Keep a Care Journal: A Guide for ICU Patients and Families

What is a Care Journal?

A Care Journal is a personal notebook that you and your family can use while your loved one is in the Intensive Care Unit (ICU). It’s a powerful tool for healing, communication, and remembering.

Benefits of a Care Journal

Support Each Other During the ICU Stay
Writing messages of hope and encouragement for your loved one and family members can really help everyone through the experience.

Stay Organized
With so much going on, it’s easy to forget details. Your Notebook keeps everything in one place.

Improves Communication
Use it to keep your family in the loop and to prepare questions for the medical team.

Reduce Stress and Process Emotions
Writing things down can be really therapeutic and help clear your mind.

Promote Mental Health Post-ICU
Writing can be therapeutic for both you and your loved one in the moment, but also reflecting on your Care Journal post-ICU can be very helpful in processing the experience.

What should I write about?

What happened?

The first thing to write about is what happened that landed your loved one in the ICU? It can be scary the face the reality of the situation, but it’s important to start from the beginning.

As you continue on this healing journey things will get cloudy. It can be very helpful to have updates from the start to keep the patient oriented on what happened.

Daily Updates

Write about what happened each day in the ICU, including any treatments, procedures, or changes in the patient’s condition. You might want to include who was the patient’s nurse and other care team members. Describe your feelings, worries, fears, and hopes.

  • What is the current status of the patient’s medical condition? 
  • Are there any signs of improvement? 
  • Are there any signs of decline? 
  • Are there any changes in medications or treatments being considered? 
  • How is the patient responding to the current treatments or interventions? 
  • Are there any upcoming procedures or tests planned? 
  • What are the patient’s recent test results? 
  • How do today’s test results compare to yesterday/last time? 
  • What are the patient’s current vital signs? 
  • How do their vital signs compare to yesterday’s/last time? 
  • What is the plan for the day? 
  • Is the patient eating or drinking? Why or why not? 
  • Is the patient moving? Or being moved by staff members? 
  • What issues are keeping the patient in this unit? 
  • When should I expect to hear from the medical team next? 
  • What symptoms is the patient experiencing? 
  • What is being done to treat these symptoms? 
  • What lines or medical devices are still connected to the patient? Does the patient still need all of them?
Log Milestones

Keeping track of milestones helps patients and families see progress. Celebrating these achievements helps everyone stay positive and work together.

See List of Milestones to Consider

Respiratory:

  • First attempt at a pressure support (breathing) trial 
  • First “passed” pressure support (breathing) trial
  • Breathing tube removed 

Consciousness

  • Opened eyes
  • Followed commands
  • First words

Nutrition

  • First time taking a drink
  • First bite of food

Mobility

  • First time sitting up 
  • First time out of bed 
  • First steps  
  • First time out of the ICU room 
  • First time out of the ICU
Life Outside the Hospital

Write about anything that may interest the patient related to their life outside of the hospital including things about home, children, friends, pets, current events.

See full list of Life Outside the Hospital prompts

Home and Family

  • What’s new with the family? Share any recent achievements or funny stories.
  • How are the pets doing? Describe any cute or silly things they’ve done lately.
  • What changes or updates have been made to the house or garden?
  • What family traditions or events are coming up that might be enjoyable?

Friends and Community

  • Have any friends or neighbors sent their well-wishes? What did they say?
  • What’s the latest news from the social circle or community group?
  • Are there any upcoming community events they might enjoy when they’re back?
  • Has anyone done something kind or helpful for the family recently?

Hobbies and Interests

  • What’s happening with their favorite sports team?
  • Have there been any exciting developments in their hobby or area of interest?
  • What new books, movies, or TV shows have come out that they might like?
  • Are there any fun local events or exhibits related to their interests?

Nature and Outdoors

  • How has the weather been? Describe a particularly beautiful day.
  • What changes are happening in the garden or nearby park?
  • Have you noticed any wildlife or seasonal changes worth sharing?

Current Events

  • What positive or uplifting news stories have you heard recently?
  • Are there any local developments or changes in the town/city to report?
  • What’s new in the field or industry they work in or care about?

Future Plans

  • What are some things to look forward to doing together when they’re better?
  • Have you thought of any new goals or adventures they might like to plan?
Visitors

Who came to see your loved one today?

See full list of visitor prompts

  • Who visited today? Write down their name and relationship to the patient.
  • How long did the visitor stay? Note the time they arrived and left.
  • What was the visitor’s mood like? Describe any emotions they showed.
  • Did the visitor bring anything? Mention any gifts, cards, or items they brought.
  • What topics did the visitor talk about? List any news or stories they shared.
  • How did the patient respond to the visitor? Note any reactions, even small ones.
  • Did the visitor share any memories of times with the patient? Briefly describe them.
  • What well-wishes or encouraging words did the visitor express?
  • Did the visitor offer any help or support? Write down what they offered.
  • Were there any funny or lighthearted moments during the visit? Describe them.
  • Did the visitor mention any plans for future visits? Note any dates or promises made.
  • How did the visit seem to affect the overall mood in the room?
  • Did the visitor interact with any medical staff? Briefly describe any interactions.
  • Were there any updates about mutual friends or family that the visitor shared?
  • Did the visitor ask any questions about the patient’s condition or care?
Your feelings

How are you coping? What are your hopes and fears?

