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Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM, where we instantly improve the lives for Families of critically ill Patients in Intensive Care, so that you can make informed decisions, have PEACE OF MIND, real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care!
This is another episode of “YOUR QUESTIONS ANSWERED” and in last week’s episode I answered another question from our readers and the question last week was
My 84 year old Dad has been in ICU for three months! He’s ventilated with a tracheostomy, the doctors want to let him die and turn off the ventilator! We want to take him home instead, what are our options? (PART 4)
You can check out the answer to last week’s question by clicking on the link here.
In this week’s episode of “YOUR QUESTIONS ANSWERED” I want to answer the next question from Belinda
My 84 year old Dad has been in ICU for three months! He’s ventilated with a tracheostomy, the doctors want to let him die and turn off the ventilator! We want to take him home instead, what are our options? (PART 5)
You can also check out PART 1, PART 2, PART 3 and PART 4 of this series by clicking on the links.
This series of questions are excerpts from a 1:1 phone/Skype counselling session and a series of email counselling and consulting.
Thank you for following up and for keeping me motivated, sane and empowered!
Yes I know they can’t do what they are doing…but the Hospital Dr put us under pressure to either have a Permanent Catheter or no Dialysis at all for my Dad….
So what choice did I have to sign the authorization to put in the catheter…
I want to file with grievance but they are connected to the hospital so I don’t know if they do anything…but IR radiologist and his Nephrologist said that it’s OK to de-clot his graft only the ICU refused….said only options Permanent catheter or no dialysis …
You are right about physical therapy and sitting up I should ask for it….
How often you think Physical Therapy day? I can do it with him too…
Actually I would love to move him to another hospital but I need to know a doctor well in one hospital to take us in…
His old Nephorologist works out of a Hospital in a surrounding area and I talked to him and he said you can not go from one hospital ICU to an other Hospital ICU…
If we could get him home it would be the best, but they won’t let us..they say he is still not stable enough.
I will listen again to the Interview but I think I had listened to it…my Father the combination of dialysis and Ventilator makes it difficult…
You think we should do still weaning during the day?
We are in a roller coaster, one day I think he won’t make it and I said why should I bother him with weaning than he feels better and his numbers are better and I get hopeful again….
Thanks so much, keep up the good work
I’m sorry to hear the situation that you and your family are stuck in.
I know it’s difficult to watch your father suffer, whilst also wondering whether you are doing everything you can to look for the best possible options for him.
You and your family must feel exhausted by now and I can only imagine how difficult it is to carry on with everything that’s behind you and everything that’[s still in front of you. By now you have spent probably way too much time in ICU.
It looks like the Intensive Care team’s “reality” is a fairly negative and authoritarian “reality”.
It’s what they are used to. They try and “tell” families what they think is “in the best interest” for your Dad without genuinely consulting you. This is nothing new and unfortunately works in most cases, because families are not determined enough to ask for what they want and deserve.
Most families simply also don’t know about their rights and take the Intensive Care team’s words and their positioning for face value without questioning.
And unfortunately most families in Intensive Care are simply intimidated by the “perceived power” and the “perceived authority” of the Intensive Care team!
I know why they want the permanent catheter for the Dialysis in spite of all other specialists agreeing that your Dad would be OK with a de-clotting of his graft.
ICU are not the specialists with the graft but they are the specialists when it comes to a permanent vascular catheter for the Dialysis and besides they may also be able to charge a fee for it.
Even if your father is inevitably dying you want to make sure that you have tried everything that is in his genuine best interest. If you didn’t do that you may later have regrets and you may be wondering “what if”?
In any case, Physiotherapy shouldn’t be provided by a family member in Intensive Care in a first world country like the USA.
Physiotherapy should be provided by Physiotherapists in Intensive Care on a daily basis. There are no two ways about it. You or other family members shouldn’t be doing it. It should be standard care and treatment in Intensive Care.
If your Dad is strong enough you should continue with the weaning off the ventilator. Please also keep in mind that weaning off the ventilator is most often assisted by Physiotherapy as well. Their exercises and their work strengthens critically ill Patient’s respiratory or breathing muscles making it all the more likely that your father might be able to come off the ventilator.
Therefore their work is crucial.
Weaning off the ventilator and Physiotherapy are not mutually exclusive. They go hand in hand in Intensive Care.
I know you must feel that whatever you are asking for that the ICU team is going in the other direction.
I have just written an article/video with the title “Having your loved one critically ill in Intensive Care- follow your gut and intuition!”
By that I mean, if you think and feel that your father has a real chance of survival or has a real chance of an end-of life situation on your, his and/or your family’s terms, you need to do you know you need doing to get the best possible outcome for him.
That may include finding another ICU that may take him.
I’m a big believer that everything in life is negotiable, if you position your Dad’s situation and yourself correctly.
The Intensive Care team has positioned your Dad’s situation as if it was all hopeless and the only option would be to withdraw treatment”. It’s almost their default position for any situation in Intensive Care that takes effort and persistence.
