Life Support Issues/Life Support

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Question
Hi Betsy, I am wondering how long a patient can be left on life support? I am concerned that if left on too long the lungs will become dependent on the respirator and not ever be able to function on their own again. Thank you for any help you can provide.

Jane

Answer
Hello Jane,

Life support takes over the work of breathing to allow time for the patient to recover from their acute condition.  It is intended to be short term with an eye on weaning the patient from life support as soon as possible.

The success of life support seems to depend on the patient's ability to recover. Some patients with end stage lung disease seem to go on life support a number of times before their lungs fail, causing their heart and kidneys to fail also. So patients can die while on life support. Some patients are dying when they go on life support.  They may have terminal cancer, a stroke, pneumonia etc. which is not easily reversible. Some family member recognize in time that the patient's dying is prolonged, rather than their living. They decide to withdraw the artificial ventilation and allow their loved on to die naturally.

I am trying now to answer your question of how long a patient can be left on life support. A young and vigorous person may do better on life support for a longer time than an elderly person. In my experience, the more unsuccessful attempts to wean the person from life support, the less likely they will survive. It may  not be so much that the lungs become dependent on life support.  Instead, the patient has other organs that are failing (heart, kidney), and the failure of these organs is causing them to grown weaker and more debilitated.

In some very ill patients, life support is started with a possible termination date in the future. Life support is withdrawn when it becomes apparent that the patients is continuing to decline and there is little benefit from life support.

Since I don't really know the specifics of your loved ones situation, I am providing you with some broad concepts here. Remember that my area of expertise is hospice care, so the life support patients I have been involved with were universally terminally ill. If your loved one has a life limiting illness, it would be helpful to seek consultation with a Palliative Care physician at the hospital. This physician could provide you with an estimate of your loved ones' ability to survive. Please write again if you need additional information or I have not adequately answered your question.  

Life Support Issues

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Betsy Murphy

Expertise

My expertise is in end of life care for adults. Identifying when someone is approaching the end of their life. Benefits and burdens of end of life treatments. Managing pain and other symptoms. Providing care for dying patients at home. Advocating for someone who is dying in a hospital or nursing home.

Experience

More than 28 years of experience in hospice care. Currently consulting with hospices to promote access for patients to receive hospice care earlier in the course of their illness. Betsy provides training for hospice marketing staff to effectively work with nursing facilities to help identify eligible patients. She writes Additional Development Request (ADR) letters to Medicare to help hospices get paid for their services and to avoid future claim denials.

Organizations
Hospice and Palliative Nurses Association

Publications
Articles: Clinical Reviews, Advance for Nurses, Nursing Spectrum, Washington Business Woman, www.Ezine.com;www.alz-nca.com.Books: Understanding Medical-Surgical Nursing (FA Davis and Company), Guide to Caregiving in the Final Months of Life (TM Brown publishers).

Education/Credentials
Bachelors of Science in Nursing, additionally trained as a Family Nurse Practitioner and certified as a hospice and palliative care nurse.

Awards and Honors
Outstanding Woman in Loudoun County (VA) by Loudoun County Commission on Women 1997 and 2002.

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