After intensive care, it can take time for patients to find their bearings in everyday life. The physical, psychological and cognitive effects of critical illness may make returning home and resuming a “normal” life difficult. As someone close to the patient, your support can be extremely valuable. Ask what help would be useful and check that the support you provide matches what the patient actually wants and needs.
Learn more about the physical effects of intensive care
Learn more about the psychological effects of intensive care
Below are some practical ways you may be able to help:
Plan essential activities The patient may need help anticipating and preparing meals, organising care, preparing and taking medicines, remembering medical appointments and getting to them. Making sure these essentials are covered—and offering the right level of support—may help both of you feel more secure.
Support rehabilitation Going outside can feel daunting after intensive care. Offer to accompany the patient for a short walk. With their agreement, help create a gentle rehabilitation routine: simple exercises together at home, physiotherapy, cognitive rehabilitation and healthy daily habits.
Coordinate support from others You do not have to do everything yourself. Ask friends and family what they can realistically help with. You could organise a rota for visits and outings and share tasks and responsibilities among family members.
Establish a reassuring routine Routine and predictability can be comforting when someone feels anxious. They can also reduce the mental load when cognitive difficulties are present. Help the patient create landmarks in the day: fairly regular meal times—which may also support medicine schedules—a consistent bedtime, planned rest periods, walks and leisure activities.
Maintain a link with the outside world Encourage a gradual return to everyday life. Suggest outings that feel manageable, plan gentle social contact together and support the patient in returning to hobbies, while respecting their pace. It may take time before noisy or unpredictable environments feel safe again. Interests and priorities can also change after intensive care, so remain open to that possibility.
Look after yourself The strategies that helped you cope while the patient was in intensive care may still be useful. Keep taking breaks and preserve some time for yourself: walk, read, have a coffee, breathe or spend a few quiet minutes alone without guilt.
Look elsewhere for help and ideas Build a support network of friends, extended family, charities, patient groups and family-support groups where you can exchange advice and experiences. You are not alone, even though setting this up may take some initial energy. It can be well worth it.
Begin reclaiming your own life The patient may still have a long recovery ahead, which can create a difference between your respective experiences. You, however, can begin returning to parts of your usual life—work, outings, hobbies and friendships. Your mental health depends on it, as does your ability to provide sustainable support over time.
Continue what was helping Did encouraging messages, photos, funny videos or other small gestures comfort you while the patient was in intensive care? Ask the people who sent them to continue for a while. Leaving the ICU closes one chapter, but it does not mean that support is no longer needed.
Create a sense of security After intensive care, you may become frightened of many things—especially a relapse or another health problem affecting someone close to you. Small health-related routines may provide reassurance: a medication record, an appointment calendar and a clear list of warning signs and what to do if they occur.
Céline’s storyOverprotectiveness
Families are often told that while a patient remains in intensive care, the situation can still change at any time, and that leaving the ICU marks the end of the most uncertain and frightening period.
After the transfer, you may therefore feel enormous relief. At last, the hardest period appears to be behind you and you may hope to regain some normality, lightness and freedom from anxiety. You are right to feel relieved and to celebrate this important milestone with the patient and those around you.
However, although the worst may indeed be over for you, the most difficult phase may only now be beginning for the patient.
Many patients remember little or nothing of intensive care. They may have spent much of the time sedated or unconscious. Although they may retain real memories mixed with hallucinations or nightmares, they have not processed the situation in the same way that you have.
I felt there was a gulf between her condition and my expectation of being reunited in this incredibly intense way—as though we had both lived through the same fear, worry and anguish. But when we were finally able to talk, she simply said: “I don’t remember what happened.”
Throughout that whole period, we had lived with the idea that she was somehow experiencing it too—that we shared something in common.
But in reality, we did not.
So much happened to us during that time, including things between the family—conversations and moments of tension. For her, it was as though none of that existed.
Of course she remembers her nightmares and tells us about some terrible experiences. But yes, there is clearly a gap: she was not conscious in the way we were.
Laurie, who supported her friend Marine during intensive care
After intensive care, patients often begin to understand something that their family recognised from the first days: their life had been in danger. It is therefore often only after leaving the ICU that they start to grasp the scale of what happened.
This is also when they may become aware of their new vulnerability, physical weakness, psychological and cognitive after-effects, and the distance still to travel in recovery. They may realise that they remain dependent on healthcare professionals, treatment and those close to them. This can be frightening or depressing and may deeply shake their confidence. Patients also often feel guilty: guilty that their illness caused distress to family and friends, or guilty that they are not recovering faster and have not yet regained their independence or previous family and social roles.
These factors can combine and contribute to depression, which is common after intensive care. Stay attentive and encourage professional help when needed.
You may see the period after intensive care primarily as a time to move forwards and rehabilitate. You can see how far the patient has already come, but the patient may feel as though they are standing at the foot of an enormous mountain without knowing whether they can reach the top.
Another source of tension may be the patient’s need to understand and revisit a period of which they have few clear memories, while you may want to put it behind you. If these conversations are too painful, you could communicate in writing or agree on specific times to discuss intensive care while protecting other times when you both choose not to talk about it.
You may long to have the person and the life you knew before, just as the patient begins to realise that they have changed and may never be exactly the same. They may need you to understand this. Intensive care can be life-changing, and some people need time to rediscover who they are.
These differences can be difficult and may unsettle your relationship. Open communication is often essential. Couples or family therapy may sometimes help, as can talking to other relatives who are living through—or have lived through—the same experience.
To talk with other relatives who have been through a similar experience, join Second Life, a community for intensive care and life afterwards. This private, secure network welcomes patients, relatives and healthcare professionals. It offers personal stories, peer discussion, advice and information so that you feel less alone.