Is there really nothing else we can do? My mom with COPD (Chronic Obstructive Pulmonary Disease) is on a ventilator in ICU. What’s next?

My name is 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, control, power, and influence, making sure your loved one always gets best care and treatment, even if you’re not a doctor or a nurse in intensive care.

So today I have a question from one of our clients, Chris, who says,

“Hi Patrik,

My mother is diagnosed with COPD and required use of an oxygen machine at home. She had complained and began panicking from not being able to catch her breath three days ago and is now on a ventilator with a breathing tube  in ICU in the hospital. She was admitted for extreme shortness of breath. Oxygen saturation was in the 50s. They sedated her and placed her on a ventilator with a breathing tube.

3 days later, the ICU doctor expressed there are no other options, placed her on hospice. And are doping her up with sedatives, propofol, and opiates, morphine until she dies from organ failure. Is there really nothing else we can do? Please help us ASAP before they kill my mom. I need to know.

We did all we could for her.

From Christie”.

Christie, I’m very sorry to hear what you are currently going through, and this is such an important and also urgent situation and question and sadly a situation I see all too often in intensive care and I have seen it all too often over many decades now. So, let’s unpack this step by step.

The very first thing you need to do is to get access to the medical records. That is the very first thing you need to do. Because it’s one thing for the ICU doctor to say, there’s nothing else they can do. It’s another thing to verify that and look at medical records.

Also let me talk to them, I mean, I’ve talked to so many ICU teams over the years and I turned situations around quickly by holding them accountable, by looking at medical records, me and my team look at medical records, then we talk to them and we find the things that they are not prepared to tell you.

So, when someone with COPD chronic obstructive pulmonary disease ends up in ICU on a ventilator, it’s not automatically the end. Many COPD patients can and do recover from being ventilated if the care and treatment is managed properly, just keep in mind. Around 70 to 90% of intensive care patients survive, which means the odds are actually in your mom’s favor.

So, the first question that you have to ask yourself, why would your mom be in the minority of patients who actually don’t survive? So, because the vast majority of patients in ICU survives, why would your mom be in the minority? That’s the very first questions you need to ask.

The biggest challenge for families in intensive care is 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.

However, what often happens is that ICU teams or doctors give up too early, especially when they don’t see quick improvement, they may label. It has Futility of care and or end of life, but in reality there are often other options. What they also often do is they tell you that even if your mom does survive, she won’t have any “quality of life”.

And what is quality of life? I’m glad you’ve asked. Quality of life is something very subjective, that is not being measured in objective terms. Quality of life is entirely up to you and your mom what that means to you. It’s not up to ICU teams.

Next, what you also need to know is when ICU teams come to you and say. The only option here is hospice care or end of life care or palliative care, any of the above. What they really say is, we need the ICU bed. We need it quick. We have other patients waiting. It’s not financially viable for us to look after your mom. Let’s talk about end of life. Instead, that’s one way, one easy way for them to empty the ICU bed by letting patients die.

So, here’s what you need to know. Number one, sedation and propofol use. Sedation is often used to keep patients comfortable on the ventilator, but too much sedation can delay and often will delay recovery and prevent weaning off the ventilator. Drugs like propofol and morphine suppress breathing drive and make it near to impossible for the patient to participate in weaning trials. So, if your mom is being doped up, as you describe, it’s likely preventing her from even having a chance to come off the ventilator. So, if they’re not, if they’re not trying to wake her up, she will have a hard time even coming off the ventilator.

Next, weaning trials. Has your mom had any spontaneous breathing trials or ventilator weaning attempts? For COPD patients, weaning can take time and must be done carefully and step by step with non-invasive ventilation, BIPAP (Bilevel Positive Airway Pressure), or CPAP (Continuous Positive Airway Pressure) or after extubation if needed. If the ICU hasn’t tried this yet, and I know they haven’t because they’re doping your mom up with morphine and propofol, or have already given up, they are denying her the opportunity to recover.

So. What does that look like?

1.  What ventilator settings is she on?

2.   Are they trying to wean off the sedation? And the morphine, the opiates. If they haven’t, they must attempt that. If they have, ask them what’s happened.

3.  What are her arterial blood gases looking like?

For example, if your mom with COPD, that is, compromised from a respiratory point of view, she most likely has a high CO2 and potentially low oxygen levels. The lungs are stiff with COPD, and therefore often CO2 rises and PO2 decreases. So. What are arterial blood gases looking like, and are ventilator settings adjusted accordingly depending on the arterial blood gas? What do chest X-rays look like.

Now, I repeat what I said earlier, you need to get access to the medical records as soon as possible. I cannot understand why families in intensive care do not get access to their loved ones’ medical records. You are flying blind. And even if you don’t understand what’s in there, that’s where we come in, where we help you. Break it down step by step. You can’t just trust the intensive care team blindly because they have their own agenda and their own agenda only, especially when things are not going the way they want it to go, which is a quick recovery for your mom.

Next, palliative care or hospice push. Once doctors use the word hospice palliative care, families often feel cornered. But here’s the truth. You don’t have to agree with their recommendation. You have every right to a second opinion and the right to continue life sustaining treatment if you believe recovery is possible. Many ICUs push hospice or comfort care simply because they don’t want to keep investing time or resources into a long complex case.

Next. Get independent ICU advocacy and consultancy. This is exactly where we, here at intensivecarehotline.com can help you and come in. We can look at your mom’s medical records, ventilator settings, ABGs, arterial blood gases, sedation plan, medications. X-rays, all the diagnostics to determine what’s really going on and what can be done next. To give your mom the best chance of survival and recovery.

Like I said, once we look at medical records, if you and I were to talk with the ICU doctors, you will see that I ask questions that you haven’t even considered asking, but must be asked when you have your mom in intensive care.

Families who contact us early often discover that the ICU has not done everything possible, especially in cases like COPD where long-term weaning and step-down options such as Intensive Care at Home, are also viable alternatives. So, I encourage you to check out intensivecareat home.com for a viable long-term option at home. Where we bring the intensive care treatment into your home in the comfort of your own home where you have choice and control.

So, what you need to do right now, do not consent to hospice or “comfort care or palliative care” until you fully understand all options. Next, get access to all medical records right now. It’s a right, not a privilege. Ask them to continue treating your mom and make sure she gets the best care and treatment and that’s where we can help you.

Ask for latest blood gas results, ventilator settings, and sedation, and opiate plan. Again, that’s part of the medical record and contact us here at intensivecarehotline.com so we can guide you and hand hold you step by step on how to advocate for your mom, ask the right questions, stop the ICU from giving up prematurely.

Your mom has a fighting chance, but you need to act fast before you’re going down the slippery slope of palliative care, comfort care. Which is also often a euphemism for euthanasia. Euthanasia is the hastening of death, and it’s illegal.

At intensivecarehotline.com, we have families in real time, 24 hours a day. Go to intensivecarehotline.com right now and book a free 15-minute appointment with me so I can talk to you directly and map out the next steps.

Also check out out our second service at  intensivecareathome.com, where we provide home care for long-term ventilated and or tracheostomized patients, adults and children giving families quality of life and keeping loved ones out of ICU long term.

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 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.