Family Accommodation For Inpatient Families

Seven in ten relatives of intensive care patients show symptoms of anxiety. When families were allowed to visit up to 12 hours a day, their anxiety and depression scores fell.

Illness happens to families, and hospitals are slowly learning to plan for that. A French study of 920 relatives in 43 intensive care units found symptoms of anxiety in 69.1 percent and of depression in 35.4 percent, and the figures were worse where there was no waiting room and no regular meeting with staff (Pochard and colleagues, Critical Care Medicine, 2001). A Brazilian trial in 36 units later showed that longer visiting hours lowered both scores in relatives without raising infections (Rosa and colleagues, JAMA, 2019). Where the family sleeps, eats and waits is part of care. This page explains how family accommodation works for inpatients at Biruni Hospital in Istanbul, in the room and near the hospital, and how relatives can look after themselves during a long stay.

Two ways to stay close

Families of inpatients at Biruni Hospital have two arrangements, and most use both.

• In the room. Ward rooms have a companion bed, and one relative can stay overnight beside the patient.
• Near the hospital. The international patients office arranges accommodation close by for the rest of the family, with daily transport between the two and transfers to and from the airport.

A typical pattern is one person in the room at night and the others in a hotel or apartment, swapping every day or two so that nobody goes a week without proper sleep. While a patient is in intensive care the companion bed is not in use, visits are shorter, and the whole family sleeps outside the hospital until the move back to the ward.

What research says about families

Of 836 relatives who completed the questionnaire in full, 69.1 percent had symptoms of anxiety and 35.4 percent of depression. Among spouses, 84 percent had one or the other.

Among 280 caregivers of patients who had spent a week or more on a ventilator, 67 percent reported high levels of depressive symptoms at first, and 43 percent still did a year later.

Read together, the two studies point at things a family can arrange. Information from one consistent source, a place to rest that is not a corridor chair, company, and enough of ordinary life kept going that the caregiver remains a person. The Brazilian trial adds a third point. Units that extended visiting from a median of an hour and a half to as much as twelve hours saw relatives actually stay for 4.8 hours a day, and those relatives scored lower for both anxiety and depression, while infections acquired in the unit and staff burnout did not increase. Being near the patient helps the family. Nobody can keep it up for weeks, though, without a proper bed within reach, regular meals and someone to take over, and that is the practical case for treating accommodation as part of the treatment plan and settling it before the flight instead of on the pavement outside the hospital on the first evening.

Choosing where to stay

Tell the coordinator the following, and the options offered will fit better.

• How many people are coming, their ages, and who will share a room.
• The expected length of stay from the written treatment plan, plus the days the doctor wants the patient to remain in Istanbul after discharge.
• Whether you need a kitchen, which matters on stays longer than a week and for special diets.
• Mobility needs, such as a lift, a walk-in shower or a ground-floor room for the patient after discharge.
• Budget range, so that options are realistic from the start.

Staying in the room

A night on the companion bed is not a night in a hotel. Nurses come in for observations, pumps beep, the patient wakes and needs help to the bathroom, and the companion who stays five nights running will be exhausted by the weekend, however willing. It is also the most useful thing a relative can do. Someone who knows the patient notices confusion, pain or a change in breathing long before a chart does, and someone who speaks the patient's language at three in the morning matters a great deal when the interpreter has gone home.

Who arranges what

Nearly everything runs through one office. The ward handles the companion bed.

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One coordinator handles all of it, from the first message through discharge, and the same WhatsApp number answers once you are back home. The office works in English, Arabic, French, Russian, Serbian, Romanian and Spanish and books interpreters for other languages.

Looking after yourself

Relatives rarely give themselves permission to rest, so here it is. A caregiver who has not slept makes poor decisions, forgets what the doctor said, catches every cold on the ward and is no use to the patient by the second week. Sleep in a real bed at least every other night. Eat at mealtimes, away from the bedside, and drink water, because hospital air is dry and coffee is not a meal. Walk outside once a day. Istanbul is a large and absorbing city, and an hour beside the water, in a park or simply in a street full of people going about ordinary business does more for a frightened mind than another hour of watching numbers on a monitor that the nurses are already watching. Keep one person at home informed and let that person update everyone else, so that your phone is not a second job. Bring your own medicines in sufficient quantity, and tell the coordinator if you have a health condition of your own, since hospitals are well placed to help a relative who becomes unwell. If the fear or low mood becomes heavy, say so. The studies above show how common that is, and nobody on the ward will be surprised.

Take turns. Rest counts. Nobody earns credit for exhaustion, and the patient, who sees your face every day, will read it there and begin to worry about you on top of everything else.

Children and older relatives

Families sometimes travel with small children or with grandparents who cannot be left behind. Say so early. Notice helps. An apartment with separate bedrooms, a cot, a quiet floor or step-free access is easy to find with notice and hard to find on the day. Children visit general wards briefly and by arrangement with the nurse, and anyone with a cough, fever or stomach upset stays away from the hospital until well. Plan something for children to do that has nothing to do with illness. Older relatives tire faster than they admit, and a journey of many hours followed by days of waiting-room chairs is hard on anyone past seventy, so build in rest days for them and check that their own medicines, travel insurance and mobility aids have come along.

Cost

Accommodation sits outside the treatment estimate. Confirm with the coordinator whether you pay the hotel directly or through the office. Length of stay drives the total. Use the nights in the hospital and the days in Istanbul afterward from the written plan when you budget, add a margin of several days in case discharge or the fit-to-fly date moves, and book on terms that allow a change of dates without penalty, because medicine keeps its own calendar.

Hospitals in this market obtain negotiated rates from nearby hotels, and weekly rates for apartments are lower than nightly ones. Request two or three options. Compare them on distance first.