Caring for Patients’ Families (or Lack of Family) in Neurocritical Care

Excerpt

This issue of Neurocritical Care presents several articles focused on the families and surrogate decision makers of critically ill patients with acute neurologic injury (ANI) and collectively highlights several key points. First, as the general critical care community has recognized for their patients’ families [1], families of patients admitted to neuroscience intensive care units (neuro-ICUs) are not just put in tough, unfamiliar situations, but are at real risk for adverse psychological outcomes. Second, while developing interventions to improve family outcomes is crucial [2], implementing new practices and proving that they improve family experiences are not necessarily easy tasks, even when a practice seems as though it should be a “slam-dunk.” Third, goals-of-care decision-making is an area where improvements could be impactful, yet clinicians and families can be far apart on issues even as granular as the exact words used to express prognosis. Finally, as challenging as issues for families are, the management of incapacitated patients who lack surrogate decision makers can be even tougher. While caring for families is often (and rightfully) thought of as part of the “art” of neurocritical care, the articles in this issue demonstrate the value of scientific study in understanding best family-centered practices. …