What Can I Do if My Family Member Is in the COVID ICU?
A few tips for coping.
Posted December 16, 2020
This is Part 4 of a series of articles on ICU trauma and how to cope.
Part 1 is here: "The Psychological Trauma of Having a Loved One in the ICU" by Maureen O'Reilly-Landry, Ph.D.
Part 2 is here: "Making an Emotional Recovery Together" by Ethan Lester, Ph.D.
Part 3 is here: "Managing Emotional Distress in the Hospital and ICU" by Ethan Lester, Ph.D.
This post was written by Irina Wen, Ph.D.
A partner of a COVID19 patient in the ICU wrote:
“What about those of us with a sedated and ventilated spouse, a situation where it is medically known that hearing loved ones is beneficial to their health and recovery? How do we cope when we can't see our loved one? When we can't talk to them? When, on top of all of that, we are still in our own quarantine period, so we can't even get a hug from anyone?”
Her voice speaks for the pain of so many families across this country and the globe who feel disconnected and scared, hoping and waiting for their loved ones to come home.
This article will provide some tips for how to deal with the isolation that family members can experience during a difficult time when a family member is in the ICU.
We are not designed to suffer alone. Yet, during these extraordinary times, many people who are hospitalized in the ICU due to COVID-19 often suffer in isolation, away from their families and friends.
Their families are also left to grapple with the fear and uncertainty, often being unable to get in touch with their loved ones or to get regular and frequent updates from the hospital.
Family members might experience a range of emotions, such as overwhelming fear and terror, stress and anxiety, helplessness, uncertainty, anger, and waves of hope and hopelessness.
They might also experience ongoing anxiety, trouble focusing, difficulty sleeping, and other cognitive and emotional struggles while waiting for the outcome of treatment of their loved one in the ICU.
While all these feelings are normal in these abnormal and challenging circumstances, they are difficult to manage.
A scientific explanation for why isolation is so difficult
The need for connection is at the core of our neurobiology. We are hardwired to build and maintain connections and to rely on them as a buffer when dealing with stress and trauma.
Sue Johnson, the founder of Emotionally Focused Therapy—an approach that helps couples build secure and long-lasting bonds—reminds us that creating and maintaining connection “is our most ancient survival code."
Social connection promotes physical health, decreases the risk of mortality, and supports our general physical and mental well-being.
Touch is an especially powerful tool of connection. For example, hugs have been shown to lower blood pressure in married couples and other groups (e.g., Light, Grewen, & Amico, 2005).
A powerful fMRI study demonstrated that holding the hand of a loved one helps regulate how our brain processes pain and threat.
Our nervous system responds to distance and disconnection from others as it would when dealing with stress—by releasing stress hormones and activating the stress response
In fact, isolation can lead to a range of physical and mental health problems, including negative impacts on the cardiovascular and immune systems.
Some ways to find relief
Below are some recommendations that can help support the family members of patients hospitalized in the ICU.
While no individual recommendations can take away the range or depth of your feelings, they might provide some guidance and relief.
1. Maintain a routine:
Trying to stick with the structure and rhythm of the day, such as bedtime routine, meals, physical activity, etc., can help provide some grounding and consistency when dealing with overwhelming stress.
2. Worry, rumination, and even panic are common and natural reactions to a significant stressor
Yet, they tend to exhaust our minds, leading to more stress, worry, and anxiety. If you catch yourself in a vortex of worry thoughts or feeling panicky, try:
- Distracting yourself by engaging in a different activity
- Focusing on what you can control instead of what you cannot control
- Engaging in a grounding practice. Here are some examples: Put your hands in water; pick up or touch items near you; breathe deeply; savor food or drink; take a short walk; hold a piece of ice; move your body.
Avoid self-medicating with alcohol or drugs. This may result in an additional problem for you to cope with later.
3. Reach out to your friends and family for support
Remember, connections make us stronger!
4.Talk to a professional
Reaching out to a psychologist or other type of therapist for help can be a good way to gain additional support.
5. Seek support in faith and spirituality
Religious and spiritual views and beliefs can offer hope and perspective when dealing with scary and overwhelming stressors. Reach out to your religious or spiritual community for support and guidance, if it resonates.
6. Maintain communication with the ICU when possible
Every hospital has different protocols for managing communication between the treatment team and the family members of COVID-19 patients. Some offer telecommunication, others provide updates from the staff, and some struggle to maintain regular contact with the family. Make sure to find out the protocol for communicating with your hospitalized family member and their treatment team.
7. Provide children with information about the situation
Consider children’s developmental levels while offering information. Share hope and reassurance with them.
Mental Health Crisis Hotlines
- The Disaster Distress Helpline: 1-800-985-5990 or text TalkWithUs to 66746
- National Suicide Prevention Lifeline: 1-800-273-8255
- 24/7 Crisis Text Line: US and Canada: text 741741
Dr. Irina Wen is a member of the Hospital, Healthcare and Addiction Workers, Patients and Families workgroup that sponsors this blog.
Dr. Irina Wen is a clinical psychologist and Clinical Associate Professor, in the Department of Psychiatry at NYU Langone Health. She is a certified therapist and supervisor in Emotionally Focused Therapy (EFT) and specializes in the treatment of trauma and relationship distress. She is the Lead Clinician at the Steven A. Cohen Military Family Clinic at NYU Langone Health, where she oversees the couples therapy program for military families. Dr. Wen also offers psychotherapy, consultation, and supervision through her private practice Touchstone Psychology, PLLC.
Additional links and resources:To learn more about Sue Johnson’s work on the role of attachment and connection: https://drsuejohnson.com/videos/ To learn more about Emotionally Focused Therapy: https://iceeft.com/what-is-eft/ National Institute of Mental Health’s list of resources for coping with COVID pandemic Information on Acute Stress Disorder: https://www.healthline.com/health/acute-stress-disorder#prevention Some additional ideas for grounding and centering practices: https://www.psychologytoday.com/us/blog/the-empowerment-diary/202002/wh…
Johnson, S., Moser M., Beckes, L., Smith, A., Dalgleish, T., et al. (2013). Soothing the threatened brain: Leveraging contact comfort with Emotionally Focused Therapy. PLOS ONE 9(8): e105489. .https://doi.org/10.1371/journal.pone.0105489
Light, K., Grewen, K., & Amico, J. (2005). More frequent partner hugs and higher oxytocin levels are linked to lower blood pressure and heart rate in premenopausal women. Biological Psychology, 69(1). Doi: 10.1016/j.biopsycho.2004.11.002