Why do we need a separate ICU for Elderly?

By – Anusha & Rajashree Kallapur

Each of us must have seen ICU – in tv shows or films. A blue door, with a peeping glass, on which the letters ICU are painted in red. The anxious relative can peer through the glass, see the patient surrounded by nurses and a doctor on either side of the bed. The truth however, is far from the utopian world of tv shows and films.

In reality, the ICU is a congested, cold room (I am not talking only about the temperature), in which patients are ‘fitted’, as many as possible. Imagine yourself in an ICU; everywhere you see, there is a critical patient, and you witness one death per day. Now, let me ask you this question – would an ICU be the last place you would want to be in before you die?

ICU: I Can’t bear to See You

It is traumatic to be in the ICU, and equally traumatic to see a loved one in the ICU. More so, for elderly patients. It is depressing to see them all by themselves even if they are unconscious. Will the patient recover, or not? If not, wouldn’t they want to spend their last moments with us? They spend their life for us. Can’t we, the younger generation, make their life better at least at the end?

Isn’t old age called second childhood? Can’t we have a separate ICU for the elderly, just as there are pediatric ICUs?

The truth about ICUs is that, for the staff, each patient is treated as a case. But for us, as relatives, the patient is a person. The mentality, especially with older patients, is even worse as the ‘age factor’ comes in. Anyway the mortality rate in elderly is high; might as well take care of younger patients, don’t you think so?

For elderly to be treated well, not only do we need a change in mentality, but also the approach to treatment. For most elderly patients, their organs are in precarious condition – it is critical to achieve the perfect balance. We need more doctors who can think holistically and work with specialists to be able to strike the balance. What we have instead, is a group of specialists, expert in their own field, but with almost no coordination. How can one lift a heavy rock if each person puts in effort one-by-one? It requires collective and organized effort.

Even with both mentality and treatment in place, there is a huge barrier to get the elderly back onto their feet: secondary infections. These can be avoided by maintaining hygiene, but somehow, the focus gets diverted due the number of patients (most of them much younger, I understood, in my personal experience) with different problems. Hygiene should be maintained for all patients, no doubt, but more so in elderly, because their immune system is already compromised and they are not as strong to fight the infection.

Now, we strive to understand the patient’s psychological state, no less important than the rest of the factors. Psychology is very important in the healing process. Most elderly patients, witnessing deaths in front of them in the ICU, are in a torn and confused state. They need us to be with them, they need counselling, they need gentle handling and reassurance. In short, they need relatives by their side and approachable staff.

For these elderly-specific reasons, it is high time we consider separate ICUs for elderly.