MOM CAN’T BE WEANED OFF THE VENTILATOR IN ICU. CAN INTENSIVE CARE AT HOME HELP US TO BRING HER HOME?

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MY MOM CAN’T BE WEANED OFF THE VENTILATOR IN ICU. CAN INTENSIVE CARE AT HOME HELP US TO BRING HER HOME?

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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 Mom Can’t Be Weaned off the Ventilator in ICU. Can Intensive Care at Home Help Us to Bring Her Home?

Hi Patrik,

My mother is 76 and she’s in intensive care. She was intubated for pneumonia and she ended up with a tracheostomy after about two weeks of ventilation with a breathing tube. The pneumonia got cleared with antibiotics, but she was in an induced coma and sedated for almost two weeks. That’s how long it took to get the pneumonia cleared. And then when she woke up, she was too weak to breathe by herself and to be extubated. Hence, the decision was made for her to have a tracheostomy.

After that for a whole week, they seem to overload her with saline solution without giving her Lasix for her kidney disease. On top of that, my mom has AF (atrial fibrillation) and therefore has a weak heart. Her kidneys stopped and then she ended up on dialysis for the AF. She had Amiodarone, which seemed to slow, at least a heart rate down, but she’s still not back in a regular heart rhythm.

After the 14 days on intubation ran out and we were told she has to have the tracheostomy and they told us she would then to be weaned. But now it’s been a month and they’re saying that she’s too old, weak and not responsive enough. You can fill in the blank. It always comes back to age that even though she was active before this and lived a very good quality of life.

I finally got them to check her anemia. It was half of what it should have normally been. So blood transfusions brought her blood pressure back up and they were able to wean off the vasopressors and the inotropes.

She also had a UTI, I believe, but the ICU team swore she didn’t have a UTI, even though she had a large one now being treated with Bactrim. It’s getting worse. After two months in ICU, her lungs are infected again. I have been told three times this week that she probably can’t be weaned, even though she wants to be, she is now alert and she can communicate with me on a piece of paper, write things down. She definitely has the will, but being bedridden for two months, clearly isn’t helping.

We are in Sydney, Australia, and we want to bring my mom home. How do we go about it?

From Katrina.

Hi Katrina,

Thank you so much for your email and inquiry.

Katrina, the best way forward for your mom is really Intensive Care at Home. Get her out of ICU after two months in there. It sounds like a situation like many of our other clients that are stuck in ICU and we can help them to go home. Weaning can be done at home. She just needs to be off the inotropes and the vasopressors ideally. We can do blood transfusions at home. But it would be ideal if she was off the inotropes and vasopressors. But other than that, we can start mobilizing your mom at home. It’ll be such a better environment. The other challenge that I can see is that, if you’re not getting her home, they might eventually send her to a hospital ward and on the hospital ward, she won’t get the ICU care that she will need as long as she’s on a ventilator with a tracheostomy.

So therefore it is imperative for you to get the ball rolling and talk to us and start looking at home care options. So for example, your mom at 76, won’t qualify for the NDIS, but she should qualify for hospital in the home options. And again, you should be starting the discussions with the hospital, as well as with us here at Intensive Care at Home...

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