After a severe traumatic brain injury (TBI), patients who are admitted to the intensive care unit (ICU) are often unable to care for themselves and usually rely on caregivers. Family members and loved ones may provide functional, cognitive, and psychosocial support, becoming essential care systems for the injured person during their ICU stay and throughout the recovery period. Although caregiving is a necessary and important role, research suggests that caregivers experience high levels of stress, anxiety, and depression during ICU admission. In addition to the emotional pressures associated with supporting a loved one through a medical crisis, caregivers may also experience social isolation and financial stress.
A recent Indian study addressed the issue of psychological distress among caregivers of TBI patients. Researchers interviewed 60 primary caregivers of TBI patients who were admitted to the ICU between 2016 and 2017. They asked questions about the participants’ experiences with financial burden, daily routines, leisure time, family disruption, and mental and physical health. The researchers also administered the depression, anxiety, and stress scale (DAS-21) to measure the severity of psychological distress. They found that:
- Caregivers experienced severe financial burdens and significant disruptions to daily activities and family interactions.
- The participants reported mild depression and moderate anxiety.
- As TBI severity increased, so did the severity of caregiver burden.
- Caregivers with more family responsibilities tended to experience higher levels of psychological distress.
Caregivers experience high levels of family burden and psychological distress while their loved ones are in ICU. As a result, effective emergency and trauma care ideally should include counseling, family education, and stress management protocols to support caregivers during a medical crisis. In addition to caring for their patients with TBI, clinicians are advised to watch for signs of anxiety and depression in primary caregivers to ensure that all individuals receive the highest standard of care during an ICU stay.
Kamnami TR, Thimmappur RM, Reddy K, & Raj P. Burden and psychological distress of intensive care unit caregivers of traumatic brain injury patients. Indian Journal of Critical Care Medicine. (May 2019).