Caring for caregivers critical

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Serious illness doesn’t just affect those who are sick. Their caregivers at home suffer, too, yet resources generally aren’t flowed that way to help these caregivers through the challenge of nursing their loved one after discharge. A Canadian critical care powerhouse of five centres, including Sunnybrook, with a gaggle of six critical care doctors, studied what aspect of patients and caregivers best predicted who was likely to need help. They looked at different times within the immediate one-year period after patients were sent home. They included 280 people whose family member had been on mechanical ventilation in the intensive care unit for at least seven days.

They found that 67% of caregivers reported high levels of depression at six months, which tumbled but gently to 43% at one year. Symptoms of depression decreased a bit with time in 84% of the caregivers, but 16% experienced no such reduction. Worse mental health outcomes were linked to being younger, patient care having a greater impact on other activities; and having less social support, less sense of control over life and less personal growth. Results were published in the New England Journal of Medicine. They underscore that intervention to improve family outcomes after critical illness should address the support needs of not only survivors, but also their caregivers.