Different types of care
There are 3 main types of care that you may receive when you are seriously ill:
What is Intensive Care?
When patients need intensive care for serious illness or organ failure, they may be cared for in the Intensive Care Unit (ICU). Patients may be in the ICU because of:
- severe infection or bleeding
- breathing problems
- a bad accident
- major surgery
Along with strong medicines, there are several machines used in the ICU, including:
- ventilators or breathing machines
- mechanical pumps to keep the heart beating
- intravenous catheters (small plastic tubes put into big veins) that are used to provide medications
- plastic tubes placed into the stomach to provide medications and nutrition
- machines that provide cardiopulmonary resuscitation (also known as CPR)
Is ICU right for me?
Most patients recover from a serious illness when admitted to the ICU, especially if they have had a short stay. However, if you are in the ICU for some time, you may leave the hospital being much weaker than you were before you became ill and, you may have problems thinking or concentrating. Also, up to half of survivors will have significant depression, anxiety, or post-traumatic stress disorder in the months that follow illness. Without intensive care, most seriously ill patients with organ failure will die. However, even with intensive care, some patients will die from their serious illness. On average, about 20% of ICU patients will die and 80% will survive and leave the hospital.
What is Medical Care?
Medical care is given in the general part of the hospital, often known as a hospital ward. People who are in a hospital ward usually have conditions such as:
- less severe infections
- problems due to an ongoing disease, such as diabetes
- mild heart attacks or strokes
- the need to recover after a surgery
Along with medications, some of the machines used to treat you in a general ward are:
- intravenous tubes (IV) to deliver medications and nutrition
- tubing to deliver oxygen but not ventilators or breathing machines
- blood pressure monitors
- specific machines for a disease, such as a dialysis machine
Is Medical Care right for me?
When admitted to hospital for medical care, most seriously ill patients recover from their serious illness and have little or no decrease in their quality of life. Approximately 70% will survive and leave hospital alive. However, the survival might be higher or lower depending on the age and health condition of the patient before they got sick. Most people who pick this option have fixable medical problems or a declining or low level of function or quality of life and wish to avoid the more burdensome ICU treatments.
What is Comfort Care?
Comfort care can be provided in a hospital, a long-term care home, a hospice, or at home. The goal is to keep you as comfortable as possible, but not to focus on curing you. For example, you may receive medications to help with pain or breathing problems, but you may not receive treatments (such as a breathing tube or CPR or even antibiotics) that would keep you alive longer, but may cause pain or make you uncomfortable. This is sometimes called a “palliative care approach” and may or may not involve services from palliative care clinicians.
Is Comfort Care right for me?
Most people who choose comfort care have serious medical problems that can’t be fixed. They may also be very old or have a poor quality of life and don’t want any treatments to help them live longer. Instead, they would rather be made comfortable.
The videos on the side of the pages show conversations between a doctor and a patient talking about the different types of medical care.
Do you know the facts about CardioPulmonary Resuscitation (CPR)? Our CPR video can help you learn more about CPR and whether it’s right for you.
Best location of care for you or your loved one?
Some people will develop a serious illness while residing in a long-term care home. For many patients, staying at their residential, rather than be transferred to hospital, is viewed as desirable. Long-term care homes are able to provide a variety of medical treatments, such as oral antibiotics for infection or x-rays on site in order to minimize the need for transfer to acute care hospitals. Long-term care homes are also able to provide comfort and palliative care to support those residents who no longer wish to be transferred to hospital or have chosen to pass away at home in long-term care. However, there may be situations where a long-term care physician may recommend a transfer to acute care when one requires care that is not offered in long-term care (e.g. intravenous medications, more intensive monitoring, or surgery).
Transferring to acute care has some risks and benefits. It will be important to discuss you or your loved one’s values and medical condition with the clinical team in the long-term care home in order to understand what medical services can be provided if a serious illness develops while residing at the long-term care home.
Is transferring to hospital right for you or your loved one?
Acute care hospitals can offer more aggressive and intensive care when managing serious illnesses. Thus, a transfer may be associated with a greater chance at surviving the serious illness. However, there are ‘downsides’ or ‘risks’ associated with transfer to acute care hospitals. The transfer itself may be uncomfortable, difficult, and distressing because of the unfamiliar setting of the hospital. Compared to residents who stay at their home in long-term care, residents that go to hospital may develop additional complications, such as confusion and worsening memory, falls, new wounds and infections. Often, residents don’t return to their ‘baseline’ condition after going to hospital.
Because of these risks, some people choose to remain at the long-term care home to receive less aggressive care during times of serious illness. Long-term care homes can provide high quality palliative care because residents and families are familiar with the local staff, and the local staff know the needs of the long-term care resident. Therefore, in some situations, remaining at home in long-term care could be better for you or your loved one than transferring to hospital.
Remember, if you are making this decision on behalf of your loved one, please consider what your loved one would want if they knew of these risks, the alternative option of staying at home in long-term care, and their current medical condition.