Impact on children

Here men and women talk about the effects on children when a relative, partner or close friend was critically ill in ICU. This included both dealing with decisions about visiting ICU, which can be a frightening and unfamiliar place, but also making practical arrangements such as childcare.

When a person becomes critically ill, it affects everyone he or she is close to. Relatives and close friends often need to make many practical arrangements so that they can visit the patient, including time off work, child-care, elderly care, and care of pets and homes. Many people said they’d had to think about children and grandchildren as well as themselves when the patient had suddenly become critically ill and been admitted to ICU. Child-care arrangements often had to be made quickly so they could visit ICU all day, every day, at least during the early stages. One woman explained that, when her son had had a car accident some distance from where they’d lived, she and her husband had had to stay in a hotel near the hospital. Her mother had had to move into their home and look after her two younger children, aged fifteen and ten. She’d also had to inform their teachers about what had been happening.

Her husbands mother sat at her son’s bedside so she could go back home, organise child care and…

Age at interview 49

Gender Female

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[My husbands] parents came up and they took over from us [by sitting at the bedside]. And we went home and got our stuff together. My mum moved in. And then the next morning, we obviously were phoning the hospital, that was very hard actually being back away from him so far. But we had to really prioritise the other two and make sure they were okay and give them normality back. So the next morning, we saw them both to school and we went in and we spoke with the schools. And they obviously then were very aware of what was happening and were keeping an eye on the situation.

The middle son, he felt that he couldn’t cope with school to any great degree. But the school, it was a catholic school and very, very good mentoring, where they said, ‘Look, just come in, chat, do what you want. Both boys had gone to that school, so they knew both of them.

So they’d said prayers for him in school and it was all very, very emotional from that point of view.

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Another woman said her mother had become critically ill during the school holidays. After telling her two young daughters what had happened, she’d asked them if they’d wanted to visit the hospital or stay at home. She’d been surprised that they’d wanted to visit and how easily they’d accepted what had been happening. Although they’d been frightened on one occasion, when her mother had had a problem with her breathing tube, throughout her time in ICU they had been keen to visit, ask questions and had shown an interest in what had been going on.

She was very honest with her two young daughters about their grandmother’s illness and about how…

Age at interview 37

Gender Female

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I involved the girls in everything. They knew there was a high possibility she [her mother] would die. I explained everything to them. Whether rightly or wrongly. And they were absolutely fine about going in. And one of the consultants said to me, They are very confident in ITU. They would go off, wed would get in, they would go and get chairs for us all. They knew were the chairs were kept. They would put the chairs out for us, they would wash their hands. They would sit and talk to Mum. We would talk about the machines. They were completely unfazed.

There was a gentleman opposite on a rotating bed, which looked quite scary. They would ask questions about what was happening. They were more interested in what was happening rather than being scared by any of it. But, as I say, kind of the older generation thought I was doing wrong by taking them in. But they are so close to my Mum that I couldnt just leave them out of it. They needed to know what was happening and they coped absolutely fine with it.

Yeah. And did they ask questions later as well or even now, do they talk about it?

Very rarely. They were obviously here helping when Mum came home. And they knew that she could and couldnt do things. And occasionally they referred back to it. Generally her pulling funny faces and things. They don’t seem to remember any of the scary stuff because they accepted that so well. They just remember the funny moments and we talk about it. If it comes up we talk abut it. And they tell my Mum things that she was doing while she was in there, which she doesnt know about. But yes they have accepted it quite well.

And did they see how upset you were or did you try to keep that back a bit?

