Caregivers of ICU patients discharged home: what burden do they face?

Reforms in healthcare aimed at cost-cutting have led to early hospital discharge for many patients, including those who have sustained critical illness or injury requiring admission to an intensive care unit (ICU). Many former ICU patients experience ongoing health-related problems following discharge from hospital, and need ongoing support and care from their family once discharged. However, family members who take on a caregiving role often experience an enormous burden. The literature has demonstrated the impact of economic, social, physical and psychological factors on those who care for the critically ill following discharge. It is therefore essential that all nurses involved in the ongoing management of ICU patients have an understanding of the caregiving role, and consider both the patient and his/her carer in the discharge planning process. This paper reviews the literature on caregiving, and examines research studies which describe and measure the factors involved in the caregiving role. Although only a small number of studies specifically focus on caregivers of former ICU patients, findings suggest that these caregivers experience a substantial burden which is associated with the complexity of the patient's physical and psychological impairment, and complex technology. To enable nurses to incorporate planning strategies and interventions aimed at minimizing the impact on the caregiver, further research is needed to more fully explore, examine and measure the factors involved in caring for ICU patients post-discharge. Furthermore, ongoing research and evaluation of interventions will build an evidence-base to inform future practice.