Caring for a Parent with a Tracheostomy at Home: What Families Can Do, What Needs Trained Hands, and When to Call 1669

Tracheostomy care at home works best when families separate the tasks into three levels from day one. Level one is daily care your family learns from the hospital and carries on: positioning, keeping the skin and surroundings clean and comfortably humid, communicating when your parent cannot speak, and watching for changes. Level two is specially trained care tasks, such as suctioning and care of the tracheostomy tube, which must be done by someone who has actually been trained for that task. Level three, changing the tube or solving a problem with the tube itself, belongs to the medical team, or is done only as the hospital has taught and assessed for that individual; families should not try it on their own. Call 1669 immediately for difficulty breathing, a tube that has come out or is blocked, heavy bleeding, or blue lips.

Many families bring Mum or Dad home with a tracheostomy after the nurse has shown them the basics once or twice. By the first night the worries begin: a rattling sound in the throat at 2 a.m., a parent who cannot say what feels wrong, and the constant question of whether we would notice if something were really wrong. This article is not a procedure manual. It is the big picture families need: what to ask the hospital for before discharge, how to prepare the home, who does which task, and when to call for help without hesitating.

Quick answer

• Families can handle daily basics: raised head position, hygiene around the neck as the hospital taught, a way to communicate, and careful observation of breathing, skin colour and secretions
• Suctioning and tracheostomy tube care are specially trained tasks. They should be done by a trained caregiver working under a registered-nurse team, not learned from an article or video
• Changing the tube and solving tube problems are for the medical team, or done only as the hospital has taught and assessed for that individual. Families should not try on their own
• Before discharge, get seven things: hands-on teaching for the family, written care instructions, the tube type and size, spare supplies, an out-of-hours number, the next appointment date, and your parent's limits
• Difficulty breathing, a tube that is out or blocked, heavy bleeding, blue lips or face, or marked drowsiness: call 1669 at once, and follow only the individual emergency plan the hospital taught
• A carer who is alone every night tires quickly and misses things. Shift cover at night and regular nurse visits help both your parent and your family

1. What a tracheostomy is, and what families should understand first

A tracheostomy is an opening made in the neck, with a tube placed in it, so that air can pass in and out of the airway. Doctors choose it for many reasons. Some people need the tube for a short time, others for much longer. Ask the medical team which tube your parent has, how long it is expected to stay, and when it will be reviewed.

Three things are worth understanding early:

• The tube is often an important airway, but not in the same way for everyone. Some people can still breathe through the nose and mouth too. Ask the team which applies to your parent and what to do if the tube has a problem. Changes in the position of the tube, the sound of breathing or the secretions should never be dismissed
• Every person is different. Tube types, supplies and care instructions vary. Follow the team that looks after your parent directly, not another family or an online post
• Feeling worried is normal. Most families feel worried in the first week. It is natural, and it reminds you to prepare and ask for help. It does not mean you cannot cope

2. What to ask the hospital for before going home

Get all seven items before you leave, and photograph or write them down where everyone in the household can find them. For more questions to ask before discharge, see what to ask before bringing your parent home from hospital.

1. Hands-on teaching for the family. Not just watching a nurse. Try the tasks you will be responsible for in front of the nurse, and ask directly which tasks the hospital does not expect families to do themselves
2. Written care instructions from the team looking after your parent, so everyone follows the same routine
3. The tube type and size, kept where it can be read at once, in case you must tell emergency staff or another hospital
4. Spare equipment and supplies. Ask what must always be kept at home, what to reorder, and where
5. An out-of-hours number. Ask whom to call at night or on holidays, and when to go straight to the emergency room or call 1669
6. The date of the next appointment and what the team will check
7. Your parent's limits, such as whether they may eat by mouth, whether oxygen is needed, and positions to avoid

Tip: Photograph the summary sheet and the phone numbers on every carer's phone and tape a copy beside the bed. In a fright people forget, but they can read a sheet that is right in front of them.

3. Three levels of tasks: who does what

The principle KIN HomeCare uses for every family is this: tasks the hospital teaches families to continue at home can be done by a trained caregiver on the family's behalf, while nursing procedures belong to registered nurses. For a tracheostomy the lines fall like this.

