Aging and Postintensive Care Syndrome– Family: A Critical Need for Geriatric Psychiatry

Abstract

Post-intensive care syndrome-family (PICS-F) describes the psychological symptoms that affect the family members of patients hospitalized in the intensive care unit (ICU) or recently discharged from the ICU. Geriatric psychiatrists should be concerned about PICS-F for several reasons. First, ICU hospitalization in older adults is associated with higher rates of cognitive and physical impairment, compared to older adults hospitalized in non-ICU settings or dwelling in the community. This confers a special burden on the caregivers of these older ICU survivors compared to other geriatric populations. Second, as caregivers themselves age, caring for this unique burden can be more challenging compared to other geriatric populations. Third, evidence for models of care centered on patients with multimorbidity and their caregivers is limited. A deeper understanding of how to care for PICS and PICS-F may inform clinical practice for other geriatric populations with multimorbidity and their caregivers. Geriatric psychiatrists may play a key role in

Raising awareness of the needs of older COVID patients after hospital discharge

“…If the results indicated that assistance was required, social workers and, where necessary, psychologists or psychiatrists could be contacted to provide support. The family's perception of the quality of care received by their loved one, their confidence in open communication, and their access to resources to help reduce the care-related and social burden are key contributors to reducing the psychological impact of PICS [14].…”

“…Old patients recovering from severe respiratory illness present secondary disability resulting from intensive treatments. This includes (but is not limited to) acute unit-acquired weakness, long-term cognitive impairment, and poor mental outcomes [4,5,12], while the patient's family members, especially the older ones, will suffer a high psychological burden [13,14].…”

Customised Care: Post Intensive Care Syndrome

“…This patient met the previously described PICS symptomatology. Patients treated in an ICU have a wide range of baseline situations before admission, primary diagnoses, comorbidities and other factors that may influence burden and coping capacity [29] Known factors present that influence the outcome of the patient’s recovery programme were: old age, extensive medical history, unknown baseline situation and good support from the patient’s wife and family [12, 30-33]. The significant medical history and unknown preoperative coping capacity made it difficult to estimate the patient’s postoperative function and the feasibility of achieving the ultimately desired function.…”

Family-Centered Care in the Intensive CareUnit—What Does Best Practice Tell Us?

“…While survivors of critical illness are at risk for developing postintensive care syndrome, family members are similarly at risk for post-ICU syndrome family (PICS-F). 16,61 Caregivers face significant challenges postdischarge including the need to quit or change jobs, as well as significant economic hardships. 62,63 In one prospective study, 67% of caregivers of critically-ill patients had depressive symptoms initially and 43% reported symptoms 1-year post discharge.…”