I've had a few families take trached to the vent patients home. Couple different scenarios: family hated the only facility available to them, patient is awake, alert and appropriate...just needs lots of respiratory support, patient is being refused by all facilities due to difficult families and doctors have discharged them. Normally, whatever insurance they have (and by the time you've reached that point, the hospital has at least gotten you Medicaid) pays for a vent, nurses and respiratory therapist works one on one with a few household members on trach, vent, peg tube, basic patient care, etc, and the company that supplies the vent brings in a person to train on that particular machine. The family then has to have a home inspection, electrical plugs that can handle the vents, and generator backup for power failures. There has to be a huge coordination to get all supplies delivered & set up at the home. The patient can never be left home alone for a minute...even to go outside to mow or shovel snow. This patient will probably never make it home alive, or will die shortly after arriving there. I've had PVS patients that have had very difficult, horrible to staff families(which is why all facilities denied them) that have taken the patients home, had them pass away very shortly at home. In all of those cases, the families seemed to accept it...and I am sure they would have brought the roof down had they died in our care. It's giving them a sense of control over a horrible situation.
