Quick Tip for Families in Intensive Care: ICU Wants Hospice or Tracheostomy After 2 Weeks of Hypoglycemia—Is It Too Soon to Decide for My Mom?

My mom has been in ICU for 2 weeks after hypoglycemia, and she’s on a ventilator. The doctors are pushing hospice for tracheostomy.
What should you do?

My name is Patrik Hutzel from intensivecarehotline.com, where we help families of critically ill patients in intensive care.

To improve their lives instantly, make informed decisions, have peace of mind, control, power and influence, even if you’re not a doctor or a nurse in intensive care. Making sure your loved one gets best care and treatment always.

Today, I want to talk about a situation that is far too common and quite frankly, it’s outrageous how often I hear this from families in intensive care. I was talking to a client whose mom has been in ICU for 2 weeks after she accidentally took too much insulin, went into hypoglycemia and ended up on a ventilator.

Now the ICU team is telling the family she’s unresponsive and that they have only 1 week to decide if they want to do a tracheostomy and PEG (Percutaneous  Endoscopic  Gastrostomy) feeding tube or withdraw treatment and go to hospice and letting their mother die. Let me be clear, this is completely premature and puts families under unfair pressure.

I’m saying this. After having worked in critical care nursing for over 25 years in 3 different countries where I worked as a nurse manager for over 5 years in intensive care. And I’ve been consulting and advocating for families in intensive care all around the world since 2013 here at intensivecarehotline.com.

Let’s break this down. 2 weeks in ICU is not enough time to make life or death decisions like this. When someone has had hypoglycemia, which means low blood sugar, especially severe enough to require ventilation, the brain may have been affected. That’s a metabolic or hypoxic brain injury, and recovery from that takes time. We’re talking weeks or even months, not days. I’ve seen plenty of patients wake up and recover after 3, 4, even 6 weeks, especially if they were taken off sedation and given time.

if the ICU team is saying she’s unresponsive, your next question needs to be. What do you mean by being unresponsive? Is she opening her eyes, responding to pain, any purposeful movement? And also, has sedation been completely off for at least 72 hours? Have opiates been off completely for at least 72 hours? What is her Glasgow Coma Scale? Has a neurologist reviewed her? What does the CT (Computed Tomography) or MRI (Magnetic Resonance Imaging) scan of the brain show? Has she had an EEG (Electroencephalogram) to check for brain activity or seizures? You need facts, not vague language like being unresponsive.

Next, why the rush to hospice or tracheostomy? Well, because ICU beds are expensive and in short supply. It’s as simple as that. ICU teams are under pressure to free up beds, and once the patient is ventilator dependent, beyond 10 to 14 days, the next step is tracheostomy, or PEG feeding tube. We don’t advocate for a PEG tube. I’ll come to that in a minute. Or, quote unquote comfort care, also known as withdrawal of treatment.

But here’s the truth. Tracheostomy and, even a PEG, are not death sentences. They are interventions that give time. They can stabilize your mom, get her off the ventilator gradually, and give her a real shot at life and recovery.

If you go down the hospice route, be aware that this often means no more active treatment, i.e., antibiotics, nutrition, fluids. Gradual withdrawal of treatment, and yes, patients often die from starvation, dehydration or untreated infections. Hospice is often quote unquote pulling the plug with a pretty name.

You also need to find out where’s the rush to kill your mom. Find that out. Where’s the rush to kill your mom? Also, a tracheostomy, we’ll just, we’ll buy time, get her off the ventilator hopefully, but even. If she can’t get off the ventilator, it still gives her time to live. That’s what she wants, if that’s what’s what you want. There’s always an option like intensive care at home, if she can’t come off the ventilator or even if she needs to live with the tracheostomy for the rest of her life. There are options like intensive care at home.

Next, you’re being forced into a false choice. The ICU team is making it sound like your only options are tracheostomy and PEG with no quality of life. Hospice where your mom dies, quote unquote, peacefully, but nevertheless, she will die.

But there’s the 3rd option, they won’t tell you. Do the tracheostomy and wait. Wait to see if your mom improves neurologically, wait to see if she starts waking up, wait to make an informed decision not based on pressure or fear.

A withdrawal of treatment often happens under false pretenses like it is in your mom’s “best interest.” Since when is it in the best interest for someone to die, if people want to live?

Keep that in mind. Also, don’t make decisions today that you might regret in 12 months’ time or in 24 months’ time. If you give consent to let your mother die today. You will regret that, because you will find out that you may not have left all stones unturned. You want to leave no stone unturned here.

What should you do? Push back on the one-week timeline. That’s an arbitrary and completely random deadline that they shouldn’t be giving you. Ask for a neurology review and full brain assessments. Insist on stopping all sedation and opiates if it hasn’t been stopped already. Request daily updates on responsiveness. If needed, demand a second opinion or consider transferring your home with intensive care at home after a tracheostomy, and the nasogastric tube or a PEG tube.

But do not give consent to a PEG tube straight away. Your mom can live with a nasogastric tube for months on end. If she can’t come off the ventilator, you can still give consent to a PEG tube.

Most importantly, get access to all medical records now, so that you can have a look at them and that we can have a look at them here at intensivecarehotline.com.  We will give you that second opinion.

Final thoughts. Do not let the ICU team make you feel like rushed into a decision that ends your mom’s life prematurely. 2 weeks is nothing in ICU. Many patients take much longer to show signs of recovery. Ask questions, get access to the medical records, get the data. Don’t settle for vague answers like she’s unresponsive.

You have the right to prolong life, not end it based on hospital timelines. If you need help advocating for your mom, go to intensivecarehotline.com and book a free strategy session there with me. This could be the most important conversation you’ll ever have.

I have worked in critical care nursing for 25 years in three different countries where I worked as a nurse manager for over 5 years in intensive care. I’ve been consulting and advocating for families in intensive care since 2013 here at intensivecarehotline.com. I can very confidently say that we have saved many lives with our consulting and advocacy because of our insights. You can verify that on our testimonial section at intensivecarehotline.com. You can verify it on our intensivecarehotline.com podcast section where we have done client interviews because our advice is absolutely life changing.

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.

That’s why we help you to improve your life instantly, making sure you make informed decisions, have peace of mind, control, power, and influence, making sure your loved one gets best care and treatment always. That’s why you can join a growing number of members and clients that we have helped over the years, saving their loved ones’ lives.

That’s why I do one on one consulting and advocacy over the phone, Zoom, WhatsApp, whichever medium works best for you. I talk to you and your families directly. I handhold you through this once in a lifetime situation that you simply cannot afford to get wrong. When I talk to families directly, I also talk to doctors and nurses directly, asking all the questions that you haven’t even considered asking but must be asked when you have a loved one critically ill in intensive care.

I also represent you in family meetings with intensive care teams.

We also do medical record reviews in real time so that you can get a second opinion in real time. We also do medical record reviews after intensive care if in case you have unanswered questions, if you need closure, or if you are suspecting medical negligence.

We also have a membership for families of critically ill patients in intensive care, and you can become a member if you go to intensivecarehotline.com, if you intensivecarehotline.com, if you click on the membership link, or if you go to intensivecaresupport.org directly. In the membership, you have access to me and my team, 24 hours a day, in the membership area and via email, and we answer all questions intensive care related. In the membership, you also have exclusive access to 21 eBooks and 21 videos that I have personally written and recorded. All of that will help you to improve your life instantly, make informed decisions, have peace of mind, control, power and influence, making sure your loved one gets best care and treatment always.

All of that you get at 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.

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Thank you so much for watching.

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

Take care for now.

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