Where do I start in getting my mom home and out of the nursing home/rehab she is in?

The very first thing you need to do is speak with her social worker. All resident's have social workers in nursing homes and they are the people who would work on her discharge. Good Luck!

Pam, I now do understand your explanation; your post of 7 hours ago put it all in perspective.

For another analogy, I'm thinking that it's kind of like my using a portable air compressor connected to the lighter in the car to pump up a flat tire, vs. the commercial air compressors in dealerships or even at gas stations. It generally takes 1/2 hour for me to pump up a flat tire, whereas the commercial ones can do it in minutes.

Now it does make sense that the home equipment couldn't possibly have the capacity the commercial medical equipment has. And the ventilators are major pieces of equipment; I'm visualizing the ones Dad was on and they definitely weren't home variety equipment.

Thanks for taking the time to explain.

And again thanks for having chosen such a necessary and hopefully rewarding occupation.

I don't really know how to explain it with t he O2 demand, but most home vents don't deliver extra O2.. the flow needed is higher, and it's constant. 6 liters is about 40% O2, and the flow on a cannula is much less than is needed to get through the vent. ( hope that makes sence) Bipap and CPAP machines normally use a face or nose mask to deliver nighttime flows to people with things like sleep apnea.. the flow keeps the airway open, not the O2 so much. Most of the bipap and cpap machines I see for home use don't deliver O2 either, we just set the flow rates, and maybe add humidity. I believe the concentrators can;t keep up with the higher demand the vent requires... but they come up with new stuff everyday! I mainly see pretty bulky home vents, or the newer LTVs that can deliver O2, but you need an outside source to hook it too. Tanks run out very fast.

Ediggity, if it was me, I'd want to go home on Hospice and not let them keep poking at me or shoving tubes in my trachea. It's important to know what your mother's wishes are.

So, if I understand, someone on a vent needs more than a concentrator, which as I recall can provide up to 6 liters of oxygen. That person would need something like a hospital oxygen system? Maybe something like a bi-pap or C-pap, with more power than just a cannula?

Interesting.

If the O2 need is above room air (21%) then you normally need a bigger system than the concentrator can provide 24 hours a day For a vent, Those are great for people who need a cannula only. If they can get to a trach collar it would work for trips.. but a bigger O2 demand is a problem . I love the portable units..they let people still get out and enjoy life. The vents suck alot of O2, and that is why most people on home vents need to NOT need extra O2. But that does not seem to be the OPs problem!

Pam, in my father's recovery, I think the respiratory therapist were the ones who were the most critical. So, yes, thank you!

I could never have done the suctioning; it was hard for me to just watch the therapist do it.

As to the oxygen issue, when Dad came home he had been decannulated, but we also had a concentrator as well as the portable tanks. Would that have been incompatible with a trach in a home environment?

Now the oxygen supplier we have has provided not only the stationary concentrator but a portable concentrator as well. It looks like a large lunch bucket, operates on lithium ion batteries and we take it wherever we go. It's a lot easier than the big tanks.

The lithium ion batteries lose about 10% of a charge each day, so I suspect they're old, but I also bought a car charger so I can charge them up if we have a ways to travel.

And Garden.. thank you for the recognition.. so many have no idea what we do!

OK, I am a respiratory therapist so I am going to wiegh in here. Lots of people live at home with a home care vent. Yes you do need to be trained in trach care and suctioning,, and there will be some home care help involved for trach changes and the like..( yes the entire thing needs to be pulled out and replaced every 30 days )but you can learn and they can teach you. Lots of families do this, and it works fine for many. Suctioning is gross for many people, so be SURE you can do it.. it is very important or they can "drown" for lack of a better term. Many people can be weaned to a trach collar, even if just for daytime hours. A good rehab can help with all this I agree with Garden!
Once you bring her home your home care company will set you up with the vent ( a simpler version of the one at the hospital) and the suction system. You will also need to look into a generator for power in the event of an emergency. And she will need to have no oxygen requirements, as homes are not set up to provide extra oxygen, and tanks and portable systems can not normaly be available for the majority of us. But if it's her CO2 levels and not her sat that is the problem this is doable.AND the trach needs to be cleaned every 8 hours or so. It's a big responsibity,, and a full time job. Good luck!

I am a CNA I know that's not enough to bring her home. There is no facility closer:( she was in a great facility for a month they have high wean rates. My moms insurance wouldn't pay for her to stay there any longer. She weaned for 6 hours and that was the max.

Ask her pulmonary doctor about being placed in a long term care hospital. Select Specialty Hospital is one. Back in 2003 and 2004, it used to rent a whole floor from St. Joseph Mercy Hospitals.

We used 2 of them back in 2003 and 2004 specifically for vent weaning and eventually decannulation from a trach.

I'm surprised someone didn't recommend this directly from the hospital; that would have been the logical choice instead of going to rehab. The long term care hospitals have staff just like a hospital does, a much higher level of staff than any nursing home would have.

Vent weaning requires a respiratory therapist. Select Specialty had them, as did the rehab facility I eventually chose when the time was appropriate.

Eventually enough progress was made to begin vent weaning. In 2004 there were only 13 rehab homes in the whole state of Michigan that had the capability to undertake vent weaning. I interviewed and visited 3, one of which was a dump, another which was beautiful and top notch, but inadvertently represented it could handle vent weaning but couldn't.

The one I chose was a Heartland facility in Ann Arbor and was the best rehab place I've ever seen. The staff was extraordinarily supportive and responsive; the place was beautiful.

Taking care of someone with a trach requires some special medical training.

Don't even consider bringing her home without first addressing whether or not you can find training for management of a tracheostomy.

I agree, it sounds as though her needs are too complex to be cared for by family at home. What about finding a better facility closer to home?

Ediggity, any one in your family a RN, LPN, or healthcare Aid? Your Mom would need some type of skilled care.