Having a loved one in the ICU: the forgotten family

An appreciation of the post-ICU burden for family members, as well as the ways to prevent and minimize their symptoms of stress, anxiety, and depression.

The long-term consequences of critical illness are growing in importance as the aging population increases its demand for critical care, and as the short-term mortality after critical illness decreases. Recently, postintensive care syndrome family was proposed as a new term for this cluster of psychological complications. Critical care providers are now recognizing the need to also address the psychological needs of the relatives earlier after ICU admission.

A high proportion of family members present with symptoms of anxiety (70%) and depression (35%). Acute stress disorder and posttraumatic stress disorder (PTSD) related symptoms are also common. These symptoms are significantly more frequent when the relative is a spouse, or in bereaved family members. Few long-term data are available. However, in family members of dying patients, 1 year after the loss, up to 40% of them present with criteria for psychiatric illness such as generalized anxiety, major depressive disorders, or complicated grief. Prevention of post-ICU burden, mostly based on communication strategies, has been proposed to assist relatives.