Critical illness and intensive care

Older adults constitute the majority of intensive care unit (ICU) patients, and are increasing in both absolute and relative numbers. Critical care for elderly people should be tailored to their unique physiology, susceptibilities to complications, social circumstances, values, and goals for their care. Knowledge of the short and long-term outcomes of critical illness should guide therapy and goals of care. With a growing number of elderly ICU survivors, the functional, cognitive, and psychological consequences of critical illness and ICU exposure will become a more prominent problem to address. In this chapter, we will discuss morbidity and mortality of elderly ICU patients, provide an evidence-based bundle for the management of pain, agitation, and delirium that has been developed with the vulnerabilities of older patients in mind (though it is also being applied broadly to younger patients as well), and explore the long-term physical, cognitive, and psychological consequences that ICU survivors face.