Is it safe for my grandma to go to LTAC after stroke, tracheostomy and nasogastric tube?

https://intensivecarehotline.com/blog/quick-tip-for-families-in-intensive-care-is-it-safe-for-my-grandma-to-go-to-ltac-after-stroke-tracheostomy-and-nasogastric-tube/

Quick Tip for Families in ICU: Is it safe for my grandma to go to LTAC after stroke, tracheostomy and nasogastric tube?

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Hi, it’s Patrik Hutzel from intensivecarehotline.com with another quick tip for families in intensive care.

So currently, we are working with a client who has their 72-year-old mom and grandmother in intensive care after stroke with the tracheostomy and a nasogastric tube and she’s been weaned off the ventilator. Her Glasgow Coma Scale is probably around a six to an eight, depending on the day. So, she’s not awake yet, but she’s certainly having some movement. She’s been weaned off the ventilator despite not being mobilized. And now, the hospital and the ICU are adamant to send her to an LTAC.

And the client is obviously asking, “What should they be doing? Should they be letting her go to an LTAC?” And I advised the client that they should go to the LTAC, have a look for themselves, ask some questions. We set them up with a series of questions and it turns out that at the LTAC, there won’t be any rehabilitation. There will be a nurse-to-patient ratio for one nurse to eight patients during the day and one nurse to 30 patients overnight. Now, that’s pretty daunting going from ICU from one-to-one or one-to-two, to an LTAC with one-to-eight or one-to-thirty overnight. That’s pretty scary. And especially if someone has a tracheostomy and a nasogastric tube, a tracheostomy in and of itself needs 24-hour one-to-one nursing care with a tracheostomy experienced nurse, which is really only an intensive care nurse or emergency nurse.

So also, the ICU told the family that this particular LTAC would take the patient with the nasogastric tube. Most LTACs do not take patients with the nasogastric tube. They only take patients with a PEG (Percutaneous Endoscopic Gastrostomy) tube. And lo and behold, when the family inquired themselves, that was inaccurate. The facility would not take their grandma with a nasogastric tube. They will only accept PEG tubes. So, lo and behold, they are stuck between a rock and a hard place, but the better option is still probably to stay where they are and not go to LTAC because we haven’t really had any clients that have been happy of having their loved ones go to LTAC. It’s always went from bad to worse.

So, for now, my advice is really to keep staying put. Keep their grandma in ICU until she can wake up. The ICU team needs to start mobilizing her, needs to start rehabilitating them, and only then can things get better. She won’t get any rehabilitation or mobilization in LTAC. It’s just not happening from our experience. And it’s definitely not happening if one nurse is looking after eight patients. LTACs are just designed to save money. They’re not designed for clinical needs.

Now, an alternative is, of course, a service like Intensive Care at Home, and you should be checking out intensivecareathome.com. If your loved one is in a similar situation and needs to go home, you should check out intensivecareathome.com.

That is my quick tip for today.

If you have a loved one in intensive care, go to intensivecarehotline.com. Call us on one of the numbers on the top of our website or send us an email to [email protected].

Also, have a look at our membership for families in intensive care at intensivecaresupport.org.

Continue reading at: https://intensivecarehotline.com/blog/quick-tip-for-families-in-intensive-care-is-it-safe-for-my-grandma-to-go-to-ltac-after-stroke-tracheostomy-and-nasogastric-tube/