📖 12 min read
When Your Parent Is in the ICU
The phone call that changes everything. Your parent is in the ICU in India and you're thousands of miles away, trying to understand what is happening from a phone, often through second-hand information, often in the middle of your night. This guide won't make it easy — nothing does. But it will help you understand what you're hearing, what to ask, and how to make the best decisions you can from where you are.
You are doing the best you can from where you are. The distance is real, and the helplessness is real, and the guilt is real — and none of it means you love your parent any less. One step at a time. One question at a time.
You don't have to read this whole guide right now. Tap where you are.
This is a long guide because ICU situations vary hugely — it's meant to be a reference, not one sitting of reading. Tell it where you are and get just the next few things that matter. It remembers, so come back anytime.
In the next hour, in this order:
- Get one person physically to the hospital — a sibling, relative, or trusted friend. That's more urgent right now than your own flight.
- Ask the ward for the treating intensivist's name and a contact number, and request a scheduled daily update call.
- Pull up the Emergency Card and Parent Profile — blood group, conditions, medicines — and share it with whoever's there.
- Agree on one family spokesperson to talk to the medical team, so the team isn't fielding five separate calls.
Trying to understand what's happening right now:
- Don't recognise a machine or term the team used? Tap it here — plain-language explanations for the common ones.
- Getting only vague, one-line updates and not sure what they actually mean? Decode the update — and the rage, confusion and fear of the wait itself, named.
- On your next call, work through the question checklist — tick each one off as you ask it.
- If you can't be physically there, ask the patient-relations desk to arrange a video call with the intensivist — most Indian hospitals now support this.
- Keep a running WhatsApp note of what each doctor says, who said it, and when — memory fails under stress.
If the team is asking you to decide something:
- Ask: "What would you do if this were your family member?" — often the clearest read on where the team's thinking is.
- Ask what's time-critical versus what can wait 12–24 hours. Most decisions aren't as immediate as they feel in the moment.
- "Doing everything" is not always the same as doing the right thing — it's fair to ask honestly what a treatment will actually achieve.
- You don't have to decide alone, and you don't have to decide today.
You are not going to be useful to anyone if you completely fall apart — this is not a small thing to say.
- Sleep and eat something, even in small amounts. Set an alarm for it if you have to.
- One update call a day, not twenty separate ones — repeating devastating information is its own trauma.
- Talk to someone outside the family. If you're in Australia: askmygp.com.au can point you to a GP, and helplines.com.au has free, confidential support.
The first 24 hours — what to do right now
When the call comes, the first instinct is often to book a flight. That may be the right call — but do these things first:
- Get one person to the hospital. A sibling, relative, trusted family friend — someone who can be physically present, talk to the team, and report back to you. This is more urgent than your own travel arrangements.
- Identify the treating intensivist (ICU doctor) by name. Ask the hospital for a contact number or email for them or the ward coordinator.
- Ask for one scheduled daily call. Most Indian ICU teams do a family briefing — often morning or early evening. Ask to be included by phone or video, or to receive an update from the person on the ground immediately after.
- Designate one family spokesperson. Multiple family members calling the ICU team separately creates confusion and uses time the team doesn't have. Agree on one person to speak to the medical team, then relay to others.
- Pull up your parent's details. The Emergency Card and Parent Profile you've built will have blood group, conditions, medicines, allergies, and insurance — exactly what the team needs.
- Check the insurance/Ayushman situation immediately. Start cashless pre-authorisation as early as possible. See the admission day checklist.
What the machines and terms mean — ICU glossary
Tap any term to understand what it means in plain language.
Browse every ICU term
All the terms and machine names from the tool above, written out in full — including ventilator "modes" like PRVC and SIMV, which families are often told without any explanation.
Ventilator / Mechanical ventilation (MV)
A machine that breathes for someone who cannot breathe effectively on their own. A tube is placed into the windpipe (intubation) and the machine delivers oxygen. Being on a ventilator is serious but does not mean the situation is hopeless — many people recover and come off it. The team will trial reducing support daily (called weaning). Ask: what is the plan for coming off it, and what is the realistic timeline?
Ventilator "mode" — PRVC, SIMV, AC/VC
If the team says your parent is "on PRVC" or names another mode, this is about exactly how each breath is timed and shaped — a separate thing from whether they're on a ventilator at all. PRVC (Pressure-Regulated Volume Control) is one of the most commonly used modes: the machine targets a set breath size but automatically adjusts how much pressure it uses to get there, breath by breath, aiming to protect the lungs while still delivering enough air. You may also hear SIMV (some breaths are fully supported by the machine, others are more the patient's own effort — often used while easing someone toward breathing independently) or AC/VC (every breath, however it's triggered, gets the same set volume). The exact mode name matters less than the direction it's moving in: ask whether the current settings mean more or less machine support than yesterday.
