How to write in an ICU diary?

Write directly to the patient and tell them anything you feel may be meaningful. Do not hesitate to describe the positive moments during their hospital stay, but also the difficult events and how you felt. These experiences—especially the difficult ones—may matter greatly to the patient once they regain full awareness, helping them understand the extent of what they have been through.

A word of caution: while it is helpful for patients to understand what they and their loved ones experienced, an intensely emotional diary may leave them feeling guilty—for example, for having put those close to them through such a difficult time—and make the diary harder to read. If you need somewhere to express everything you are feeling, consider keeping a separate personal journal in which you can write freely about your fears and emotions.

Describing any episodes of delirium or hallucinations, as well as ordinary events during the hospital stay, can help the patient make sense of unusual memories later on.

For example: telling them that they spent a long time staring at a mark on the ceiling, or that building work made the unit very noisy all day, may help them understand a strange memory of seeing an animal in their room or feeling as though they were in the hold of a ship.

Do not censor yourself. Anything can help, because in reality… we have nothing to fill in the gaps.

Former ICU patient

Place what is happening to the patient within the wider context of everyday life. Describe what is happening at home—the children’s progress at school, the changing seasons, a relative’s travels, and so on. Mention events in the outside world, such as sporting results linked to the patient’s interests, major news stories they have missed, or political events. Putting their experience back into context can help them rebuild their personal story.

It is important to:

Write events in chronological order
Date and sign every entry
Remember that a short note each day is better than a long summary at the end of the week, as daily entries capture the small details that may later be invaluable to the patient
Keep writing after the patient wakes up—at least until they leave the ICU, and possibly until any lingering cognitive difficulties have fully resolved. Patients may be awake for several days before leaving the unit yet retain no memory of that period.

You can:

Add messages or letters from people who cannot visit your loved one
Add sealed envelopes for messages intended for your loved one alone. LifeMapp Diary allows you to write private messages that only the patient can access.
Add photographs of everyday life that the patient is missing
Add children’s drawings
Photographs of the patient during their hospital stay may help them understand the different stages they went through. However, we recommend placing these photographs in sealed envelopes with a warning: seeing themselves in this condition can be both therapeutic and deeply upsetting. In LifeMapp Diary, photographs can be marked as “sensitive content” to protect the patient and any other readers who may find them distressing.

Jean-Yves’s story
The ICU diary: a testament to our shared humanity