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Rebuilding after Chronic Critical Illness

** This session earns RN and CCM Ethics **
Patients and families tell professionals they suffer during and after Chronic Critical Illness. Patient's fear, frustration, loss, worry concentration lapse, guilt and sadness are among some of the responses to hospitalization for serious and elongated illness. Caregiver burden grows with the changes of these strong and influential emotions, confusion over changed relationships, and the loss of 'self based on forced adaptation to provide care. Evidence supports the prevalence of Post Intensive Care Syndrome manifested in family decision makers as depression, anxiety and PTSD. Also, critical illness survivors who report symptoms of depression are at an increased risk of dying in the 2 years following discharge. Factors of delirium, deconditioning, severity of illness, pre-existing dementia, frailty and ICU acquired weakness are the risk factors identifying patients in need of intervention. Presentation of published interventions and the expanding post-acute and post-long-term-acute transition plan for those at risk are reviewed.

  1. Recognize patient and family responses to critical illness or injury.
  2. Integrate the value of family engagement in the treatment and transition plans.
  3. Describe the adjustment in coping with post-critical illness in the after-plan.