Level 1: daily tasks for families and general caregivers

• Positioning your parent in bed or a chair with the head raised, as the team advises
• Helping with general hygiene and changing clothes and bedding, taking care that nothing covers or pulls on the tube
• Keeping the skin around the neck clean and dry and the room air comfortably humid, as the hospital taught
• Helping with food and fluids according to the doctor's plan
• Helping your parent communicate: answering the call bell at once and staying close so they feel safe
• Observing and recording skin colour, breathing pattern, amount and colour of secretions and temperature, then reporting according to the thresholds the team set

Level 2: specially trained care tasks

Suctioning and care of the tracheostomy tube belong here. They must be done by a caregiver trained for that task, working under the supervision of our registered-nurse team, at the same price as a general caregiver. The reason for insisting on training is that international clinical practice guidelines on suctioning through artificial airways, including tracheostomy tubes (AARC Clinical Practice Guidelines, Respiratory Care, 2022), set out several safety conditions: when to suction, sterile technique and choosing equipment that fits the tube. To be candid, that guideline is written mainly for hospital staff, not for families doing this at home. So this article will not teach steps or settings. Please learn this part only from the nurse who cares for your parent.

Level 3: tasks for the medical team and the hospital

• Changing the tracheostomy tube, on schedule or when there is a problem. This is for the medical team, or done only as the hospital has taught and assessed for that individual; families should not try it on their own
• Judging whether the tube is blocked or has shifted, and fixing problems with the tube
• Decisions about the tube type, adjusting it or stopping its use
• Redness, swelling, pus or bleeding around the opening, which a nurse or doctor needs to assess

If something goes wrong with the tube, call 1669 immediately and follow the individual emergency plan the hospital taught. Family members and carers should not try to fix the tube on their own beyond that plan.

4. Preparing the home before your parent returns

The best room is one where the carer can reach all sides of the bed, close to the toilet and to a seat for the carer. In a two-storey house, prepare a ground-floor room if you can, because in an emergency staff must reach your parent and move them out easily.

What to arrange:

• A bed with a raised head. A raised head helps many people breathe more comfortably and helps with secretions. Ask the team how high. If you do not yet have an adjustable bed, see the equipment rental page: we deliver, install and demonstrate at your home. An electric bed with mattress starts at THB 4,500 per month (deposit THB 9,000). Beds are available to rent or to buy; ask 061-881-9399 (+66 61 881 9399) for purchase prices
• A reliable electricity supply. If your parent uses electrical equipment, check there are enough sockets, avoid chained extension leads and keep cables out of walkways. Ask the medical team what to do in a power cut
• Oxygen, only if the doctor prescribes it. If your parent is prescribed oxygen at home, read more about setup and safety in using an oxygen concentrator at home: power cuts and alarms. The flow rate follows the doctor's order and must never be adjusted by the family. A 5-litre oxygen concentrator rents from THB 2,500 per month (deposit THB 8,000), and a 10-litre unit for continuous 24-hour use at THB 4,000 per month (deposit THB 11,600)
• Spare supplies as listed by the hospital, kept in one easily reached box, separate from other items, with expiry dates checked from time to time
• A call bell or another way to call for help, always within reach
• Enough light for the carer to see skin colour and lips clearly even at night. When you need to assess breathing, turn the light up enough to see skin colour and lips; do not judge colour under dim light. If the doctor advises a fingertip pulse oximeter, it can help with monitoring, but if you see any danger sign do not wait for a reading before calling 1669
• Emergency numbers: 1669 and the hospital's number beside the bed, with the home address written clearly in case a frightened carer cannot say it
• A clean room: keep dust, pet hair and smoke away, and do not smoke or burn strong incense near your parent

5. General principles on cleanliness and humidity (as taught by the hospital team)

The straight answer is that families should keep the skin around the opening and the clothing near the neck clean and dry, and follow the method the hospital taught, because the right materials and technique depend on the tube type and your parent's skin.

General principles:

• Wash hands before and after touching the neck area or equipment. It is the simplest and most effective way to prevent infection
• Check the skin around the opening every day for colour, moisture, smell and anything seeping out. If it changes, write it down and tell the nurse
• Humidity. Air entering through a tracheostomy does not pass through the nose, so it misses the natural warming and moistening, and teams often advise ways of adding moisture. Ask what suits your parent at home
• Keep foreign material away from the tube opening: lint, fibres, powder and water. During a bed bath, take care that water does not splash the neck
• Neck scarves. A thin cotton scarf can keep dust off and look tidy, but it must not make breathing harder, and it must not be so thick that you cannot see skin colour or so tight it pulls on the tube. Ask the team what suits your parent

For suctioning and cleaning the tube itself, go back to Level 2 in section 3: this is for trained people, not something families should learn from an article.

6. Communicating when your parent cannot speak

Many people with a tracheostomy cannot speak or can speak only with difficulty, and this is the distress children overlook most often. Being unable to speak does not mean thinking and understanding are lost, but each person's cognitive abilities depend on their underlying condition and should be assessed individually by the medical team. What many share is that they cannot say what they need. Pressing a bell and waiting, or being unable to say where it hurts, can lead to frustration or withdrawal. Preparing ways to communicate in advance helps a great deal.

