Why does my loved one act different?

Most critical illness affects the brain and confusion is very common in Critical Care. To ensure comfort, we often give sedation and pain medication which could also make the patient seem sleepy or confused. If the patient has a breathing tube in place, he or she will not be able to talk until the breathing tube is removed.

Why isn’t he/she getting better?

Patients cared for in Critical Care are very sick. Improvement can be slow and setbacks are common, and sometimes patients decline despite maximally aggressive care. Things can change from day to day and it can be difficult to predict the final outcome. The best way to deal with this is to get daily updates from staff and to focus on the short-term daily goals.

What are all of these tubes connected to my loved one?

Your loved one may look different because of his/her condition and various tubes and devices in place. Each device has a purpose. The endotracheal tube in the patient’s mouth connects them to the breathing machine so that they can breathe safely. A feeding tube in the nose or mouth allows delivery of nutrition and medications. A catheter in the bladder allows careful monitoring of urine output and kidney function. Large IVs in the arm or neck, called PICCs or central lines, allow us to administer multiple strong medications safely and at the same time. Please ask the nurse if you have questions about other tubes or devices.

Why are the doctors always changing?

In order to ensure that there is a critical care specialist, or intensivist, in Critical Care 24 hours a day, the doctors work in 12-hour shifts. Because of this, the intensivist taking care of your loved one changes during the day shift and night shift and every few days. Sometimes, it could be challenging to see a new face after becoming familiar with the previous doctor. Our group of intensivists are all well trained in critical care and communicate very clearly about the patients so that care will remain optimal when a new doctor comes on.

What can I do to help?

Talk to the bedside nurse regarding activities that you could participate in such as passive range of motion, oral care, massage, reorientation, calming techniques, helping them to fill out the journal, meal/menu selection and feeding assistance. If your family member is confused, you can try to help reorient them throughout the day. Please follow rules and visiting hours so that the health care team can provide optimal care.

How can I get an update and communicate with the doctors?

A nurse is at the bedside for most of the day and can usually provide you with an update. Intensivists usually make multidisciplinary rounds in the morning, around 10 a.m., and can provide a brief update and answer your questions at that time. With large families, it is much more efficient to have one spokesperson get updated and pass on information to others rather than the physicians updating everyone separately throughout the day. If you are unable to make it to morning rounds for an update, please ask your nurse to contact the physician so they could update you in person or by phone. Remember that our intensivists are taking care of several patients and often have unpredictable emergencies, so your patience is appreciated. In special circumstances, the physician will try to set up a formal meeting with your family to discuss the situation in more detail.

Where will they go after Critical Care?

Most patients who survive their critical illness and improve, will be transferred out of Critical Care to a regular bed in the Hospital. Remember that they will have a new doctor managing their care once they leave Critical Care. The health care team will assess their condition on a daily basis to determine what level of care they will need when they leave the Hospital. Some patients are able to make enough recovery to go back home. However, some patients will be too weak to go home and will need to be transferred to a facility that provides extensive rehabilitation. In these situations, case managers are available to provide you with information about the options of various facilities where your loved one can go after their hospital stay.