfind that his or her Quality of Life might not be the same than it was before
\nbeing admitted to Intensive Care. A short and speedy recovery might be out of
\nsight for some Patients.
\nAs for some Patients in Intensive Care, especially the ones requiring ongoing
\nventilation with Tracheostomy, the reality is that their Quality of Life is not as
\ngood as it was before admission to ICU. And here is a massive dilemma. Should
\nthe ICU community in this day and age simply give up? And they often do with
\nmany Patients- and present to the Patient and the Family, that due to the lack of
\nperceived Quality of Life and\/or Quality-of-end-of- Life, treatment needs to be
\nlimited or withdrawn, leaving the Patient in Intensive Care for a short period of
\ntime, after the decision has been made to withdraw treatment and the Patient
\nthen actually is going to die, as life supporting mechanisms such as ventilation is
\nwithdrawn- leaving no option for the Patients and the Families, but to accept the
\nfailure of the Health System to respond to Patients and Families wishes as the
\ncurrent paradigm in Intensive Care and within the Health Industry is based on a
\nscarcity mindset.
\nThere is no thinking outside of the box. Specialised Intensive home care nursing
\nservices for long term mechanically ventilated Customers with Tracheostomy and
\ntheir families? \u201cWe\u2019ve never heard of that\u201d or \u201ctoo complicated\u201d. Those are some
\nof the comments people might make, when they hear about successful overseas
\nmodels of Home Intensive Care Nursing services for long-term mechanically
\nventilated Customers with Tracheostomy and their Families. Those services have
\nbeen successfully operating for more than a decade now in many developed
\ncountries all over the world.
\nBut rather than continue talking about the obvious issues, INTENSIVE CARE AT
\nHOME wants to talk about solutions and ways out of the dilemma.
\nTo start with, let me point out one crucial thing that I think we keep forgetting
\nwhen we talk about long- term Ventilation with Tracheostomy in Intensive Care.
\n? Every human has the right to determine where they want to live
\n? Every human has the right of making their own decisions and to develop
\ntheir personality to the best of their abilities
\n? Nobody can be forced to go into aged care against their will
\nAfter a referral has been made to our services, we optimise and streamline your
\nloved ones discharge home. We look at your loved ones equipment needs and
\nwe put a support and nursing structure in place where your loved ones Quality of
\nLife and\/or Quality-of-end-of-Life is paramount.
\nAt the beginning of your loved ones transfer home, stabilisation of vital
\nparameters is paramount. Therefore our focus is on stabilisation vital organ
\nfunction initially, before we can provide your loved one with the Quality of Life,
\nhe or she has been waiting for in Intensive Care.
\nIn order to achieve Quality of Life we focus on autonomy, independence,
\ncommunication and mobility. In order to achieve those goals we need the full
\nsupport of the nursing team and the Family.
\nHere we focus on your loved ones holistic needs.
\nWhat does \u2018focusing on\u2019 needs really mean in a home care environment, when
\nmy loved one is ventilator dependent with Tracheostomy?
\nGreat question. For example, when I worked overseas in the community to
\nprovide specialised home care nursing services for long-term ventilated
\nCustomers with Tracheostomy and their Families, two prime examples come to
\nmind.
\nWe had one Customer who was in his early forties and who had- prior to being
\ninjured in a car accident and becoming Paraplegic and ventilator dependent- run
\nhis own business, as he was the owner of a car dealership. With the help,
\nsupport and our \u2018can-do\u2019 attitude, we managed to get this gentleman back to
\nwork for about 20 hours a week. I guess it would have been easy to just give up
\nwith the sort of challenges this gentleman was facing. But giving up is never an
\noption. It is all about making things work.
\nThe other Customer standing out and achieving amazing results was a 12 year
\nold girl who spent a good 24 months in ICU, before a specialised Home Care
\nNursing service took on the Care of this girl. She had a rare muscular disease,
\nleaving her respiratory muscles weakened and ventilator dependent.
\nWithin 6 months of taking her back home to her Family, we managed to get her
\nback to school every day. Once again it came down to looking outside of the box
\nand looking of what is possible and making it work. Imagine what sort of
\ndifference in Quality of Life it makes to a 12 year old girl going back to school
\nafter 24 months in ICU.
\nNow, I also want to highlight that every case is different and every case has its
\nunique challenges and opportunities. But we always find a way of focusing on
\nyour loved ones biggest needs and make it work.
\nPatrik Hutzel, Critical Care Nurse July 2012<\/p>\n","protected":false},"excerpt":{"rendered":"