Early Mobilization in the ICU and in Acute Care – A Family's Perspective


Kathryn Biel

As a PT, it’s not uncommon to spend our days in the hospital. This fall, I got to spend more time in the hospital than I’d planned for. My dad had a stroke. Unfortunately, he was at my house when it happened, so I had the task of bringing him to the hospital. I sprung into PT mode, assessing his mobility, his coordination, his speech, his balance. Of course, I was scared. We all were. What I was thinking about the whole time were about the possible lifetime limitations my dad would face. What would his impairments be? What would he get back?

He was admitted of course, and due to unstable blood pressure, was admitted to the ICU. The next morning, he seemed pretty good. There was some barely noticeable dysmetria in his hand. Occasional dysarthria. His balance was a bit off. I was pleased that his PT was in by 9 am. Ambulation and transfers were assessed, and he was able to get out of bed.

Mid-day, he went south. We still don’t know why. What I do know is that while the nursing documentation stated “no change” (long story there), his PT was able to not only provide documentation, but to speak with the physician on our behalf to explain the gravity of the situation. My dad went from being stand-by assist without assistive device to moderate assistance x 2 with a rolling walker. His speech was virtually unintelligible. His right hand barely worked. The PT knew. The PT understood. The PT got the ball rolling and advocated for transfer to the best rehab in the area.

Just under three months later, my dad’s doing great. He’s not 100%. Like I feared in the ER, he may never be 100%. But I know, those first few days in the ICU and acute care were critical. And I know what a difference early mobility made for him.

So, on behalf of my family, thank you to the therapists who brave the machines, the illness, the crazy families (of which I may or may not be one of) to get in to the ICU and acute care. I know you know what a difference you make. Now I know too.

~Kathryn Biel, PT, DPT