Intensive care - After intensive care

Once you are able to breathe unaided and you no longer need intensive care, you will be transferred to a different ward to continue your recovery.

Depending on your condition, this will usually either be a high dependency unit (HDU), which is one level down from intensive care, or a general ward.

The time it takes to recover completely varies greatly from person to person. It will also depend on factors such as:

• your age
• your overall level of health and fitness
• the severity of your condition

After you are finally discharged from hospital, it will probably still be some time before you feel you are back to normal.

Follow-up clinics

Some hospitals offer follow-up clinics, or outreach services, for people who have been in intensive care. These clinics provide an opportunity for you to discuss your time in intensive care with the intensive care staff. This will enable you to:

• understand the treatments and procedures you were given
• fill in any gaps in your memory that may have been caused by sedation (medication that makes you drowsy)
• discuss your recovery and any problems you are having, which may help speed your recovery

If your hospital does not offer this service, you can visit your GP to discuss any problems you are experiencing following treatment in intensive care.

Common recovery problems

Being in intensive care can put an enormous strain on you, both physically and emotionally. Even after you have been discharged from hospital, your recovery may be slow. Some of the most common problems you may encounter while recovering are described below.

Severe weakness and tiredness

Severe weakness and tiredness is the most common problem of recovery. It is difficult to predict how long this will last, but it will improve over time. Many people who have been in intensive care start to feel better after two to three months.

However, it may take as long as six months before your energy levels are fully back to normal. If you have had a severe trauma, such as a head injury, it may take even longer.

Loss of weight and muscle strength

If you have been in intensive care for a long time, it is likely you will have lost weight and muscle strength. This is caused by the length of time you were immobile. Your joints may also be very stiff.

It is important you regain strength and balance by walking but, at first, you should not attempt to walk without assistance.

A physiotherapist may draw up an exercise programme which you must stick to. However, you should never exceed the amount of exercise you have been given.

Read more about physiotherapy.

Talk to your GP or physiotherapist before starting more vigorous forms of exercise, such as swimming, running or cycling.

Weak voice

If you were on a ventilator to help you breathe during your stay in intensive care, your voice may be husky or croaky. However, this should improve quite quickly.

Inability to grip small items

After being in intensive care for some time, you may also find it difficult to grip small items. For example, at first, you may not be able to hold a pen to write.

Feeling depressed

If you have been in intensive care for some time, you may feel very low afterwards. Some people experience anxiety (feelings of unease) while in an ICU and, in some cases, this can get worse after being discharged. Some people may also:

• feel angry
• feel tearful
• feel panicky
• have flashbacks
• have nightmares

In severe cases, some people who have been in intensive care develop post-traumatic stress disorder (PTSD). This can cause sleep problems and panic attacks, as well as distressing images or sensations.

If you have PTSD, it should pass within a month of leaving hospital. However, if it does not, or if you are finding it difficult to cope for any other reason, you should visit your GP or return to your follow-up clinic or outreach service.

Read more about PTSD and depression.

Cognitive function

After being in intensive care, some people experience problems with their cognitive function (mental ability). For example, you may find it difficult to concentrate or have trouble remembering things.

Rehabilitation 

If possible, you will be assessed while still in hospital to determine whether you are at risk of developing any physical or emotional difficulties after your stay in an ICU. For example, you may be asked about any:

• physical problems you are having
• communication problems you are having
• psychological symptoms that you have, such as depression or anxiety

If you are at risk of experiencing problems during your recovery, you may be set some rehabilitation goals to aim for.

This information will be passed to the team of healthcare professionals who are responsible for your care after you leave the ICU. If necessary, they will use it to develop a rehabilitation programme for you.

As part of your rehabilitation, you may be:

• provided with any necessary information – for example, about your diet, when you can drive again and when you can return to work
• referred to further healthcare professionals – for example, an occupational therapist will be able to help identify problem areas in your everyday life, such as dressing yourself, as well as helping to work out practical solutions

See the practical guide to caring for more information about support available, as well as advice about financial issues.