The Role of the ICU Social Worker in Supporting Families

Abstract

Every year, an estimated five million patients receive care in an ICU. ICU care is often in response to a medical emergency or medical instability, and common ICU interventions, such as intubation and mechanical respiration, are considered highly burdensome and invasive. When a patient lacks capacity to communicate their preferences, the responsibility to make health-care decisions often falls to family members. Families may experience a constellation of symptoms, such as high-intensity emotions, interpersonal conflict, anticipatory grief, and a compromised ability to process complex information, known as family ICU syndrome (FICUS). The ICU social worker is uniquely positioned to intervene and support families during this critical period. Within the context of FICUS, this chapter will (1) provide an overview of the dynamic needs of patients and families who encounter the ICU; (2) define the role of social work in the ICU; and (3) discuss evidence-supported interventions that social workers can employ to address the needs of patients, family members, and interdisciplinary team members. Case examples are also provided to foster critical thinking about complex encounters with families in the ICU.