Get Help Writing About Your Feelings

  • See full list of private journal prompts
  • Describe your current emotion in one word. Then, expand on why you feel this way.
  • What physical sensations are you experiencing right now? How might they relate to your emotions?
  • What was the most challenging part of today? How did you cope?
  • What’s your biggest worry at this moment? Try to describe it in detail.
  • In this difficult time, what’s one thing you’re grateful for?
  • What’s giving you strength or comfort right now, no matter how small?
  • If you could say anything to your loved one, without barriers, what would it be?
  • What do you wish others understood about your experience right now?
  • When was the last time you felt this overwhelmed? What helped then?
  • If a friend were in your place, what advice or comfort would you offer them?
  • What’s one kind thing you did for yourself today, or could do tomorrow?
  • How has this experience changed your perspective on life?
  • What questions or concerns do you want to ask the medical team?
  • Describe a memory of your loved one that made you smile today.
  • What do you think about letting go of things beyond your control? Why is it challenging?
  • If you could change one thing about this situation, what would it be and why?
  • Who or what do you miss most right now? What makes them/it special?
  • What strength have you discovered in yourself during this difficult time?
  • How are you balancing your needs with caregiving responsibilities?
  • Imagine talking to your future self. What words of encouragement would you share?
Encouraging messages and memories

Write notes of support for your loved one or share favorite memories.

See full list of encouraging messages prompts

  • Describe a time when your loved one made you laugh. What happened?
  • Share a moment when you felt proud of your loved one. Why was it special?
  • Write about a challenge your loved one overcame. How did they show strength?
  • Recall a kind act your loved one did for someone else. How did it impact others?
  • Describe your loved one’s best quality. How has it influenced you?
  • Share a favorite tradition or routine you have with your loved one.
  • Write about a trip or adventure you shared. What made it memorable?
  • Describe a skill or talent your loved one has that you admire.
  • Share a piece of advice your loved one gave that has stuck with you.
  • Write about a time your loved one supported you during a difficult moment.
  • Describe your loved one’s favorite place. Why do they love it?
  • Share a goal or dream your loved one has. How have they worked towards it?
  • Write about a small, everyday moment with your loved one that you cherish.
  • Describe how your loved one has positively impacted your life.
  • Share a song or movie that reminds you of your loved one. Why is it significant?
  • Write an encouraging message about the strength you see in your loved one now.
  • Describe the first time you met your loved one. What stood out to you?
  • Share a family story or inside joke that always makes you smile.
  • Write about a quality in your loved one that you hope to develop in yourself.
  • Describe how you imagine celebrating together when your loved one recovers.
Goals & Future plans

What do you look forward to doing together?

See full list of future plans  prompts

  • What’s the first thing you want to do together when your loved one leaves the hospital?
  • Describe a simple daily activity you look forward to sharing again.
  • What’s a new skill or hobby you’d like to learn together during recovery?
  • Imagine a perfect day six months from now. What does it look like?
  • What’s a travel destination you’ve always wanted to visit together? Why there?
  • How do you think this experience might change your priorities as a family?
  • What’s a health or wellness goal you’d like to work on together?
  • Describe a family tradition you want to start or revive after recovery.
  • What’s a small, achievable goal you can set for this week to support recovery?
  • How do you envision celebrating the first holiday after leaving the hospital?
  • What’s a long-term dream you and your loved one share? How might you pursue it?
  • Describe how you imagine your loved one’s strength growing during recovery.
  • What’s a new way you’d like to show appreciation for each other going forward?
  • How might this experience shape your approach to enjoying life’s simple pleasures?
  • What’s a community or charity activity you’d like to do together in the future?
  • Describe a home improvement or project you look forward to working on together.
  • What’s a new family rule or value you want to establish after this experience?
  • How do you hope to grow personally from this challenging time?
  • What’s a way you’d like to give back to the medical team or other families in similar situations?
  • Imagine writing a letter to your future selves a year from now. What do you hope to be able to say?

Adding Visual Elements

  • Attach photos of family, friends, or pets.
  • Include drawings or artwork.
  • Stick in get-well cards or notes from visitors.

Tips for Effective Journaling

  • Date each entry: This helps create a timeline of events.
  • Write regularly: Try to add something every day, even if it’s brief.
  • Be honest: Don’t worry about perfect writing – focus on expressing yourself.
  • Involve others: Invite family and friends to contribute entries.
  • Review with the care team: Share the journal with nurses and doctors daily. They might offer valuable insights.
  • Set a 10 min timer: consistency is key. Keep your commitment short.

After the ICU Stay

  • Take the journal home with you when you leave the hospital.
  • There’s no rush to read through it – take your time.
  • When you’re ready to review or share the journal, consider getting support from:
    • A counselor or therapist
    • An ICU support group
    • A spiritual advisor
    • Someone experienced in helping process traumatic events

Important Notes

  • The Care Journal is not part of the official medical record.
  • Avoid writing confidential information, as others may read the entries.
  • If your loved one is unconscious or sedated, reading entries aloud can be comforting and may help with their recovery.

Remember, this journal is a tool for you and your family. Use it in whatever way feels most helpful and healing for your unique situation.