Your loved one has been admitted to the ICU because their body can’t work normally. If they don’t get special help, they may have serious long-term health effects or they may die.

Your loved one needs to let their body rest. They may get strong pain medicines or sedatives. They may be connected to special equipment that supports their body.

Seeing your loved one in the ICU for the first time can be stressful. You may feel helpless. Your loved one may be connected to machines, and they may not look the same as usual.

If you have questions about what is happening, ask the ICU staff. They’ll explain what they’re doing and give you updates. Any care decisions will be discussed with the family or the spokesperson.

What to expect

Information and forms

You or your loved one may get an information package about the ICU, including contact information. Review it carefully and ask questions if there are things you don’t understand.

You may also get a form with questions about your loved one. Filling out this form helps the staff get to know your loved one. It will help them give more personal care. The form asks for information such as your loved one’s preferred name and what did or do for work.

If your loved one can’t speak for themself, ICU staff will also talk to you about a personal directive (a living will) or your loved one’s care wishes. Staff may ask about Goals of Care or a Green Sleeve.

Whiteboard

You may see a whiteboard in the ICU room. Check it for updates. It lets everyone know:

• the plan of care for the day
• the plan for mobility, such as moving limbs in bed or sitting up in a chair
• the names of the staff members caring for your loved one
• the date

It also has a space for you to write questions or concerns you want to talk about

Behaviour changes

Sometimes people in the ICU may act differently than usual. It may be because of how ill they are or a medicine they’ve been given. This is called ICU delirium.

Your family member may be:

• agitated
• confused
• scared
• paranoid (believing people are trying to hurt them)

They may also hallucinate (see or hear things that aren’t really there) and have nightmares that seem real.

Some people may be at risk of hurting themselves or others when they get agitated or confused. If this happens, your healthcare team will do everything they can to help keep your loved one from hurting themselves. As a last resort, they may need to use restraints on wrists or ankles. Staff will talk to you about using these and regularly assess how long these may be needed.

As your loved one starts getting better, they will get less sedatives. They may be drowsy, confused, or agitated while the dose is being lowered.

Tell ICU staff if your loved one uses tobacco, alcohol, cannabis, or other drugs. They may have withdrawal and staff can help treat the symptoms and take care of your loved one.

Behaviour changes can be hard for you to see. You can help your loved one by staying calm. Talk to them about your daily life, the weather, and tell them they aren’t alone.

Privacy

The ICU can be busy. Your loved one’s bedside may be crowded with machines, equipment, and chairs. You may be asked to leave at times when your loved one needs treatments or procedures, such as x-rays or dressing changes.

You may also be asked to leave to protect the privacy of another patient in the next room or cubicle.

Transfers

Your loved may be transferred (moved) to a different hospital if:

• They need special care that’s not available at your hospital.
• Your hospital doesn’t have enough ICU beds.
• Beds at your hospital are needed for those who are more seriously ill.

A transfer can be upsetting. You may have to travel farther to visit your loved one. The ICU staff and doctors always consider their patients’ needs before they make a transfer. Patients are only transferred when absolutely necessary.

How you can help

Remember that you are an important part of the ICU healthcare team. There are many things you can do to help your loved and the ICU staff.

Join patient-care rounds

You are welcome to take part in patient care rounds that happen every day. This is when the whole healthcare team discusses:

• treatments
• progress
• the plan for the day

Staff will talk to you and your loved one about treatment options as they come up. If there’s anything you don’t understand or want to know more about, ask the staff.

If you have comments or concerns, talk with your nurse, the charge nurse, or the unit manager. They’ll help answer your questions or look into your concerns.

If you still have concerns or don’t feel like you can talk to the staff on the unit, you can contact the Patient Relations department.

Choose a spokesperson

Choose a spokesperson (primary contact person) early in your loved one’s stay in the ICU. This person may be a spouse, child, other family member, or significant other. Your loved one in the ICU may have already decided who the spokesperson should be.

The spokesperson will get regular updates about your loved one. They’ll be expected to share this information with everyone who needs to know. Having only 1 person to update allows the ICU staff to spend more time caring for your loved one and less time making calls.

Communicate with your loved one

Your loved one may be able to hear what’s going on around them, even if they’re sedated or not awake. Many nurses talk about what they’re doing as they provide care. This can be reassuring, even if your loved one doesn’t remember it later.

Talk to your loved one, whether they are awake or not. Tell them what’s happening outside, what the kids are doing, or anything you’d normally talk about. This can help your loved one relax and feel more connected and cared for. Talking about shared experiences of holidays and good times can make you feel better too. You could also try reading to your loved one out loud.

Your loved one may find it hard to talk to you even if they’re awake. But they may be able to:

• Write
• Point to words, letters, or numbers on a piece of paper.
• Use a cell phone to text or “talk”.

Give personal care

ICU staff may suggest you bring personal items, such as your loved one’s favourite books or music, to help their recovery.

You may want to be involved in your loved one’s care. What and how much you can do depends on how ill your loved one is. Talk to the staff if you want to help.

You may be able to do things such as:

• brushing their teeth
• massaging their hands, feet, legs
• putting lotion on their hands and feet

Keep a diary

You can keep a diary of what’s happening each day. It can help you to look back and see small changes in how your loved one is doing.

This diary can also help your loved one understand and remember what happened to them. They may remember only a little or nothing at all about being in the ICU.

Many ICUs in Alberta provide a notebook for you in the ICU information package. You can use this for your diary or to write down questions that you want to ask.

Help stop infection

People who are critically ill may be at higher risk of infections. Staff will do all they can to protect your loved one.

You can help too by cleaning your hands with soap and water or using hand sanitizers (alcohol-based hand rub) on the unit. Clean your hands:

• Before you enter the ICU.
• Before you go near or touch your loved one.
• When you leave the ICU.

It’s OK to ask staff and other visitors to clean their hands too.

Your loved one may need isolation precautions to protect them from infection or to protect others. If this is needed, the staff will be show you how to put on the masks, gowns, and gloves.