No. If I was upset, if I needed to cry, then I did it with them as well. Because I believe that they needed to know it was all right to cry. don’t keep it all inside, so if they cried and [my younger daughter] was too young, but [my older daughter] did keep saying is she going to die, is she going to die, and I was honest with her. We don’t know. When we went to see the doctors or the consultants I would ask them in front, if a child was there, I would ask them as well, you know, Do you think she is going to make it? So they heard from the doctors as well that they werent sure what was going to happen. And I just explained everything. As I say, obviously in more basic details for them to understand. But they knew everything that was going on and they would ask me about all the other patients as well. What was happening. They werent frightened. If I took them to the toilet, there was a lady that had been a long time, and we stopped and talked to her and they were quite happy. She had had a tracheotomy and ventilator and things and they were always quite happy to talk to her as well. Because they just werent scared by anything.

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ICUs vary in terms of their visiting policies and whether they allow children to visit. Some do, others don’t, and some only allow children above a certain age because it can be frightening for very young children and they are at a higher risk of catching infections. Some people said they’d discussed whether they should allow their children to visit the patient with ICU nurses first and then decided what was best under the circumstances. Everyone is different and parents and families had decided what to tell children, what not to tell them and when, depending on their own personal situations, how ill the patient had been, and on the emotional strength of the children to cope with the information. Some people had felt their children or grandchildren had been too young to visit ICU but had got the children to make cards and record messages for the ill person. A few said that they’d talked about their grandchildren to the patient when he or she had been sedated or unconscious and this had had a positive effect. One man said his wife’s monitor readings changed whenever he played a recorded message from their grandchildren.

He and his son talked with ICU nurses and decided to let his son’s nine-year-old and seven-year…

Age at interview 67

Gender Male

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Were you allowed to go to the ICU whenever you wanted or were there specific visiting hours?

No, I was immediately assured that 24 hours, I could go just whenever I wanted.

And as you live quite far from the hospital, were you able to go every day and stay there? Or what was your routine over those five days?

Yes, I was able to go in. There was a unit there I could have stayed. I was offered the chance of staying. And as it happened, domestic things here, I wanted to come back and do some things. But there was complete freedom. And the other thing which we were very pleased about, our son came down with his family. I discussed, two of our grandchildren are aged 9 and 7, discussed with the staff in Intensive Care, although my wife was completely incoherent, babbling in sort of pseudo-German, she was in fact a German teacher and, although she obviously had tubes all over her, we discussed whether the grandchildren should come and see her. And they left it entirely to us. We decided that it was the right thing to do and that it, and, you know, the proviso being no more than two people at the bedside at a time. Which we accepted. But we were sure that was the right, in our case, the right decision for the children to see her.

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Some people said they hadn’t wanted to take children into ICU but, depending on the situation, had had to reconsider what to do and what to tell them. Maintaining a sense of normality for children had been important for many people, who’d felt it vital not to disrupt their children’s daily lives too much. One woman said that, when her best friend became critically ill, her friend’s fifteen-year-old son had to be told about what had happened. He’d stayed with his grandparents throughout her illness and they’d all tried to ensure his life was kept as normal as possible. She observed how children can react differently to news of illness and said he’d found it difficult to see his mother so ill and weak.

Her friend’s son didn’t understand how seriously ill his mother was until afterwards and stayed…

Age at interview 37

Gender Female

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It must have been quite a shock for her son?

It was, but being 15 nearly 16, although he understood what was going on, I dont think he understood the enormity of the situation, the fact that his mum, you know, could possibly die. I dont think that sunk in until she was probably weeks later and getting better.

Was it explained to him or did you feel maybe not to go into so much detail and hold on to some information back to protect him?

He was aware before he went away for the weekend that she was going for a sterilisation procedure. And we told him that there were some complications and shed ended up with these problems with her breathing and she needed the ventilator. And thats why she was in hospital and she was sedated so she wouldnt be distressed. But it seemed just to go right over his head [laughs] really, you know. He was concerned because it was his mum but I dont think he really understood or took it all in. It was quite strange because although he knew his mum was ill he didnt particularly want to be sat at the side of her. He was quite happy to sit in the waiting room and be told by everybody else what was going on. And obviously we didnt that we wanted to force him to go and sit with her at all. So that was what happened. His days were tried to be kept as normal as possible. He was at college at the time so he continued to go into college. He was staying with his grandparents who only lived a couple of doors away from his mum and his house. So he could go home if he wanted to and he slept there and ate there and went to college. Came with them to the hospital in the evenings.

