Information for relatives of patients in intensive care with COVID-19

9 April 2020

People with suspected COVID-19 may need help with their breathing. Some treatment can be given at home. Others can be treated in a hospital ward with oxygen given through a face mask. However, sometimes this is not enough to keep oxygen at the right level in the body. In that case your relative may need to go to the Intensive Care Unit for further treatment.

Treatment in intensive care supports the lungs and other organs while a patient gets through the illness.

To support the lungs, often patients are connected to a ventilator via a breathing tube inserted through the mouth into their windpipe. Patients on ventilators are always heavily sedated to keep them comfortable. 

They may need drugs to manage their blood pressure and antibiotics to treat infections.

They may also require support for their kidneys if they are not working properly.

Who looks after patients in the intensive care unit?

A team of highly trained healthcare professionals will look after your relative. This includes specialist doctors, nurses, physiotherapists, dietitians and other team members. As there are many extra patients with COVID-19 needing this care at the moment, your relative may be looked after in another area of the hospital that is now providing intensive care to the same standards of the main Intensive Care Unit.

What will happen if your relative is admitted to intensive care?

Members of the health care team will care for your relative day and night. Each day they will look at how well they are responding to the treatment and at what additional support they might need.

Unfortunately even with the best intensive care treatment 1 out of every 4 people (25%) on the intensive care Unit will die because of complications from COVID-19. If a person is frail (or has underlying medical conditions), their chances of survival are lower. In those who are frail, 60% will die even with the best possible care.

How long will my relative need to be in intensive care for?

Most people with COVID-19 spend between 7 and 10 days on a ventilator. Each day the team will look for any signs that they are getting better or worse and change the treatment as needed.

Someone who is young and fit will need at least 3 to 6 months to recover from being on a ventilator for a week in the intensive care unit. It can take up to a year for their mental health to recover. Full recovery is sadly less likely for those who are frail or have other medical problems. They may never reach the same quality of life as they had before. This can be because of weakness, lung problems or other difficulties with recovery. ICUsteps.org is a charity that supports patients and relatives who have had an intensive care admission.

What do intensive care teams need to consider?

The team will look at how sick your relative is and what other health conditions are present.  They will look at how these may affect the chance of recovery. If it is clear to the whole team that treatment is not working, the treatment options may change to accepting that the situation is not treatable. This normally means best ensuring comfort and dignity in a patients’ final illness. This is a normal part of management in intensive care. Sometimes patients may be moved to a more appropriate, less busy area of the hospital to make this experience more dignified.

These decisions will be made much easier for healthcare staff, if Advance Care Planning discussions have taken place and patients, especially those with underlying medical conditions, have created a Living Will. If your relative has a Living Will or an Advance Care Plan you should let the staff know as soon as possible.

How will I get a medical update?

We will give you the telephone number of the ward where your relative is. The team may be very busy caring for patients and so may not be able to take non urgent phone calls. Therefore it is best to give the team just one contact name and number for the team to call you on. The team will usually give you a medical update each day but will ring you sooner if they need to tell you about any changes in your relative’s condition.

Can I visit my relative?

For everyone’s safety you may not be allowed to visit at this time. This is to minimise the risk of visitors bringing in infections or carrying an infection back into the community.  Anyone from your family who shared a home with your relative or who spent time with them in the last week should be self-isolating at home. This is in line with Government’s advice.

We can understand how upsetting this must be for you, but rest reassured that your relative is comfortable and not aware of their surroundings or treatment. Support for families like you coping with this separation, and the worry and anxiety you may be experiencing, including talking with any children about the situation is available via your general practitioner.

When patients are at the end of their life...

Despite all our best efforts and treatment, not all patients with COVID-19 can be helped. Sadly some become very unwell and die.

We want you to know that although your loved one may not have a family member with them at this time, we will do our very best to care for them, ensure their comfort and dignity and make sure that they will not be alone in their last moments.

Please let us know if you would like a representative from your faith to visit your relative at their bedside. This is allowed and if someone is available in the hospital they will attend.