Boost in support for patients after critical illness

Thursday 11th July 2019

A multidisciplinary programme is being praised by patients and their families for the dedicated support provided to them following the trauma of a critical illness.

The intensive care syndrome: promoting independence and return to employment (InS:PIRE) programme is delivered to patients who have been in intensive care but who have recovered and are well enough to go home.

Dr Lucy Hogg, an NHS Fife consultant in intensive care medicine, says coming out of intensive care is not the end of the journey:

Patients who come to intensive care have life-threatening critical illness. Part of the therapy to stabilise and support them can involve a number of invasive procedures, which may be uncomfortable or prolonged.

For patients who are less than clear about where they are it can be a distressing and emotionally difficult time.

The medications that are used to keep patients calm and comfortable can also mean that their perception is distorted and they have a patchy recollection of events, making it difficult for them to make sense of what has happened.

The InS:PIRE programme seeks to enable and empower patients and their families to manage their rehabilitation from a physical, emotional and psychological perspective.”

Patients are contacted between six and 12 weeks after their discharge, and are invited to attend the five-week programme over consecutive weeks with a family member or carer.

A one to one session between the patient and clinical staff involved in their care is offered as part of the programme, alongside pharmacist support and physiotherapy, including a group exercise class to assist with rehabilitation.

Intensive care can be very disorienting for patients. As they recover, not only do patients have to deal with the physical changes which may be the result of a critical illness, there are also a huge range of emotions to process,” says Dr Chris McKenna, NHS Fife medical director.

In addition, their loved ones have been through a very worrying and anxious time. InS:PIRE allows patients and their families to understand and process their experience, and to manage their recovery effectively going forward.”

To help patients recover from any emotional effects, clinical psychology group interventions for patients and carers are available, as well as peer support to provide opportunities to speak to others with similar experiences as a patient or as a family member.

Patients are then signposted to services in their community that can provide further support once they complete the programme.

Glenrothes resident, Grant Fenton, was supported by the InS:PIRE programme in 2018 after being diagnosed with sepsis before losing his right leg and experiencing kidney failure.

I was in intensive care for three weeks and in hospital for almost three months altogether. I clearly remember the hallucinations and delirium, which tricked my brain into thinking I was somewhere else,” he said.

The hallucinations affected for me for a long time. I often had nightmares and panicked remembering everything that had happened. At first I wasn’t too sure about InS:PIRE, I was out of hospital and wanted to stay out, but my mum persuaded me to go and I’m glad I did.

InS:PIRE was absolutely amazing, and I can’t praise it highly enough.”

The first day I went I met staff who had looked after me and that was so helpful. I clicked instantly with other patients who had been in intensive care and was able to talk about what happened and they were able to share their stories too.

I realised I was only at the beginning of my journey. I was terrified of the future but life is good now – I feel like I have a purpose and have turned negativity into positivity.”