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At home – with ventilation support

Being at home with respiratory support also reduces the risk of hospital-borne infections

ST 20170822 At home – with ventilation support
 

Dr Chan Yeow, director of TTSH’s Home Ventilation and Respiratory Support Service, and senior staff nurse Ni Bin with patient Jason Ong, who suffered a spinal cord injury 14 years ago. The portable ventilator in Mr Ong’s bedroom at his home in Telok Blangah is turned on for eight hours at night. ST PHOTO: LIM YAOHUI 

The Straits Times (22 August 2017) - For people who are unable to breathe on their own, Tan Tock Seng Hospital’s (TTSH) home ventilation programme is a chance to live life on their own terms.

Rather than being hooked up to a machine in a sterile hospital ward, they can have all the equipment they need at home. Doctors and nurses will visit regularly to make sure they are coping well.

“The main thing is that patients can be at home and the autonomy that this affords them,” said Dr Chan Yeow, director of the hospital’s Home Ventilation and Respiratory Support Service.

TTSH’s structured programme is believed to be the only one of its kind here. In 2012, there were 17 patients on board. Today, the team is caring for around 70.

Those under the scheme typically have conditions such as spinal cord injuries, muscular dystrophy or stroke. Many are unable to walk and may have difficulty breathing, speaking or even coughing.

Being at home helps prevent hospital- borne infections, which can have serious consequences for patients who are so ill, said Dr Chan.

“The risk of cross-infection in hospital multiplies,” he said. “But if the family members and helpers are well-trained, home may be safer.”

One of his patients is 37-year-old Jason Ong, who suffered a spinal cord injury 14 years ago. He was previously under the care of another hospital and was referred to the TTSH programme only in 2015. Mr Ong said: “Previously, I was left to fend for myself. Now, there is more support.”

He uses the ventilator every night when he sleeps. He cannot walk or move his arms much, but surfs the Internet using a pointer controlled with his mouth.

Doctors visit every two to three months to check his lungs and blood pressure, and make sure he has not developed bed sores.

The programme has helped many patients avoid making visits to the emergency department or the need to be admitted to hospital. Yet, despite being in a familiar home environment, this is not an ideal existence.

Dr Chan and his team are well aware of this. He said: “Are we prolonging life or are we prolonging suffering?”

The team asked patients and 73 per cent of them said they would choose to be on a ventilator again.

Dr Chan said: “At every point, we will ask patients what they wish for.

So far, most of them are satisfied.”


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Source: The Straits Times © Singapore Press Holdings Limited. Permission required for reproduction