What works at home:

• A letter board or picture board. Make one from stiff card with short, common words such as water, pain, toilet, hot, cold, or with pictures your parent can point to
• Hand signals agreed in advance: one finger for yes, two for no, and a specific signal for "I cannot breathe comfortably" that everyone in the house knows
• An easy-press call bell within reach of both hands, in case your parent uses the non-dominant hand
• Yes-or-no questions, with time for your parent to answer. Do not rush or guess
• Everyday conversation, not only talk about symptoms. Your parent still wants news of the family, the neighbours and favourite music

If your parent becomes newly confused, more drowsy than usual or communicates less than before, tell a nurse or doctor. Do not put it down to tiredness.

7. Eating, drinking and choking

Some people with a tracheostomy can eat by mouth, some are fed by tube, and some are practising swallowing under the team's plan. So ask the medical team clearly before discharge what your parent may eat, how, in what position and with what food texture. Never experiment: food or fluid going the wrong way can cause choking and pneumonia.

Safe principles for every household:

• Sit upright or raise the head as the team advises, during meals and for the period afterwards that they specify
• Do not feed a parent who is drowsy or not ready
• Watch during and after meals for coughing, choking, a changed voice, faster breathing or a lot more secretions. Stop and tell the nurse
• If your parent is tube fed, read tube feeding at home and learn the method from a nurse before doing it yourself

8. Emergencies: signs that mean call 1669 immediately

Airway emergencies can develop quickly, and a delay of even a few minutes in deciding can have serious consequences. Agree in advance as a family: if you see any of these signs, call 1669 immediately (free, 24 hours) without first phoning relatives or waiting to see.

• Difficulty breathing, gasping, abnormally noisy breathing, or being unable to breathe
• The tube has come out or moved out of place, or you suspect it is blocked
• Heavy bleeding from the opening or the tube
• Blue or dusky lips, face or fingertips
• Marked drowsiness, difficult to wake, or unconsciousness

Remember:

• Follow the individual emergency plan the hospital taught. Do only the steps the carer has been trained for and the treating team has allowed. If there is no plan or no training, do not try to fix the tube yourself, and follow the 1669 operator's instructions on the phone
• When you call, say clearly that your parent has a tracheostomy, the tube type if you know it, how they are now, the address with landmarks and a number to call back. Do not hang up until the operator tells you to
• Keep the hospital summary sheet ready to hand to the team that arrives
• One person stays with your parent, while another calls and opens the door

For a whole-household plan, see 1669 emergency plan for homes with older adults.

Signs that are not emergencies but should be reported to your nurse or care team the same day include: thick or discoloured secretions unlike usual, an unusual smell, fever, redness, swelling or pus around the opening, your parent seeming more tired or restless than usual, or a clear increase in rattly breathing.

9. Everyday help: do not leave one carer alone for too long

Caring for someone with a tracheostomy is heavy not because of physical strength but because of constant vigilance. A carer who is alone day and night grows tired without noticing, and the moment they are most tired is the moment they most need to decide well. Arrange these early:

• Divide shifts clearly: who watches by day, who by night, who is on standby. Write it on a chart beside the bed. If family cannot rotate, a caregiver on the 20:00–08:00 night shift lets the family actually sleep
• Keep a daily log: time, breathing pattern, secretions, temperature, food and fluids. It hands over cleanly at shift change and gives you the answers when you phone a nurse
• Have a nurse visit regularly, not only when problems arise. A nurse looks at the whole picture, checks that what the family does is still right and answers questions that have built up
• Look after the carer too. If you cannot sleep, are irritable or your thoughts loop, treat that as a sign to ask for help, not a weakness

Mistakes families often make

• Trusting videos or online groups over the team caring for your parent. Tube types and conditions differ. Follow what the hospital taught and ask again if unsure
• Trying to fix the tube in a panic. Trying anything beyond the plan the hospital taught can cause injury and waste critical time. Call 1669 first
• Letting someone who has not learned a Level 2 task do it, such as a new family member or untrained carer attempting suctioning. People should do only the tasks a nurse has actually trained them for
• No spare supplies or contact numbers. Then a night-time incident finds nothing to hand. Check weekly that supplies are complete and numbers still work
• No plan for communication. Your parent keeps discomfort to themselves and carers miss warning signs. Prepare a board and signals from day one
• One carer watching alone every night. Accumulated tiredness makes missed warning signs likely. Arrange shifts
• Delaying a call to the nurse for fear of disturbing. Small problems reported early are usually easier to handle, and the team is glad to be asked

When to bring in the professional team

Many families manage daily care well when someone teaches them and they can take turns. But if your parent has a lot of secretions and needs frequent suctioning, if nobody at home has been taught tube care, or if the main carer is so tired they fear making a mistake, help is available at several levels.

