Long-Term Mechanical Ventilation

"Community Care or Home"?
"Invasive or Non-Invasive"?


Some patients may be candidates for Long Term Ventilation (LTV) at home or at other community sites.  These patients require an extensive interdisciplinary care plan to ensure patient safety and coordination of care among the medical, nursing, and respiratory care professionals. 

While living at home is often the first choice of patients who wish to live with LTV, this option may require extensive financial resources and networks of friends and family.  For many patients, living in their home is not feasible.  The LTV team will explore this possibility with the patient and their family. However, the supports can be sometimes be substantial to meet the in-home care needs, hence other community living placements that support LTV will be explored. Other community placements in the London area are the Complex Care Program at Parkwood Hospital and Participation House

Parkwood Hospital has five beds that can be used for the residential care of ‘medically stable’ ventilator-dependent individuals. The facility provides a more appropriate setting to care for and manage the health, welfare and social needs of the LTV whose care cannot be managed at home. However, the facility is not mandated, staffed nor resourced to facilitate protocols for attempting weaning from mechanical ventilation or care for sudden deteriorations in clinical status.  If a LTV patient suddenly deteriorates, the patients is transferred back to the referring ICU for this care. LTV specialists, from LHSC, support the Complex Care Program staff as required.

Participation House is a supportive housing organization with attendant services that provides independence and safety, however placement opportunities for LTV patients is rare as these facilities are limited in the South West LHIN. 

Patients and families must be prepared for relocating beyond the London area, if home is not an option, and there are no LTV placements at Parkwood Hospital or Participation House.

Resources

London Health Sciences Centre (LHSC) is working with the Ministry of Health and several other hospitals on a three-year pilot to improve the quality of life for patients who require ventilation. See more below: