Long-term ventilator-dependent care in nursing homes: How does a nursing home begin to provide care for residents who are dependent on ventilators? An example from New York state

Abstract

For some persons, being dependent on a ventilator is the only alternative to death. Most residents residing in New York state's approved ventilator-dependent beds have needed the support of a ventilator for more than a year. The quality of their lives since admission to specialized programs has been significantly different than it had been in hospitals. These residents are now actively participating in the life of the facility. Many who had not spoken during the entire time they were hospitalized are now speaking with the aid of special tracheostomy tubes. Many have been assisted out of bed for their first shower or tub bath since hospitalization. Additionally, each resident participates in activities of his or her choice. If able, residents, at their request, are taken out of the facility to attend family functions. Outcomes of care in these facilities have generally been positive: some residents have been weaned from ventilator use; others have been discharged home. The overwhelming positive aspects of these programs are evinced by individuals living in an environment that promotes the best quality of life and quality of care possible when living at home is no longer possible.