Effects on children
People are admitted to an intensive care unit (ICU) because their illness or injuries may be life-threatening and they need intense support while they are treated, constant monitoring and 24-hour nursing care that cannot be performed on general wards. Patients stay in ICU for varying lengths of time, depending on the nature of the illness, and during much of this time they may be sedated or unconscious [see ICNARC website]. Because critical illness is often a sudden, unexpected emergency, it can change the lives of both the patient and those they are close to in a matter of minutes. The everyday lives of family and close friends may come to an abrupt halt or be turned upside down as they live in the uncertainty of not knowing whether the patient will survive. The ICU, an unfamiliar, alien environment, often becomes the centre of peoples' lives as they wait desperately for any signs of change or progress.
Here men and women talk about the effects on children when a relative, partner or close friend was critically ill in ICU.
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.
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.
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 [see ICNARC website]. 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 perso n. 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.
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.
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.
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.
