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Quick Tip for Families in Intensive Care: My Dad Has Been in ICU for 2 Weeks & He’s Intubated. Should He Have Comfort Care or a Tracheostomy?

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

So today I was talking to a lady who has her 77-year-old dad in ICU with Parkinson’s Disease. He’s been intubated for the last two weeks, and the ICU team is telling her that they can’t get him off the ventilator and he has two options. The first option is comfort care/ end-of-life care, and the second option is to do a tracheostomy.

Now, I believe, and this is a very incomplete story that the intensive care team is telling this lady. I have worked in intensive care for over 20 years in three different countries and I have been consulting and advocating for families all around the world for the last 10 years. And here’s why this is a very incomplete picture the intensive care team is painting. What about avoiding tracheostomy in the first place? What about making sure the intensive care team is doing everything beyond the shadow of a doubt to avoid a tracheostomy? And here is why.

So, this particular client is in the United States and what the intensive care team inconveniently hasn’t mentioned to the lady is, well, once they do a tracheostomy, they will send her dad to an LTAC facility. She didn’t even know what an LTAC was. So, I explained to her that LTAC is a long-term acute care facility. It’s not even the better version of a nursing home.

So, it’s like bait and switch. They’re trying to sell her for a tracheostomy or for end-of-life care. Neither option is great. No one is mentioning what’s the best-case scenario here. How can we avoid the tracheostomy, wean this man off the ventilator, and remove the breathing tube? Have they done everything beyond the shadow of a doubt to achieve that goal? They haven’t even mentioned it as a goal, and it should be the primary goal for any ventilated patient in ICU to avoid the tracheostomy.

The biggest challenge for families in intensive care is simply that they don’t know what they don’t know. They don’t know what to look for. They don’t know what questions to ask. They don’t know their rights and they don’t know how to manage doctors and nurses in intensive care. And that is another classic example that this is what many, many families in intensive care are dealing with. They don’t know what they don’t know.

So, what’s the remedy to this situation? The remedy is really to get a second opinion, which we can provide here at the Intensive Care Hotline. We can ask all the questions you haven’t even considered asking, but you must be asking in order to make informed decisions, get peace of mind, control, power, and influence in those situations so that your family member, your loved one that’s critically ill in intensive care, doesn’t end up in facilities that can’t look after ventilated or tracheostomy patients. And make sure you’re getting more than just two very black and white options.

In either situation, the intensive care team can wash their hands clean, either move her dad towards comfort care, end of life care or a number 2, to do a tracheostomy, send him out to LTAC, they wash their hands clean. No one is holding them accountable to see whether another option is the best option, which is to remove the breathing tube. Maybe they’ve kept the man sedated for too long, maybe they’ve given him too many sedatives, too many opiates, and that’s why he can’t be weaned off the vent and that requires a second opinion to look at that situation in much detail, which we can provide here at intensivecarehotline.com.

Now, if you have a loved one in intensive care and you need help, go to intensivecarehotline.com. Call us on one of the numbers on the top of our website or simply send us an email to [email protected] with your questions.

Also, we have a membership for families of critically ill patients in intensive care at intensivecaresupport.org where you have access to me and my team 24-hours a day in a membership area and via email and we answer all questions intensive care related.

I also offer one-on-one consulting and advocacy over the phone, via Skype, via email, via WhatsApp, Zoom, whichever medium works best for you. And I talk to intensive care teams directly. I ask all the questions you haven’t even considered asking, but you must be asking in order to get peace of mind, control, power and influence and so that you can make informed decisions.

I also represent you in family meetings with the intensive care team so that you have a clinician on your team that once again can ask all the questions that you haven’t considered asking and you must have a clinician on your team when you’re going into family meetings with intensive care teams. Otherwise, you’ll be fighting an uphill battle. They know what to say, they know how to say it and they know when to say it to get their agenda over the line.

We also offer medical record reviews in real time to give a second opinion in real time. So please contact us for that as well. We also provide medical record reviews after intensive care if you have unanswered questions, if you need closure, or if you are simply suspecting medical negligence.

Now, if you like my videos, subscribe to my YouTube channel  for regular updates for families in intensive care. Click the like button, click the notification bell, share the video with your friends and families and comment below what you want to see next or what questions and insights you have from this video.

Thanks for watching.

This is Patrik Hutzel from intensivecarehotline.com, and I will talk to you in a few days.

Take care for now.

Related Articles:

Quick Tip for Families in Intensive Care: When’s a Pt a Candidate for a Ventilator? What Criteria for a Pt No Longer Needing a Ventilator? Case Study: How to Save your Loved One’s Life in ICU or How to Prevent a “One Way Extubation” Quick Tip for Families in ICU: My 80-Year Old Dad’s in ICU After Heart Attack & Now ICU is Saying He’s in Multi organ Failure! Help! Quick Tip for Families in Intensive Care: How to Treat a Cardiac Arrest in Intensive Care! Quick Tip for Families in Intensive Care: Is it Safe for My Grandma to Go to LTAC After Stroke, Tracheostomy, and Nasogastric Tube?