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ICU diaries - how do they help?
For many people their first experience with an Intensive Care Unit may be when they find themselves or a loved one critically ill or injured. It can be an intensely stressful and scary time. It is not uncommon for those who experience critical illness or injury to later develop sleep disturbances such as insomnia, vivid dreams, and even nightmares. Many of the symptoms that former ICU patients experience are consistent with post-traumatic stress disorder and are included within the syndrome we are now calling Post Intensive Care Syndrome or PICS. Many interventions are being explored that address post-ICU recovery, however one intervention has already proven its usefulness in combating PTSD in post-ICU patients - ICU diaries.
"The only intervention that was shown to reduce PTSD is ICU diaries," said pulmonary and critical care fellow Ann Parker. - Laura Benshoff/for WHYY
How and why do ICU diaries work? What is helpful with ICU journals is how the journals fill in the gaps of missing time that many patients experience with a critical illness or injury. Often patients will fill in missing time with "memories" that may have evolved from delusions or hallucinations experienced during their ICU stay. Through reviewing the journal, one can replace missing time gaps or delusions with the real events that happened in this space of time as documented by loved ones or caregivers.
There are many approaches to ICU diaries and not one specific r
ight or wrong way to do these. In some cases, family members take control of the diary entries and themselves find therapeutic benefit in this. In other cases, the bedside nurse or other caregiver will take a moment to record significant daily events. To be maximally effective there needs to be individualization to the journal and the process associated with it. For more information and guidance regarding the process of starting ICU journals please visit the following website: ICU-diary.org
For patients, loved ones, or caregivers at Mayo Clinic there are journal options such as the one shown. Please be sure to ask your provider or caregiver for more information.
The following podcast from The Pulse discusses how ICU diaries can assist in recovery:
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Perhaps others who receive a diary would like to know that I wish my experience had been recorded while it was happening. Later they might also wish there was a record in the diary. While I was in Intensive Care, I was unresponsive for seven of the nine or ten days; and only have three or four very brief memories once I became somewhat alert. Perhaps my family received a diary but did not have the emotional-mental energy to create a record because of concern about the critical nature of my condition. When I moved to a room on another floor, I did not have the mental and physical ability to write in the diary. Even though my story is unrecorded, I clearly know that I received wonderful, life-giving care from all of the medical and other personnel at Mayo Methodist Hospital. I am forever thankful.
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