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Monday, December 9, 2013
COPD (Chronic Obstructive Pulmonary Disease)
Emphysema, ventilation & G-tube? Home health?
My grandmother is 86. Has had emphysema for several years. For the last 6 weeks, has been on ventilator and g-tube. It was either pneumonia or not getting enough oxygen at home (she was on 24-hr oxygen) that brought her to intensive care. She`s been at a Long term acute facility for 3 weeks now. She wants to go home. Doctors can`t agree on what services she needs. One doctor says, she has to have 24 hour nursing care at home and a generator for the ventilator. Another staff doctor says that family can learn how to operate ventilator, administer meds, etc. This is extremely overwhelming. There is no skilled nursing facility in our state that accepts patients on ventilators. We are in the process of looking for home health but need additional nurses to donate time. What is most accurate? Does she really need 24 hour care? I happen to think so but I have to be able to convince relatives that caring for her isn`t casual but very serious. Other than this, she is still healthy. The g-tube feeding liquid is causing her to have diabetes however. For now, her heart is okay. I understand that being on the ventilator and g-tube for extended period of times may cause other health issues. What are those issues? She is bed bound. Her mind is sharp. She appears to be 100% ventilator dependent after several tries to remove her. She`s got the excess mucus thing now. We just need to know about the 24 hour nursing issue and what might happen to her body now?
Your grandmother will need 24 hour care. The physicians caring for your gandmother and dealing with you and your family members are really in the best position to assess your family’s ability to care for your grandmother at home. There are many possible disease processes that can occur related to a patient being on a ventilator long term, as well as, the tube feeding. Aspiration pneumonia would be one concern.
I would suggest a team meeting with physicians, nurses and all family members who would be taking on any responsibility in her care.
Gretchen Whitby, APRN
Nurse Practitioner of Chronic Obstructive Pulmonary Disease
College of Medicine
The Ohio State University