What Risk Factors Affect The Development Of Fiicus?

FICUS - Risk Factors and Assessment When assessing family members for likelihood of developing FICUS in the LTACH, risk factors are noted to be characteristic of the family member themselves, or acquired as a result of the stressors of having an ill family member. Although not much research exists in the development of FICUS in the LTACH, many of the risk factors that lead to FICUS in the ICU can be extrapolated to the LTACH environment. Demographic risk factors include female gender, patient age, lower education level, having a critically ill spouse, being an unmarried parent of a critically ill child and having a younger relative with FICUS [30]. Other factors include distance from the hospital, adequate support including financial stability,
Acute stress is experienced by up to 57% of family members within 3 to 5 days after their loved ones admission to the ICU, and is a common risk factor for the development of FICUS [14, 37]. Evidence suggests that family members with acute stress disorder (ASD), may progress to chronic Post Traumatic Stress Disorder (PTSD) in up to 80% of cases [38], another prominent characteristic of FICUS. Majority of people who develop PTSD do not have diagnosable ASD [38]. The most common symptoms of PTSD include hyperarousal, flashbacks, or nightmares [14, 39]. These symptoms have an increased association with the female gender for unknown reasons [40]. Females, those who knew the patient for a shorter time, and those whose preference for decision making was discordant with their actual decision-making role had higher prevalence of PTSD and depression [30, 41, 42]
In the shared decision-makers model, the patient (or their surrogate) and clinicians collaborate to make decisions regarding which therapies to use, withhold, or withdraw, informed by the patient’s values and preferences as well as the clinician’s scientific knowledge about indications, risks, and prognosis One way to build partnerships is through formal family meetings. The Academy of Certified Case Managers recommends that family meetings with the multi-professional ICU team begin within 24–48 hours of ICU admission and should be scheduled at regular intervals and as needed [46]. If the patient is young (>18 but <45), family members are more likely to have increased anxiety and stress due to the emotional turmoil of seeing a young family member in the LTACH. For example, a mother of a 20 year-old quadriplegic man will want to pursue all possible avenues and resources to treat her son. Caregivers would recommend to admit her son to the LTACH. The mother will experience a multitude of emotions during this time period witnessing her son struggle. The daughter of a 98 year-old man with end-stage renal disease requiring renal transplant would have a very different decision to make regarding her father. Age is strongly associated with mortality in