A need for long-term ventilation in the home has created a demand for home care services that has been a source of growth for an industry. Evaluation of the patient and family who will guarantee successful home care requires careful psychological and psychiatric evaluation. Beyond this evaluation, long-term success is possible if appropriate financial resources are available. The implementation of successful home care is best done by a team consisting of primary physician, primary ICU nurse, social worker, psychiatrist, and home care respiratory therapist. An appropriate classification of patients based on goals of care, as well as the study of the incidence and prevalence of associated disorders, will be helpful in the future allocation of resources.
Sivak et al. (1986) studied this question.