MY HUSBAND’s IN ICU ON A VENTILATOR WITH TRACHEOSTOMY, DEPRESSED IN ICU&WE WANT TO BRING HIM HOME

https://intensivecareathome.com/my-husband-is-in-icu-on-a-ventilator-with-a-tracheostomy-hes-getting-depressed-in-icu-and-we-want-to-bring-him-home-please-help/

MY HUSBAND IS IN ICU ON A VENTILATOR WITH A TRACHEOSTOMY. HE’S GETTING DEPRESSED IN ICU AND WE WANT TO BRING HIM HOME. PLEASE HELP!

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In today’s blog post, I want to answer a question from one of our clients and the question today is

My Husband is in ICU on a Ventilator with a Tracheostomy. He’s Getting Depressed in ICU and We Want to Bring Him Home. Please Help!

Hi Patrik,

My name is Denise and I am reaching out to you on behalf of my husband, John. My husband has been diagnosed with COPD and now, also has pneumonia. He was hospitalized on June the 10th and has been in and out of ICU since then.

He currently has a tracheostomy and during the day he’s off the ventilator, overnight he’s on pressure support ventilation. He’s mentally and physically stable. And at this point they’re going to keep him in ICU because he’s got nowhere to go.

My husband is 68 and me and my family are very upset with this decision for many reasons. We want him at home because he’s getting very depressed in ICU. He’s having sleepless nights. He’s tired during the day and his day and night rhythm is completely upside down.

The ICU team also has warned us about him staying in ICU for much longer that he may catch a hospital infection and that he may die. So they are telling us that they keep a very close eye on his care, so he doesn’t fall through the cracks.

However, now they want to give him a one to two, nurse-to-patient ratio and I am not sure whether my husband is ready for that. And whether that would really help him with attending to all his needs, which are quite complex, which leads me to another concern with current COVID restrictions.

The visitation for this hospital is insane. You can only visit one hour a day from nine to five. So I need to keep up on his care. And how can I do that with these restrictions? I am disabled due to a spinal cord injury and I cannot drive.

I am self-sufficient other than driving. We live with our daughter and her husband. She is very knowledgeable in the medical field because she’s a med tech. Your expertise on this subject would be very much appreciated in regards to intensive home health care.

Please get back to me at your earliest convenience. We are in Sydney, Australia. I thank you also in advance for your attention to this matter.

From Denise.

Hi Denise,

Thank you so much for writing in and sharing your husband’s situation. Unfortunately, you and your husband are in a very similar situation to many of the families that have a loved one in intensive care long-term. And as long as your husband can’t come off the ventilator overnight he would be stuck in ICU unless he will go home with our service Intensive Care at Home. We can certainly make that happen.

It sounds to me like the only thing that’s keeping him in ICU is the tracheostomy and the ventilation. And what might be stopping him as well is the lack of perceived alternatives from the ICU perspective.

So I think the next step for you is to bring up our service Intensive Care at Home and then we can organize a meeting with the intensive care team to get your husband home, because that’s where he should be.

Now, you haven’t mentioned how far away your husband is to be weaned off the ventilator. You haven’t shared what is his pressure support? What is his PEEP? What is his FiO2? Does he need frequent suctioning? Can he talk when he’s off the ventilator? You haven’t shared any of that. And it would be very good to find out what ventilator settings is he on? Is the pneumonia cleared? Is he still on antibiotics? How often does he get out of bed? How is your home set up...

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