Can INTENSIVE CARE AT HOME Provide a Dignified Death at Home Instead of an Undignified Death in ICU?

4 months ago
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https://intensivecareathome.com/can-intensive-care-at-home-provide-a-dignified-death-at-home-instead-of-an-undignified-death-in-icu/

Can INTENSIVE CARE AT HOME Provide a Dignified Death at Home Instead of an Undignified Death in ICU?

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Hi, it’s Patrik Hutzel here from intensivecareathome.com where we provide tailor-made solutions for long-term ventilated adults and children with tracheostomies 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 tracheostomy 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 antibiotic infusions 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 that also includes ventilation weaning.

We are also providing our critical care nurses for home care to avoid emergency department readmissions. We have done so successfully in the past for the Western Sydney Local Area Health district. The in-touch service is part of a successful tender.

So today, I actually want to talk about that I watched a presentation recently from the ACCCN, the ACCCN is the Australian College of Critical Care Nurses. The webinar presentation was about end-of-life decision making in ICU and the law. He talks about the law and end of life decision making. But I found a very interesting comment in the presentation was that, in ICU, some patients die an undignified death.

Now, I have worked in critical care for nearly 25 years in three different countries where I worked as a nurse manager in ICU for over 5 years. I’ve been setting up Intensive Care at Home here in Australia since 2012. I’ve worked in Intensive Care at Home in Germany. So, I draw from a wide array of experience.

Most ICUs still can’t think outside of their ICU bed spaces saying that patients in ICU may die an undignified death. I agree with you, I have seen many undignified deaths in ICU over the years but the solution here is to think outside of what ICUs perceive as an undignified death. Well, there is a dignified death at home.

When you look at the statistics, 75% of people want to die at home and yet, less than 15% of people do die at home. That’s simply a result of lack of services in the community. It’s a result of lack of creativity. It’s a lack of hospitals talking all about community care but not doing anything about it.

ICUs in particular are 30 years behind. It’s been happening in Germany and in Europe for the last nearly 25 years. In Australia, we are obviously providing Intensive Care at Home here and we have been since 2012, but a lot more could be done.

Patients in ICU do not need to die an undignified death in ICU. They can die a very dignified death at home with a service like Intensive Care at Home, and that includes one-way extubation. We have done one-way extubations at home. It can include weaning inotropes off at home when it’s end of life care.

But the bottom line is from my point of view, after having worked in critical care for nearly 25 years, there are really only undignified deaths in ICU because once end of life care, has been agreed on then that can and should happen at home, and that would provide a win-win situation.

Continue reading at: https://intensivecareathome.com/can-intensive-care-at-home-provide-a-dignified-death-at-home-instead-of-an-undignified-death-in-icu/

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