What happens to the body in intensive care?
Intensive care keeps people alive, and the cost is a body that has barely moved for days. Muscles shrink, joints stiffen, the lungs and heart lose fitness, and the person may have been sedated or on a breathing machine.
When they come home, simple things such as sitting at the edge of the bed, standing or walking to the toilet can feel enormous. This is not laziness or lack of will. It is the expected result of critical illness.
We are the Ipoh branch of Kinesio Rehab Physiotherapy Centre. Home visits across Ipoh are available now, and our Canning Garden centre is opening soon.
How does recovery feel for the patient and the family?
The patient may remember little, or remember frightening things. They can feel weak, tired by midday, short of breath, and anxious at night. Some find their voice is hoarse, swallowing feels odd, or their hands are clumsy.
Families feel relief mixed with fear. After weeks of hospital corridors, you now carry the responsibility at home. If you are in KL or Singapore, the worry travels with you.
You are not alone in this. Hospitals in Ipoh, such as Hospital Raja Permaisuri Bainun, KPJ Ipoh Specialist Hospital and Pantai Hospital Ipoh, have follow-up clinics, and physiotherapy at home can bridge the weeks between appointments.
What do we check at the first home visit?
We read the discharge papers, then watch how the person moves, always at their pace.
- Breathing: rate, effort and how easily they talk.
- Heart rate and how it recovers after sitting up or standing.
- Strength in the arms, legs and trunk.
- Sitting balance, standing and short walking with support.
- Swallowing and voice concerns, which we pass to your doctor.
- Joint stiffness, skin and pressure areas.
- Mood, sleep and memory, which we note and share with your doctor if needed.
We stop at once and advise medical help if the person has chest pain, severe breathlessness, fainting or confusion.
What does a gentle recovery plan include?
Recovery is slow, and the plan grows only as the person can manage. We aim for a small step each week, not a big push.
- Sitting up for meals, in a chair, rather than in bed.
- Supported standing and marching on the spot.
- Short walks inside the house, then outside in the cool of the morning or evening.
- Breathing practice, such as slow breaths and relaxed shoulders.
- Arm and leg exercises with light resistance as strength returns.
- Planned rest between tasks, called pacing.
Food matters, so ask your doctor or a dietitian about protein and energy. Read about deconditioning for the wider picture of weakness after illness.
How can the family help?
Be present, be patient and stay practical. Praise the small gains, keep a simple diary of activity and tiredness, and encourage the person to do what they can, even slowly.
Avoid doing everything for them, because that keeps strength from returning. Equally, do not push through exhaustion. Our post on after hospital discharge in Ipoh has a checklist for the first days home.
What can you do this week?
- Create a daily rhythm: wake, sit up, wash, eat at the table, short walk, rest.
- Keep walkways clear, and keep a chair near the bathroom.
- Put a phone, water and medicines within reach.
- Write down questions for the next hospital visit.
- Keep a note of sleep, mood and breathlessness.
- Ask a trusted friend or relative to sit with the person, so the main carer can rest.
Call the hospital or go to the emergency department for chest pain, severe breathlessness, a fast heartbeat that does not settle, fainting or sudden confusion.
When is another route better?
If the main trouble is memory, nightmares or deep sadness, your doctor can refer you to the right service, and physiotherapy continues alongside. If swallowing is unsafe, ask for a speech therapy referral.
For long-term breathing problems, see chronic obstructive pulmonary disease (COPD) and breathing rehabilitation. For ongoing tiredness after a virus, see long coronavirus disease (COVID). To learn how visits run, read about home physiotherapy in Ipoh.