Following intensive care many patients require some form of rehabilitation. A patient being discharged from the intensive care unit (ICU) should be screened for potential needs. These can help guide post-discharge rehabilitation efforts.
Physical issues:
(1) weakness
(2) mobility issues (unable to get out of bed independently, unable to stand up, unable to mobilize over a short distance)
(3) incontinence
(4) nutritional issues (swallowing difficulties, etc)
(5) other limitations in self-care
(6) physical and/or neurological deficits
(7) breathing difficulties (unable to self-ventilate on FIO2 less than 36%)
(8) pain
(9) impaired hearing and/or vision
(10) difficulties communicating
(11) equipment needs
(12) economic needs (benefits, employment)
(13) social and leisure needs
Non-physical issues:
(1) anxiety and/or depression
(2) post-traumatic stress disorder (PTSD)
(3) cognitive impairment (memory loss, attention deficit, confusion, apathy)
(4) poor self-esteem and/or self-image
(5) problems in personal relationships
(6) behavioral problems
(7) sleep problems (nightmares, etc)
(8) pre-existing mental illness
Other issues (not listed in guideline) may include:
(1) lifestyle changes (smoking, substance abuse, weight loss, exercise, etc)
(2) need to learn a compensatory skill
Some needs may be obvious and predictable while others may be subtle or masked, especially if the patient wants to avoid a subject.
Each need can be categorized based on severity and impact on the patient.
