Facilitating Ventilator Discontinuation in Rural Long-Term Care: A Case-Based Examination of Interprofessional Collaboration

This case-based report compares two residents experiencing progressive neuromuscular diseases who transitioned from palliative care to hospice and underwent ventilator discontinuation in a rural long-term care (LTC) facility. With a focus on effective interprofessional collaboration and communication, it highlights a coordinated approach while navigating system-level barriers, process challenges, and the emotional, cultural, and ethical complexities of goal-concordant end-of-life care. In the absence of well-documented protocols, ventilator discontinuation is feasible in rural LTC settings. To improve the quality of this care option, policies are needed to support the development of standardized practice guidelines, ensure simulation-based staff education to improve coordination, and enhance access to essential resources for residents, their families, and health care clinicians in the LTC setting.