Family caregivers of intensive care unit (ICU) patients are exposed to high levels of stress (1). During ICU admission, family caregivers are in a position to witness the stress-provoking ICU environment more vividly than the patients who lack physical and cognitive capacity to control or understand surroundings. Because limited decisional capacity is common in patients during the critical phase of their illness, many family caregivers are expected to take the role of a surrogate decision maker to discuss options for life supporting treatments. Demands on family caregivers do not stop after patients’ ICU discharge. Recovering from critical illness leads to a new phase of complex and unpredictable illness experience. Over time, support from formal resources dissipate and more responsibilities are assumed by family caregivers. Decades of research have highlighted that ICU family caregivers are at risk for adverse psychological responses at various timelines across the trajectory of their loved one’s illness, recovery and/or death (2-4). Despite growing awareness, supportive and effective interventions targeted to family caregivers of ICU patients are lacking (2). One of major challenges in developing interventions may be limited knowledge of ways to identify family caregivers at high risk for severe stress response and other modifiable risk factors.

More than a decade ago, Meredith Mealer embarked on research that has only increased in relevance with the passing years.

The study focused on the prevalence of post-traumatic stress disorder (PTSD) among survivors of acute respiratory distress syndrome, a devastating lung disorder. Mealer, PhD, RN, was then a research coordinator, working on the study with Marc Moss, MD, a pulmonary/critical care physician leading the effort. As Mealer paged through the symptoms patients and families reported – nightmares, high stress, emotional numbing, anxiety attacks – some struck her close to home. Prior to shifting her focus to clinical research, Mealer had been an intensive care unit nurse.

With multiple advances in critical care, more patients are given the chance to survive life-threatening illnesses such as sepsis. This growing cohort of patients, however, grapples with a new challenge – post-intensive care syndrome (PICS). As the condition is increasingly recognized, the number of clinics devoted to helping patients with PICS recover is also on the rise.