End of Life Care in ICU Sharjah

What is end-of-life care in the ICU?

Intensive care exists to support failing organs while the body heals. Sometimes, despite everything the team does, the illness advances beyond what any machine or medicine can reverse. When that happens, the goal of care changes. Treatment continues, but its purpose becomes comfort: easing pain and breathlessness, keeping your relative clean, calm and peaceful, and giving the family time to be together.

This is sometimes called palliative or comfort-focused care. It is active, attentive work, and the same doctors and nurses who have cared for your relative throughout continue to look after them. At Dar Al Kamal Hospital, Sharjah, this care is led by the ICU team, and input from a palliative care specialist is arranged where available. The wider picture of the unit is on the Critical Care and ICU page.

Who needs it

Comfort-focused care is considered when the team believes further intensive treatment is very unlikely to bring your relative back to a life they would recognise or accept. This may follow:

• organs continuing to fail despite full support
• a severe brain injury with little prospect of recovery
• a serious long-term illness, such as advanced cancer or heart, lung or kidney disease, reaching its final stage
• your relative's own earlier wish to avoid prolonged machine support

Sometimes the picture is uncertain. The team may then suggest a time-limited trial of treatment, with an agreed point to review whether it is helping.

What happens

An honest conversation. The ICU doctor asks to meet the family in a quiet room. They explain what has happened, what treatment is now able to achieve, and why they are recommending a change of focus. You are welcome to bring the relatives who matter most, to ask anything, and to take time before responding. Family meetings are described further on the family communication and support page.

A shared decision. The doctors bring medical judgement; you bring knowledge of your relative, their values and their faith. Together you agree a plan. The decision rests on medical advice, so families are spared carrying it alone.

Stepping back from treatments that have stopped helping. Some treatments may be reduced or stopped, such as medicines supporting blood pressure, further blood tests or, at the right moment, the ventilator. The team explains each step beforehand and moves at a pace that allows the family to be present.

Care that continues. Comfort medicines for pain, breathlessness and distress are given through a pump and adjusted closely, as explained on the sedation and comfort care page. Mouth care, gentle repositioning, a clean bed and a calm space continue throughout. Alarms can be quietened and unneeded equipment moved away so the family can sit close.

Changes in breathing. Near the end, breathing often becomes irregular, with long pauses, or noisy because of secretions in the throat. Families find this frightening, yet it usually reflects the body slowing down rather than suffering. The nurses watch for any sign of distress and treat it straight away.

Being present. Holding a hand, speaking, reading or praying at the bedside are all welcome. Hearing is thought to be one of the last senses to fade, so familiar voices may still reach your relative.

Preparing for it

There is no right way to feel, and the team will guide you gently. A few things may help:

• Share your relative's wishes, whether spoken or written, and anything they said about machines, pain or where they wanted family around them.
• Choose one family contact to receive news and pass it on, so the team can reach you quickly.
• Write down your questions, including the hard ones, such as how long, whether they are in pain, and what will happen next.
• Tell the team about faith and cultural needs. For Muslim families this may include Quran recitation, prayer, facing the Qibla or the Shahada at the bedside; families of other faiths may have their own prayers or rituals. Religious leaders are welcome; ask the team how a visit can be arranged.
• Contact relatives abroad early if they may wish to travel or join by phone or video. Visiting arrangements are explained by the unit.

Afterwards

After your relative dies, you are given time with them. The nurses care for their body with respect and can involve the family in washing or other rites where your faith asks for it. The team guides you through the practical steps that follow, including paperwork and arrangements for burial or repatriation, which matter for the many UAE families with roots overseas.

Grief after an ICU death can bring shock, guilt or replayed memories. These feelings are common. If you would like to understand more about your relative's final illness, you can ask to speak with the ICU doctor later.

At any stage, ask the bedside nurse or ICU doctor if something worries you, or call the hospital on 06 599 7777.

Cost and insurance

Comfort-focused care is part of the intensive care stay, which most UAE insurance plans cover with approval renewed as the stay continues. The insurance office at Dar Al Kamal Hospital, Sharjah can explain your relative's cover on 06 599 7777, so families can focus on being together.