- THE 5 THINGS YOU NEED TO KNOW IF THE MEDICAL TEAM IN INTENSIVE CARE WANTS TO“LIMIT TREATMENT”, WANTS TO “WITHDRAW TREATMENT”, “WITHDRAW LIFE SUPPORT” OR WANTS TO ISSUE A “DNR” (DO NOT RESUSCITATE) OR “NFR” (NOT FOR RESUSCITATION) ORDER FOR YOUR CRITICALLY ILL LOVED ONE!
If you’re not happy where you are you may have to go somewhere else.
Your approach needs to be to start managing the Intensive Care team and not the other way round.
Yes and this means adopting a total different mindset from “being managed” by the Intensive Care team to you managing them.
Very few families have the guts to do it, but that’s your only way forward.
You are probably running low on energy and spirits, however you need to do something that is very different, because by now you have realised that your current approach isn’t working.
I think you are very proactive just by seeking out for help and by looking for information… however putting your knowledge into practice can be daunting…
Again, currently you, your family and your Dad might not be in a great situation and even if your Dad inevitably is approaching his end of life you want to make sure that
- Everything that you wanted to have done has been done so that you don’t think he hasn’t had the best care and treatment there is
- Continue to push for home care if you can find a service provider like INTENSIVE CARE AT HOME once your Dad is more stable
- Trying to get him to another ICU if you think that current treatment and also your relationship with the current treating team has run its course. You may have to speak to your health fund as well to get him to another hospital
- If your Dad has little to no time left in hospital, make sure you and your family can get enough time with your Dad and all your cultural, religious and spiritual needs are met(if any) so that you feel you have done the best you could have probably done in this situation. You don’t want to feel bitter and disappointed
- You are not signing any documents that you don’t want to sign or that you get passed over for any documents that you should have signed in order to give consent for certain procedures
- Also make sure that you don’t go into family meetings that you are not prepared for. Family meetings are often being used by the Intensive Care team to intimidate families in Intensive Care, because they are the ones running the meetings and the agenda. Families are completely unaware of the agenda of those meetings and they are usually overwhelmed by those meetings
In any case you need to be prepared for any direction this situation is going and I highly recommend you look at these resources here to have a better understanding of what you need to do
- FOLLOW THIS ULTIMATE 6 STEP GUIDE FOR FAMILY MEETINGS WITH THE INTENSIVE CARE TEAM, THAT GETS YOU TO HAVE PEACE OF MIND, CONTROL, POWER AND INFLUENCE FAST, IF YOUR LOVED ONE IS CRITICALLY ILL IN INTENSIVE CARE!
No matter how difficult the situation appears, you and your family really need to start changing your approach towards the Intensive Care team and you need to be more firm.
They are doing what they are always doing and they know what works with 99% of the families of critically ill Patients in Intensive Care who don’t make informed decisions, don’t have peace of mind, control, power and influence!
How can you become the best advocate for your critically ill loved one, make informed decisions, get peace of mind, control, power and influence quickly, whilst your loved one is critically ill in Intensive Care?
You get to that all important feeling of making informed decisions, get PEACE OF MIND, CONTROL, POWER AND INFLUENCE when you download your FREE “INSTANT IMPACT” report NOW by entering your email below!
In Your FREE “INSTANT IMPACT” report you’ll learn quickly how to make informed decisions, get PEACE OF MIND, real power and real control and how you can influence decision making fast, whilst your loved one is critically ill in Intensive Care! Your FREE “INSTANT IMPACT” Report gives you in-depth insight that you must know whilst your loved one is critically ill or is even dying in Intensive Care!
Sign up and download your FREE “INSTANT IMPACT” REPORT now by entering your email below! In your FREE “INSTANT IMPACT” REPORT you’ll learn how to speak the “secret” Intensive Care language so that the doctors and the nurses know straight away that you are an insider and that you know and understand what’s really happening in Intensive Care! In your FREE report you’ll also discover
- How to ask the doctors and the nurses the right questions
- Discover the many competing interests in Intensive Care and how your critically ill loved one’s treatment may depend on those competing interests
- How to eliminate fear, frustration, stress, struggle and vulnerability even if your loved one is dying
- 5 mind blowing tips& strategies helping you to get on the right path to making informed decisions, get PEACE OF MIND, control, power and influence in your situation
- You’ll get real world examples that you can easily adapt to your and your critically ill loved one’s situation
- How to stop being intimidated by the Intensive Care team and how you will be seen as equals
- You’ll get crucial ‘behind the scenes’ insight so that you know and understand what is really happening in Intensive Care
- How you need to manage doctors and nurses in Intensive Care (it’s not what you think)
Thank you for tuning into this week’s YOUR QUESTIONS ANSWERED episode and I’ll see you again in another update next week!
Make sure you also check out our “blog” section for more tips and strategies or send me an email to [email protected] with your questions!
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Also check out our Ebook section where you get more Ebooks, Videos and Audio recordings and where you can also get 1:1 counselling/consulting with me via Skype, over the phone or via email by clicking on the products tab!
This is Patrik Hutzel from INTENSIVECAREHOTLINE.COM and I’ll see you again next week with another update!