It’s a quiet day at the base camp when the enemy suddenly launches an attack. The main character is scrambling to respond to the incoming fire, making quick decisions about how to respond to a danger that is largely outside their control.
“When you put that in the hospital, the sudden change in health is that my mom or dad was fine yesterday, and they’re now in the intensive care unit for life support,” said Amas, first author of the study.
He said admitting a loved one to the intensive care unit has always been an inherently stressful – and often painful – process, but the Covid-19 pandemic has prompted researchers to look more closely at the effects.
Amas and his team surveyed family members in the months after a loved one was admitted to the intensive care unit with Covid-19 at 12 hospitals across the country. Many of the subjects studied had limited visitation and patient contact.
The study found that among the families who responded to the survey, 201 out of 316 (about 63%) had significant symptoms of PTSD.
Stein, who is also a distinguished professor of psychiatry and public health at the University of California San Diego, added.
Add focus to families
The health care community can take two important steps to help improve families’ experience: pay attention to their risk factors and make a greater effort to empower them, Amas said.
“What the literature really suggests is that the more you can involve someone at the bedside, the more empowered they will feel to express their needs and the needs of their loved ones,” he said.
In addition to the survey, the study also used narrative interviews to get more details about the factors that made a difference for families.
Some have managed to experience employees who go the extra mile to make them feel connected and engaged even when they are not there.
One family member said, according to the study, “What made it easier were the video visits, video calls, and daily updates. I called and spoke to the nurses every day, and talked to the doctor.”
But other survey participants felt that the communication they received was limited and reported feeling helpless and afraid.
“They called us and said, Do you want us to pull the plug?” …you said how did you go from going home to pulling the plug? … They said her mouth was moving and her eyes were moving but they said she was dead… So, they went on and pulled the plug anyway,” another family member said.
Particularly at the start of the pandemic, hospitals were overwhelmed, and staff worked long hours to provide the best possible care. Amas said it’s often the small acts of kindness that families need to feel involved and care for loved ones who need it — such as asking for a picture that hospital staff can hang to make a patient feel happy.
“Even a small act of empathy from a family’s health care team can have a really powerful impact on these family members and their risk of developing these[PTSD]symptoms,” Amas said.
More research may be needed to figure out how health care providers can best handle families after an ICU stay, but this latest study indicates a need for more robust services, Stein said.
“The results in these surveys were so high that I would advocate for providers to actively screen family members for depression, anxiety and PTSD clinically so that they can get treatment,” Amas said.