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Zwolle – PICS and PICS-F are abbreviations for diseases that require less and less explanation. Something IC nurse Hadewey Kiekebos of Family Guidance is happy with. “Fortunately, awareness of post-intensive care syndrome and the family of post-intensive care syndromes is increasing. But it can certainly get better.”
“Post-intensive care syndrome is a collective term for a variety of physical, cognitive and psychological complaints that the patient can experience after a long-term admission to the intensive care unit,” says Hadewey. “However, what is less known is that family members often experience discomfort after their loved one is admitted to the intensive care unit.”
“Research shows that 30% of the patient’s relatives suffer from psychological problems such as anxiety, depression and even the risk of PTSD or post-traumatic stress disorder. Family members may suffer for up to six months or longer after their loved one is admitted to the intensive care unit. If PICS-F is not identified in a timely manner, it can lead to an escalation of all kinds of complaints. People can no longer carry out their work properly or fulfill their duties as informal carers. Therefore, preventing PICS-F through good care is very important.”
Attention, recognition and information
“Fortunately, thanks to research and our own experiences, we are becoming more knowledgeable about how to guide our loved ones in a way that can help prevent PICS-F as much as possible.” This guidance begins immediately when someone is admitted to the intensive care unit becomes. From now on we will accommodate the family we brought with us in one of the two family rooms in the intensive care unit. There we inform you about the practical procedures in the intensive care unit and answer as many questions as possible about your relative’s health situation. We know from research that providing good, compassionate information helps reduce stress and uncertainty in loved ones and therefore prevent PICS-F.”
“We also look very closely at what the relatives need,” says Hadewey. “No ICU admission and no two families are the same. Relationships between family members can also cause tension. For example, when determining who will act as the contact person for the intensive care patient. We also try to accompany our loved ones in making such decisions so that there is as little stress as possible. Contact and attention from person to person are the key words.”
To write a diary
In addition to providing information and advice throughout the ICU admission – which can last a few days, weeks or, in some cases, months – Family Guidance nurses also recommend that families keep a diary after the ICU stay. “The post-IC diary is digital; relatives can also use a paper diary instead,” says Hadewey. “After receiving a consent form with a unique code, relatives can install the diary app. The added value of this diary is that multiple people, including the ICU nurse, can write in the diary and photos of the patient can be added. In addition, information on PICS and PICS-F can be read, which is very important for identifying complaints.”
Puzzle pieces in place
Writing down what happens day by day can help you process all the intense feelings that come with being admitted to the ICU. For loved ones, but also afterwards for the patient. Hadewey: “After being admitted to the intensive care unit, patients can often barely remember what happened. They were kept in artificial sleep during admission, and in the meantime they may have had to undergo drastic and painful procedures. Nightmares, memory fragments and fear can result.”
“As you read the diary, pieces of the puzzle often come together; Suddenly someone understands where certain feelings come from. This helps with processing. Conversely, the patient can also read how difficult and stressful the time in the intensive care unit was for their relatives. This helps to understand each other and talk about it together. This also helps with the processing of admission to the intensive care unit.”
Family nearby
In addition, research also shows that the opportunity to be present as a family in the intensive care unit and to be involved in the care are important pillars for the prevention of PICS and PICS-F symptoms. Hadewey: “It works both ways. It helps family members to be better prepared for their role as informal caregivers, while at the same time the patient experiences support and confidence through the presence of family members.”
Follow-up care and return day
After a stay in the ICU of 2 days or longer, patients and their families also receive follow-up care from the IC Aftercare Outpatient Clinic. If they feel the need, they can go to the aftercare clinic to talk to the intensive care nurses and the rehabilitation doctor about their possible complaints after admission to the intensive care unit. The aftercare clinic also organizes a return day every year for intensive care patients and their families. Read the article about Return Day last November here.
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