• A caregiver trained in tracheostomy care, working under the supervision of our registered-nurse team, to help with daily tasks and specially trained care tasks as the family and doctor specify. A 12-hour shift is THB 1,800 per day (day 08:00–20:00 or night 20:00–08:00), or a 24-hour live-in shift for one parent THB 2,500 per day, the same price as a general caregiver. The minimum for daily hire is 3 days. A live-in caregiver rests when your parent rests; if someone must be awake all night, book two 12-hour caregivers. Our team assesses what your parent needs first and matches a suitable caregiver. See elderly home care
• A registered-nurse home visit, THB 1,800 per visit, to assess your parent overall, review what the family does, answer accumulated questions and help plan the care. Nursing procedures such as wound dressing start at THB 1,200 per visit. For complex needs requiring a nurse present throughout there is a 12-hour registered-nurse shift at THB 3,500 per day. See home nursing
• An electric bed and an oxygen concentrator, if the doctor prescribes them, to rent or buy, with delivery, installation and a demonstration at your home

Changing the tracheostomy tube and solving tube problems remain the work of the medical team, or are done only as the hospital has taught and assessed for that individual. A team at home adds more people to help watch and to do the daily tasks. It does not mean you should stay away from the hospital when the time comes.

Frequently asked questions

What do I need at home to care for someone with a tracheostomy?

You need a bed that raises the head, spare supplies as listed by the hospital, a reliable power supply, oxygen if the doctor prescribes it, a call bell or other way to communicate, and out-of-hours numbers and 1669 beside the bed. Most important is having someone who has genuinely been taught tube care by a nurse.

Can the family suction a tracheostomy at home?

Suctioning is a specially trained task. If the hospital has taught your family to continue it at home, do only what the nurse showed you in person, and do not learn it from articles or videos. If the family does not feel confident, a caregiver trained for this task and working under our registered-nurse team can do it for you.

What should I do if the tracheostomy tube comes out?

Call 1669 immediately and stay with your parent. Follow the individual emergency plan the hospital taught and the operator's instructions, and tell them your parent has a tracheostomy. If there is no plan or you have never been trained, do not try to fix the tube yourself.

How can someone communicate if they cannot speak with a tracheostomy?

Use a letter board or picture board, agreed hand signals and an easy-press call bell. Ask yes-or-no questions and give time to answer. If your parent communicates less or becomes newly confused, tell a nurse or doctor.

Can a person with a tracheostomy eat by mouth?

Some can, some cannot, and some are practising swallowing. Ask the medical team clearly before going home what your parent may eat, in what position and with what texture. Do not experiment, because food or fluid going the wrong way can cause choking.

How do I bathe or wash the hair of someone with a tracheostomy without water getting into the tube?

Water should be kept away from the opening and the tube. But the safe way to bathe, wash hair or wipe down depends on the tube type and each person's condition, so ask the hospital team to teach the method that suits your parent's tube before going home. Until then, do not try it on your own. If water splashes and your parent has difficulty breathing, call 1669.

How much does it cost to hire a caregiver for tracheostomy care at home?

A 12-hour caregiver shift is THB 1,800 per day and a 24-hour live-in shift is THB 2,500 per day, the same for a caregiver trained in tracheostomy care as for any caregiver. Daily hire has a minimum of 3 days with a THB 2,000 deposit. A registered-nurse home visit is THB 1,800 per visit. Prices as of September 2026.

Talk to the KIN HomeCare team

If you are about to bring your mother or father home with a tracheostomy, or already have and still feel uneasy every night, tell the team your situation. We will help assess whether your parent needs a trained caregiver, periodic nurse visits, or equipment, and where to start, so your family does not carry it alone.

• Home care, home nursing and equipment: call 061-881-9399 (+66 61 881 9399)
• LINE @KINHOMECARE
• Free consultation: the team helps assess which service suits you. Work normally starts within 2–3 days, caregiver profiles are shown before you decide, and we serve homes nationwide

This information is general knowledge for families and does not replace the advice of the doctor caring for your parent.

Written by Orrathai Boontuang, RN (licence 5311192883) · Medically reviewed by Dr. Kamolchat Choktanomsup (licence 40854) · Prices as of September 2026; please confirm with our staff before booking.