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MORE INFO ON LTACH

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http://ventworld.infopop.cc/eve/forums/a/tpc/f/8706082361/m/151109136

April 05, 2010, 08:15 AM
S.MACWAN
MORE INFO ON LTACH
I JUST SIGNED UP TODAY. MY NAME IS SUNITA.MY DAD 72 YRS OLD (PAST SMOKER)HAD A HRT SURG WAS OK FOR ONE DAY. HAD A SET BACK AND BROUGHT TO CTU AND IS ON VENT FOR ABOUT A MONTH NOW. DRS ARE TELLING HIS OTHER ORGANS ARE OK, BUT THE LUNGS ARE BAD, HIS DIAG IS ARDS (ACUTE RESP. DISTRESS SYND.) WHILE IN CTU HE HAD URINE INFECTION, FEVER AND PHEHNUMIA. HE IS SOME WHAT STABLE NOW. THEY MIGHT PUT FEEDING TUBE TODAY.

DRS ARE TELLING HE NEEDS TO GO LTACH OR NURSH. HOME. THE WORD NURSING HOME ALONE WILL KILL HIM. I HAVE TWO SMALL CHILDREN AND ALONG WITH MY BROTHER AND MY MOTHER I AM TAKING CARE OF HIM. BUT THIS HAS BEEN HARD ON ALL OF US. I HAVE NO CLUE ABOUT ALL THIS. I FOUND THIS WEB SITE AND FELT LITTLE BETTER KNOWING THAT I AM NOT ALONE.

MY FATHER IS MENTALLY STRONG, FOR NOW ANYWAY. HE IS ASKING ME FOR FOOD AND WATER AND WANTS TO GO HOME. ITS VERY HARD FOR US SEE HIM DESPERATE.

PLEASE PLEASE HELP ME SO THAT I CAN HELP MY DAD.
MY GOAL IS TO TAKE HIM TO LTACH FACILITY IN NJ, BUT IF THEY CAN'T WEAN HIM OFF THEN, I WOULD LIKE TO BRING HIM HOME.
ANY FEED BACK ON LTACH FACILITY IN RARITAN BAY, WHICH IS PART OF RARITAN BAY MEDICAL CENTER IN NJ?
WHAT SHOULD I LOOK FOR OR LOOK OUT FOR IN LTACH FACILITY?
HOW CAN I HELP? HOW DO I KNOW IF THE PROGRAM OR PLAN AT LTACH IS TOO AGGRESSIVE OR TOO WEAK FOR MY FATHER?
CAN HIS INSURANCE MEDICARE AND MEDICAID, WILL COVER THE COST AT HOME?
DOES ANYONE KNOW OTHER FACILITY IN NJ OR NY?
WE LIVE IN STATEN ISLAND, NEW YORK.
WHAT IS CPAP?
April 07, 2010, 01:59 PM
GaryMefford
LTAC hospitals are often a good move for patients who are taking a while to recover from a very severe illness. Some skilled nursing units in nursing homes are in certain circimstances a good choice. Your case management/discharge planner should be able to guide you as to which is a better choice for your father and your family. Home care of a vent patient requires a serious committment, but is very possible with the right training of care givers. You asked:
quote:
ANY FEED BACK ON LTACH FACILITY IN RARITAN BAY, WHICH IS PART OF RARITAN BAY MEDICAL CENTER IN NJ?
Each area of the country has a unique network of the various levels of care. Case Managers are usually the best versed in the discharge options from their individual facilities. I suggest you work with the person assigned to your father's case and determine the best options, visit the sites and based on your observations decide.
WHAT SHOULD I LOOK FOR OR LOOK OUT FOR IN LTACH FACILITY?
An LTACH that specializes in ventilator weaning should be able to cite their wean rate, the average time patients spend on the vent before they are weaned, and the average length of stay for their vent patients. It is usually better if they wean by protocol. They should be able to tell you their basic approach to weaning. You should be able to get a general sense of a clean place with freindly staff.
HOW DO I KNOW IF THE PROGRAM OR PLAN AT LTACH IS TOO AGGRESSIVE OR TOO WEAK FOR MY FATHER?
Even weaning by protocol at a LTAC that is very aggressive will tailor each patient's care to their unique abilities to tolerate the process. This should be reflected during your site visits when you ask this question.
CAN HIS INSURANCE MEDICARE AND MEDICAID, WILL COVER THE COST AT HOME?
Each individduals situation is unique and this should be reviewed with someone who knows his coverages. That again would prabably be the Case Manager.
WHAT IS CPAP?
In your father's case I am pretty sure this is a mode setting on the ventilator that provides a minimal level of assistance to the breathing that he is doing on his own. The vent is holding a little pressure in the airway at all times and may be providing a little push behind each breath to get them in a little deeper or not depending on the pressure support adjustment. You should be able to get an answer specific to what is going on with your father from his RT. It is good that your father remains "mentally strong". He is lucky to have you and your family supporting him even though it is exhausting for you all. ARDS is a disease process that often takes a long time to recover from if it is survived. It sounds like your father is on the mend and the right LTAC could really help him. I hope this is helpful. Good luck and God bless.
April 21, 2010, 07:49 PM
georgigirlof78
I am the clinical Coordinator of an LTAC in KY. Much of was written were good points, but I would add a few more. Are the physicians that round on the patients pulmonoligist? that is specialized in diseases affecting the lungs.....that would be ideal. Also do the various therapies work well together to coordinate the therapies to optimize the care. What is the credentialing if the respiratory therapists. We hire only RRT's that have critical care experience. ASK also about the VAP rate for the facility...it should be zero. VAP means ventilator associated pneumonia and could be dangerous.Ask about your Dad's progress everyday. Most Ltac's are thrilled to see a family member who is engaged in what is going on with their loved one. Good Luck and let us know how he does. Karen