Intensive Care Unit: rehab after your stay in ICU

Rehabilitation after ICU

During your stay on the Intensive Care Unit (ICU), your muscles may become weak. This is known as deconditioning. 

This, along with other factors, can cause the following:

• joint stiffness
• muscle weakness
• reduced fitness
• difficulty eating, drinking and swallowing
• difficulty communicating.

Early rehab (rehabilitation) can reduce these complications and help you recover.

Our rehab teams

At Kingston Hospital, some or all of the following teams have been looking after you during your stay in ICU:

• physiotherapists
• dietitians (diet and nutrition)
• speech and language therapists (SLTs)
• occupational therapists (OTs).

For more detail about how these teams can help you, see 'What our teams offer' below.

These teams have identified the following goals for you, when you leave ICU.

What our teams offer

Physiotherapy

ICU physiotherapists can help you with the following.

• Respiratory (breathing) complications associated with critical illness. This is especially important if you needed a ventilator (breathing machine) or a tracheostomy (breathing tube) to help you breathe.
• Potential neurological (brain, spine and nerves) and musculoskeletal issues that can be caused by long-term critical illness.

ICU physiotherapists will visit you and work closely with your healthcare team when you move from ICU to your new ward. They will make sure your move goes smoothly.

They will give you physiotherapy sessions on the ward, to help you meet the rehab goals identified when you were in ICU.

These sessions will mainly focus on improving your:

• mobility
• strength and endurance
• respiratory function (breathing)
• functional independence (for example going up/down stairs, getting into/out of bed).

They will design an exercise plan so that you can do some of your exercises on your own, when you are ready.

When we discharge you home, they will advise you on the best way to continue your recovery (if you have ongoing rehab needs). 

They may refer you to community-based services who will help you when you are back home.

Follow-up

Three months after we discharge you home, we will invite you to attend our ICU Follow-Up Clinic. This will give you a chance to ask the physiotherapy team questions about your recovery.

Dietetics (diet and nutrition)

A dietitian will calculate how much nutrition you will need during your recovery. 

While you were in ICU, we may have fed you a liquid diet. Some patients receive their liquid diet through a tube inserted in their nose (and into their stomach). Some patients are fed by a drip straight into a vein.

A dietitian will work with the wider ICU team to monitor how well you absorb this nutrition. They will decide when we can remove your feeding tube (if you have one).

You may have difficulty eating after a stay in ICU because:

• you do not feel hungry
• you feel too tired to eat
• your mouth is too sore to eat
• it hurts to swallow
• food tastes different now.

These problems often lessen over time. A dietitian can offer advice if you are struggling.

Ask for a dietitian appointment if you need more information, or are having trouble eating or regaining weight. We can arrange this for you.

Your GP can also arrange a dietitian appointment if you still need help when we discharge you home.

Speech and language therapy 

A Speech and Language Therapist (SLT) can help you with communication, assess your swallowing and recommend different textures of food and drink for you. 

An SLT may have visited you during your ICU stay.

If you had a tracheostomy, the SLT will have looked at how you manage your oral secretions (eg saliva), swallow and speak with the breathing tube (if relevant).

Some people experience changes in the way they communicate, eat, drink and swallow while they are in ICU, or when they leave.

Your SLT can help if you experience any of the following:

• changes in the way your voice sounds
• difficulties with eating, drinking and swallowing
• coughing or choking when eating and drinking
• a feeling of things getting stuck in your throat
• a different feel to your mouth and throat
• changes in your sense of taste
• changes in the way you communicate
• difficulties with your speech.

Occupational therapy

An Occupational Therapist (OT) can help you regain independence when we discharge you home.

After your ICU stay, you may find some everyday tasks difficult. This is often due to the physical, cognitive (thinking) and emotional effects of illness, medication, or being in hospital for a long time.

You may have been visited by an OT during your ICU stay. We also help patients in other Kingston Hospital wards, and in the local community.

An OT can help you with the following, after your stay in ICU.

• Difficulties with dressing, bathing or preparing meals.
• Memory problems, difficulty concentrating, or trouble with decision-making.
• Assessing and modifying your home. We can provide small adaptive aids, such as a commode, toilet frame, or perching stool (a special stool to use for sitting at home).
• Arranging help from carers.  OTs will work with you, the hospital discharge team and social workers to ensure you have the help you need when you return home.
• Planning your return to work.

More information

ICU Steps is a charity that helps intensive care patients. Their Road to Recovery booklet offers critical care rehab information and support.

The British Voice Association offers advice on looking after your voice.

IDDSI offers information for people who struggle with feeding, chewing or swallowing.