After a stay at intensive care —especially for the most seriously ill patients—there is still a long road ahead. Discharge is often a major, emotional milestone, bringing mixed feelings of joy and anxiety for both the patient and their loved ones as they leave the close supervision of the healthcare providers at intensive care. Patients then go through a series of steps before returning to a normal life.
Leaving the “ intensive care ” is good news! It marks the beginning of the next chapter—life after the hospital. Still, it can be a stressful time for patients and their loved ones, who are losing hard-won points of reference and leaving a team with whom they have, by definition, shared profound moments and with whom they have built bonds of trust and compassion…
The stress resulting from a patient’s discharge from the intensive care to downstream care services is called “relocation stress,” and it is linked to the change in environment, concerns about reduced technological monitoring, and a lower nurse-to-patient ratio: when a patient is getting better, they need less constant care from healthcare providers! While in the Intensive Care Unit ( intensive care) in France there is one nurse for every two or three patients, the continuous care units and general care units are much less staffed, and this change can be very difficult to adjust to.
It is also often at this point that the patient becomes aware of their vulnerability and the journey that still lies ahead. Loved ones often play a very important role in providing support and reassurance at this time to help the patient gradually regain their self-confidence.
Rest assured, however, that before discharging a patient, the staff made sure that the patient no longer required the intensive monitoring provided by the intensive care.
Testimony of Dr ArifoglioDischarge from the ICU and the stress of relocation
Depending on the patient's needs, he or she may go through all or some of these steps after being discharged from intensive care : each care pathway is personalized and tailored to each patient's individual situation.
SRPR units are specialized units that care for patients with persistent respiratory and/or neurological dysfunction after all other conditions have been stabilized and resolved.
These services are reserved for patients requiring very specific care, typically provided in the Intensive Care Unit ( intensive care ): complicated ventilatory weaning , mechanical ventilation via a tracheostomy tube, and support during the recovery from prolonged comas requiring technical care and a high level of monitoring (which also often involves mechanical ventilation).
SRPRs always work in close collaboration with a intensive care ation unit or an intensive care unit and aim to provide personalized care to patients who need it, to promote more effective rehabilitation, with monitoring and technical and medical care tailored to the patient’s specific needs, while providing them with a team specialized in rehabilitation.
A stay in the SRPR can be quite intense for the patient, who—depending on their needs—will be offered numerous sessions of physical therapy, neuropsychology, occupational therapy, speech therapy, and other specialized treatments to help them return to as normal a life as possible, as quickly as possible.
Depending on the medical condition that led to admission to the intensive care, discharge often occurs through a specialized department: cardiology, pulmonology, neurology, etc. Depending on the patient’s needs, the level of monitoring may be gradually reduced through a transition to the intensive care unit or continuous care unit before the patient is transferred to a so-called “conventional” care unit.
Once the patient has completed intensive care care, the transition to community care is made via a specialized department. It provides an opportunity to carry out a full assessment of the situation of the affected organ, to switch from intravenous to oral treatments, and thus to progressively "de-equip" the patient, and finally to prepare for medium-term follow-up.
This is the right place to discuss treatment and long-term management of any organ sequelae with your specialist: don't hesitate to ask any questions you may have.
These establishments specialize in re-education and rehabilitation. It is very common to spend a few weeks or even months in re-education after the longest intensive care stays. This stage enables the patient to gradually regain his or her independence, before finally being able to return home.
As with PRRS, the emphasis is on patient recovery. Far from being restful, the stay is punctuated by sessions of physiotherapy, occupational therapy, speech therapy and other rehabilitation specialties aimed at returning to as normal a life as possible as quickly as possible.
Testimony of StéphaneSurviving two cardiac arrests
Testimony of Julien
The click
Dennis's Testimonial
Rehabilitation
It's another milestone in your recovery, probably the goal you've set yourself and the moment you've been looking forward to.
Before leaving the hospital, you will receive :
Returning home can be as frustrating as it is satisfying. In addition to the joy of returning to familiar surroundings and the calm of your own home, you may feel a certain anxiety about not being supervised as much as you were in hospital, about receiving less help, and about seeing more clearly certain elements of your autonomy that you have not yet fully recovered. You'll need to be patient and kind to yourself. Your task at this point will be to set yourself small goals: take a few extra steps every day, get out and about a bit, and get enough rest to achieve them.
Dominique's Testimonial
The First Time Coming Home
Back home
Testimonial from Jean-Yves
Don't be too demanding on yourself. Evaluate and respect your limits, and be careful. After a period in intensive care, it can take months to fully recover your abilities, become fully autonomous again, and return to your former life. It will take time for your body to repair itself and recover from the ordeals it has overcome, and this time will be more acceptable if you take the measure of these ordeals: if you feel the need, ask your loved ones about your hospitalization in intensive care. Return to the ICU and talk to the carers who looked after you. They'll be delighted to see your progress and help you reclaim your history. Meeting them will also help you to realize how far you've come, and to see your new life and autonomy coming closer to you.
In some cases, certain intensive care services offer follow-up care after intensive care. These programs are relatively new, and not all hospitals offer them yet. The purpose of this consultation is to bridge the gap between the intensive care period and the post- period. It may include general or more targeted assessments and can be conducted by a doctor, nurse, physical therapist, and/or psychologist, depending on the department’s structure. It’s a good opportunity to ask any questions you have about your stay, reflect on your experience at intensive care, request to see a room at intensive care again, or ask to see members of the healthcare staff again, among other things.
Don't hesitate to bring up any subject you wish: "little" symptoms that may not be addressed directly by the teams, but which may be annoying, disabling or uncomfortable, and which cannot be detected and therefore treated or improved; social life issues: your state of mind, any imbalances in family life, any assistance you may need, your questions about returning to work, reclaiming your body (physical activity, sport, etc.), etc.
For healthcare providers, these consultations are invaluable for gaining a better understanding of patients’ experiences and what life is like “after” the intensive care, identifying new challenges, and improving care. The more feedback we receive—and the more detailed it is—the better the care will be, both during the intensive care and afterward. Don’t hold back!
After your discharge from intensive care, if your state of health so requires, you may have very frequent medical appointments, which will become less frequent over time. During these consultations, you will review your progress and discuss any problems you may be experiencing.
Allow yourself to discuss any questions you may have, and in particular any symptoms you may be experiencing. This will enable you to regain control of your health and your life. The team will also be able to give you the contact details of carers who specialize in supporting patients coming out of intensive care (physiotherapists, psychologists or psychiatrists, etc.).
Your GP will be a valuable ally in your recovery.
Returning to work after a long hospitalization in intensive care is rarely immediately full-time. Depending on the causes of the intensive care care hospitalization, the potential after-effects and the nature of the job, a period of transition and adaptation is often necessary. Listen to your needs, respect your limits, and take the time you need to recover: rushing into things can be counterproductive. Don't hesitate to discuss this with your GP, and to make an appointment with social welfare professionals if necessary. In large companies, a discussion with human resources can help you find a temporary arrangement to facilitate your return to working life.
In some cases, however, a stay in intensive care represents a major upheaval that can change a person's priorities and a desire to see their professional situation evolve: listen to yourself, but take the time to reflect and be supported in your new project: don't overestimate your strengths and take it easy.
Testimony of StéphaneReturning to work after cardiac arrest
Testimony of AlexandreBack to work, one year after a stay in intensive care