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Depending on their ages, some people had told children that the patient’s illness or injuries had been life-threatening. Others had chosen to mention this only if the patient would definitely not survive or recover. Some said they’d told their children a bit about the patient’s illness but, as time had progressed and it had looked like the ill person wouldn’t survive or fully recover, they’d felt it appropriate to tell their children more about the condition and allow them to visit.

When her brother had been in ICU for two weeks, she let her two children visit him in case he…

Age at interview 52

Gender Female

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I personally have two children as well, again twenty-one and eighteen and I wouldn’t allow them to go and see [my brother] in the ICU for the first two weeks. I personally thought the vision is too much for what I deem as youngsters, even at eighteen and twenty-one, I think when you visually see a member of family like that and the alarms going off and the buzzers going off if the heart rate would drop low and buzzer sounds. And I thought that was not good for youngsters to see. But obviously as the time dragged on and I did have to let them go and see him in the end because it seemed, well it seemed at that point he wasn’t going to recover [laughs]. So that’s another thing really. I don’t know whether that was right or wrong but anyway that was the course I chose.

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One woman, whose son had had a car accident, explained that, after ‘seeing that he looked like him still’ in Accident and Emergency, she let the two younger children see him too. He was then taken into ICU and they also visited him in ICU and HDU. She said that seeing their brother critically ill in ICU had made the two younger children realise just how close they all were as a family, and they’d all supported one another. Another woman said her partner’s grandchildren all visited him in ICU when he was critically ill. The youngest was fourteen and, although they’d all been upset, they’d been able to cope with and accept what had been happening.

Many other people who had taken children into ICU, of various ages, had also felt they’d been able to cope with the news, maybe because they’d known they’d had a lot of support around them. One man said he and his family had allowed the older children to visit their critically ill grandfather and, only when he’d started improving in HDU, allowed the younger children to visit. He felt it was important to prepare children for seeing the patient and constantly reassure them. He and his family had also felt it important not to mention that their grandfather’s illness had been life-threatening.

Many people had wanted to maintain a sense of normality for young children and some had wanted to do so for grown-up children too, worrying that they had many other responsibilities to take care of, including their own young children or babies. A few parents said they hadn’t told their grown-up daughters exactly how ill the other parent had been because they hadn’t wanted to worry them unless it had become absolutely necessary.

She downplayed her husbands illness to her daughters because she didn’t want hospital visiting…

Age at interview 49

Gender Female

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I kept things back from my daughters because I didnt want the hospital taking over their lives. I wanted them to have something in between. I mean like one of them’s got a little boy and the other’s got two, the baby and a little girl. And I didnt want. It was monopolising and taking over my life which it should have done, he was my husband and I know he was their father but I kept things from them [laughs]. And I was there one night and it was like 10 oclock and [my daughter] phoned up and she said shed phoned up Intensive Care and one of the nurses shouted, It’s your daughter. What’s the matter with my dad? And I said, Nothing why and she said, Well if theres nothing the matter with him why are you still there, you know. So I said, Oh. I think I told her a lie. I think something was going wrong and I said, Oh hes just, I’m just on my way now hes just, I’m just waiting for the next blood check or something. But I mean like I just used to try and keep some stuff from them because they didnt need to know everything. I mean things were bad enough anyway without everybody, you know. It was just chaos really.

And did they know how seriously ill he was or that…?

Yes they did, yeah. But I used to try and play some bits down a bit, you know with. And if they rang me and said, you know, Hes going to die, something’s really wrong here you need to get up here. Then I would have rung them and said it but if I thought perhaps they were being a bit overly cautious which sometimes I thought they perhaps were then I wouldn’t ring them. Id, although I know they were the experts I used to think, Well you know, weve been here before, Ill hang on a bit. And then hed pick up.

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