Quality of life and/or quality of end of life for long-term ventilated adults and children with tracheostomy and their families in their own home—A practical solution and practical introduction

Abstract

Introduction: Based on clinical experience in Intensive Care, as well as experience in the Intensive Home Care setting in Germany, a number of long-term ventilated adults with tracheostomy can be provided with quality of life and/or quality of end of life at home as a genuine alternative to a long-term stay in Intensive Care. Objectives: To show the effectiveness of the provision of Intensive Home Care Nursing services for patients and families who are either long-term ventilated with tracheostomy in Intensive Care with a holistic focus on patients, families and hospitals’ needs. Methods: The provision of Intensive Home Care Nursing services for long-term ventilated patients with tracheostomy and their families as a genuine alternative to a long-term ICU stay. This model is based on the service provision of an accredited Australian Intensive Home Care service provider. The service model is based on successful Home Intensive Care services in Germany. Results: Quality of life and/or quality of end of life for patients and their families in their own home as a genuine alternative to ICU, as well as cost effectiveness and effective resource management for ICUs. Conclusion: Considering the shift to more home care and more people wanting to die at home if given the choice, in combination with the continued high demand for scarce and expensive ICU beds, Intensive Home Care services are a genuine alternative for the provision of quality of life and/or quality of end of life services for long term ventilated patients and their families.