Teej,
Considering your husband's young age and the fact that you have young children, the vent may be a good option for him. My husband was 61 when he decided to go on the vent, he had been diagnosed for about 18 months with the bulbar form of ALS and he went into respiratory failure. The vent could give your husband much more time with you and the children. And despite what some are telling you, it can be quality time.
There are some things you should be aware of though. The vents are small, about the size of a laptop and can hang on the back of a power chair. It will have on-board rechargeable batteries that usually last several hours, normally it should be plugged into the wall, and not be running on the batteries. There is also a cord to enable the vent to be plugged into an outlet in the car, this is great for anytime you're in the car, saves the batteries.
Your husband will require a 24 hour caregiver/caregivers. These caregivers must become knowledgabe of the operation of the vent and be able to troubleshoot alarms.
Your husband will have a trach which will require cleaning and replacing periodically. We used disposable inner cannuals (the inner tubing of the trach), which made daily care much easier. There will be tubing from the vent to the trach which will need to be replaced every other day or so. And the trach will need to be suctioned anytime he feels like he needs it, many times a day. The suctioning will cause him to cough, but it's not painful. The suction tubing we used was also disposable and easy to learn to use. I want you to understand that the level of care will increase with a vent. But it's entirely doable!
I had no previous medical training. While my husband was in the hospital, after he was put on the vent, I made the nurses and respiratory therapists, teach me how to do trach care and suctioning and monitor the vent. I knew I'd have to do it when we got home and I learned! I was scared at first, but after the first day, I became more and more comfortable with it.
I did hire an LVN as a caregiver to help us. She had never done trach care or had a patient on a vent, so I trained her! She was a Godsend for us! She became a part of our family and that's important, to have the caregiver 'fit' with your family.
With my husband on the vent and in his powerchair and with the van, we took him to concerts, movies, fishing at the lake, museums, the horse races, shopping, basically anywhere we wanted to go. We'd have to suction, but that can be done discreetly. And we never had an uncomfortable experience with anyone in public.
I know there are people living many years on a vent. You just have to have a good caregiver who is willing to learn. My husband died last year and I miss him so very much, I'm glad he opted for the vent and I'd do it all over again.
I know this is long, but thought maybe I could be of some help for you.
Michelle