TRACH-Support: A Conversation Tool for Tracheostomy and Prolonged Mechanical Ventilation

Frequent Asked Questions

A tracheostomy can refer to the surgery in which a hole is created in the neck for a long-term breathing tube OR the tube inserted into the neck itself.
The term “trach” is shorthand for tracheostomy. Are tracheostomy and tracheotomy the same things? The terms usually mean the same things.
A tracheostomy allows patients to be connected to a breathing machine for a longer period of time than a breathing tube in the mouth.
This is one of the most important question that families tend to ask. Some patients can eventually breathe on their own. Some patients need to stay attached to machines forever. Unfortunately, it can be very hard to predict if your loved one will come off the breathing machine. However, older patients, patients with chronic health issues, and patients with severe brain injuries are less likely to be able to breathe on their own. Also, the longer someone needs a breathing machine, the less likely it is that the patient will ever come off.
Tracheostomies can be temporary for patients who recover and are able to breathe on their own again. If a patient successfully comes off the breathing machine, the tracheostomy tube can be removed and, usually, the hole in the neck heals on its own.
Initially, patients with a tracheostomy will receive nutrition through a tube into their stomach. Some patients with a tracheostomy can learn to eat by mouth again IF they are awake and recovering. Very few patients who are still connected to a breathing machine can eat by mouth.
Most patients with a tracheostomy can only talk again when they can come off the breathing machine. For patients with a tracheostomy who still need the breathing machine, other forms of communication are often used including writing or mouthing words.
Sometimes families want to give their loved ones more time to see if they get better. However, families can talk to the medical team about transitioning to a comfort-focused only approach at any time in a patient’s care. Make sure you are clear with the medical team about your goals for your loved one especially when those goals may change.
Long-term hospitals can offer multiple different types of services. Long-term hospitals vary by region. A patient’s eligibility is also dependent on their medical status as well as their insurance. You have to talk to the medical team to learn about options after the hospital.
The best place for your loved is the place where they can receive the care they need. Most acute care hospitals are not designed to help patients slowly come off a ventilator. While all ICU teams have experience with the weaning process, some long-term hospitals may be better. Additionally, some long-term hospitals are able to provide more physical therapy to help a patient recover.
Where patients go after a tracheostomy depends on multiple factors. Two of the biggest issues are whether a patient can breathe without a breathing machine and whether a patient can care for themselves (bathroom, dressing, etc.). In very rare situations patients with a tracheostomy who still need a breathing machine can return home. Usually, this requires lots of medical equipment and support at home. Patients who can successfully come off the breathing machine can return home, but some will still require help with activities of basic living like going to the bathroom and dressing. In some cases, patients may need a nursing home after a tracheostomy if they still need lots of help.

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The Patient decision aids on this website are licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.The material provided on this website is for informational purposes only and is not provided as medical advice. Nothing contained in these pages is intended to be for medical diagnosis or treatment. Any individual should consult with his or her own physician before starting any new treatment or with any question you may have regarding a medical condition. No personal health information will be collected from users. Contact information is only collected if the user requests additional information regarding one of the tools. Last Updated 10/31/2019

Funding by the National Institutes on Aging (1K23AG040696) and the Patient-Centered Outcomes Research Institute (PI000116-01).