People are admitted into an intensive care unit when they are so seriously ill that they need intense treatment, constant monitoring and 24-hour nursing care. The length of time people stay in ICU depends on the extent of their illness or injuries – some may recover quickly and others will need to stay in ICU for weeks. A patient in ICU receives the best care and every treatment the medical team believes will help them to recover. On occasions when recovery is not possible, the medical team will discuss with the person’s family whether certain treatments such as ventilation (life support machines) or kidney dialysis machines should be discontinued. If appropriate, the doctors may also talk to family members about organ donation.

When people are admitted to intensive care as emergencies – for instance if they have been in a car accident – they may be unconscious and have no awareness of how seriously ill they are. For this group of people, it is only after talking to relatives and health professionals later on, that they learn how ‘close to death’ they’d been. After regaining consciousness and becoming alert, some people said they felt ‘scared’ in intensive care because they were aware of how ill they were and that people around them had just died.

Some people told us that they’d been aware of a sudden increase in activity whenever a patient died in ICU. Others said they only became aware of a death when they heard relatives crying, and that this could be upsetting and frightening. Many empathised with relatives who had to cope with the news of a loved one’s death and with the medical staff whose job it was to break the news (see ‘When someone dies in intensive care: experiences of family & friends’). Others praised the staff for their caring and accommodating approach when people did die in ICU.

It is, of course, traumatic for those whose relatives die in intensive care but everyone deals with loss and bereavement in different ways. ICU staff do as much as possible to help support families. Families are usually given as much privacy as possible. Staff make sure that relatives know what they are expected to do about making arrangements for funeral services, and that they are aware of the support available in the days ahead. One woman we talked to explained that her 14-month-old daughter died in intensive care because of a rare form of meningitis. She discussed donating some of her daughter’s organs to help two other children to survive.

Coping with bereavement

Bereavement is a difficult time and some people told us that it had helped them to talk to people outside the family. Some saw counsellors and psychologists inside and outside the hospital to help them talk about their feelings. Several people mentioned how difficult they found coping with the anniversary of a death. One woman, whose unborn baby died in intensive care, said she found the anniversary of her child’s death so difficult that she couldn’t work on that day. Spending time with her family helped her cope with her loss a little better.

Some people recommended contacting these organisations or talking to others who’d been through something similar. There are many organisations that are there to help people cope with loss and bereavement (see our dying and bereavement resources).