What Happens When Patients Don’t Get Better?

 

Critical care supports patients while their bodies get better. Many ICU patients have illnesses or injuries that modern medicine can’t fix. Patients may be dying, or unable to return to the life they led before.

If the patient is not getting better, the ICU team is here to help patients and families to develop a plan that is right for each patient. When patients come to the ICU, our goal is to keep them alive while their body gets better. If the patient’s body isn’t getting better, it may be time to change the focus of care—to make the focus more on the patient’s comfort.

 

How do people die in the ICU?

Many patients die in the ICU. When that happens, the staff supports their family and answers their questions. Though all patients in the ICU are critically ill, some deaths are more expected than others. Here are some ways that patients may die:

  • After a “Code Blue:” Sometimes the heart or lungs (or both) stop suddenly and a team of doctors, nurses, nurse practitioners, respiratory therapists, and pharmacists begin immediately working to bring the patient back to life. This may be successful, but because the illness itself remains, the heart may stop again and the person dies.
  • While patients are on life support: Some people die in the ICU while they are on life support. Their injury or illness could not be fixed, and life support was not strong enough to keep them alive. For deaths that are expected, families and providers often decide to allow natural death. This means that a Code Blue is not called, and the providers do not try to bring the patient back to life.
  • When life support is stopped: Many patients and families decide to stop life support if the patient is not getting better. This happens when this treatment is seen as prolonging an expected death. Time with loved ones and comfort are the main goals. Providers use their skills and experience to providing comfort-focused care.

What happens after a patient dies?

For patients who die at UCSF Medical Center, Patient Relations coordinates the Decedent Affairs Program, which provides guidance and acts as a liaison between your family and outside agencies.

Staff members are available Monday through Friday, 8:30 a.m. to 5 p.m.

Phone: (415) 353-1936.

If you wish to speak with someone in person, the office is located at
350 Parnassus Avenue, Suite 603.

  • After a patient dies, family and loved ones have the opportunity to say good-bye in-person.
  • You may be asked whether you would like your loved one to have an autopsy performed. This is a medical examination that is performed to better understand the cause of death. The decision to have an autopsy performed is personal; some families choose to while others do not.
  • Funeral, cremation and cemetery arrangements will need to be made if your loved one has not made them ahead of time. Learn more here.
  • There are additional practical tasks that will need to be completed as well. Enlist the support of other family and friends to assist with some of the tasks listed here.

What Bereavement resources are available?

Family members of patients who die during or after a stay in the ICU frequently experience high levels of stress and anxiety. Professional help is available and recommended. Your local hospice has grief support programs. This is available even if your loved one was not a hospice patient.