The place to pursue advanced medical and nursing care do not need to be in a hospital. Today it is performed in patients’ own homes.
The advancement of medical technology and critical care has allowed adults and children, who once were unable to leave hospital due to complex needs, the opportunity to move home to their families. Increased attentions to patients’ wishes have also played an important role in the development of high-tech home care.
To remain in context of ones’ own family and their support are often assumed as the best solution. Being at home is ‘a good thing”. But being ill at home often differs from being cared for in hospital. To be cared for at home with medical technology is a complex interactive process involving both the person in need of care but also family, home care managers, personal assistants and professional health care.
To become technology-assisted may involve a life-changing event that influences the person’s body, spirit and total life situation. Caring for a technology-assisted person at home also means meeting existential needs and questions.
Healthcare environment can both promote health and wellbeing but also cause healthcare related injuries. Critical ill patients, with life-threatening conditions, cared for in the intensive care units (ICUs), are already vulnerable and unfortunately also at high risk for iatrogenic injuries. Healthcare environment in ICUs are known to give patients discomfort, change their perception of day and night, something that can lead to ICU-delirium. Sounds and lights disturb patients, loved ones and staff around the clock and this fact causes increased stress levels, which can lead to serious consequences for the patients.
An ICU is an environment filled with advanced technology and it can appear unfriendly and unwelcoming. Intensive care is given around-the-clock and the units are filled with technological equipment, which is required in order to treat and monitor the patients. The technological developments have evolved enormously during the last decades, but the design of the ICU has not developed in the same pace.
The University of Borås is conducting research with the aim to examine if and how an ICU-room, which has been designed using the principles for evidence based design, affects safety, wellbeing and functionality, for patients, loved ones and for staff.
End of life care in the ICU
Swedish intensive care is of high quality and yearly save several lives in patients with life-threatening conditions. Despite all medical efforts it is sometimes impossible to save the patient’s life and about ten percent of all patients cared for in Swedish intensive care units (ICUs) die during their stay in the ICU.
Dying patients are often too ill to communicate their care experience but we known that for family members the quality of the care given in the ICU is of utmost importance for their memories if their loved one’s death was dignified or not. This is why we need research on how we can involve family members in end-of-life care and how we can design the ICU to be welcoming and support the family members’ need for proximity and privacy.