Discharge of the ventilator-dependent person from a hospital requires careful advance planning by hospital personnel and rehabilitation of the patient to assure maximal functional ability in the home. The patient and family should be taught the techniques necessary for both routine and emergency care in the home. Respiratory equipment, including the type of mechanical ventilator best suited to the patient's needs and the home environment, and disposable supplies must be obtained, and payment from third-party payers must be assured. Equipment placement and the ability of the patient to perform self-care and activities of daily living following discharge can be facilitated by integrating results of a home care evaluation into the patient's rehabilitation program. Trips of gradually longer duration out of the hospital allow the patient to gain confidence in his ability to care for himself. Responsibilities for follow-up in the home can be shared by respiratory home care companies, visiting nurses, and pulmonary physicians.
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