PEEP and FiO2
Two settings you'll hear regardless of the mode. PEEP (Positive End-Expiratory Pressure) is a small constant background pressure the ventilator keeps between breaths, so the tiny air sacs in the lungs don't collapse — a bit like keeping a balloon slightly inflated rather than letting it go fully flat. FiO2 (Fraction of Inspired Oxygen) is simply the percentage of oxygen in the air being delivered — room air is about 21%, and 100% is pure oxygen. Both are usually started higher and brought down as your parent improves; the team lowering either number is a genuinely encouraging sign.
Oxygen saturation (SpO2)
The percentage of haemoglobin in the blood carrying oxygen. Normal is 95–100%. Below 90% is concerning. You'll see it as a number on the monitor, often with a waveform. The team watches it constantly. If it's low, they may increase the oxygen flow or consider ventilation.
BiPAP / CPAP / High-flow oxygen (NIV / HFNO)
Non-invasive ways to help someone breathe more easily without a tube in the throat. A tight mask delivers pressurised air. Less invasive than a ventilator and often used as a step before or instead of ventilation. If it's working, it may avoid intubation.
Vasopressors / Inotropes (e.g. Noradrenaline, Dopamine)
Medicines given through a drip that tighten blood vessels or strengthen the heart's pumping — used when blood pressure is dangerously low (shock). If your parent is on "pressors" or "inotropes", it means their circulation needs support. The dose being reduced is a good sign; the dose being increased is concerning.
Sepsis / Septic shock
A life-threatening response to infection where the body's own immune response starts damaging organs. It's treatable but serious and fast-moving. Treatment involves antibiotics, fluids, and often vasopressors. Sepsis is one of the most common reasons for ICU admission in India, particularly from urinary or respiratory infections in older adults.
Dialysis / CRRT (Continuous Renal Replacement Therapy)
When the kidneys stop working, dialysis removes waste from the blood that the kidneys normally clear. CRRT is a continuous, gentler form used in ICU when a patient is too unstable for standard dialysis. It does not fix the kidneys — it buys time while the team tries to treat the underlying cause. Ask: is this a temporary measure or are we looking at permanent kidney failure?
GCS / Level of consciousness (Glasgow Coma Scale)
A score from 3 to 15 that measures how responsive someone is — whether they open their eyes, speak, and move in response to stimulation. 15 is normal. Below 8 is severely impaired. If the team says "GCS of 10" it means your parent is responding but not fully. If they say "GCS of 3", it means deeply unresponsive.
Sedation
In ICU, patients are often kept sedated so they tolerate the ventilator and don't pull out tubes. Sedation is not the same as being unconscious from illness — it's a managed, medicated state. The team will reduce sedation daily to assess how the patient is doing underneath it. A sedated person may still hear and respond to touch and voice — talking to your parent matters even if they seem unresponsive.
Central line / Arterial line (CVP / Art line)
Lines inserted into large blood vessels to deliver medicines quickly, monitor blood pressure continuously, or draw blood without repeated needle sticks. They look alarming but are routine ICU equipment. A central line in the neck or chest is standard.
Prognosis
The team's best estimate of what is likely to happen. Ask directly: "What do you think will happen if we continue the current treatment? What is the realistic best and worst outcome?" Doctors are sometimes reluctant to give a prognosis, but you have the right to ask and they have a responsibility to be honest with the family.
DNR / DNAR / AND (Do Not Resuscitate / Allow Natural Death)
A medical order that if the heart stops, the team will not attempt CPR. This is not "giving up" — CPR in a frail elderly person with multiple organ failure is often traumatic and rarely succeeds. A DNR order allows a natural, peaceful death without intervention that is unlikely to help. This conversation deserves time, a direct discussion with the senior doctor, and family agreement.
Questions to ask the intensivist
You have limited time on each call. These are the questions that matter most. Tick them off as you ask them — it saves on your device.
Making hard decisions from abroad
At some point, you may be asked to make a decision — about escalating treatment, about a procedure, about what to do if things get worse. From 10,000 miles away, with incomplete information and a bad phone connection, this is one of the hardest things a person can face.
A few things that help:
- Ask the doctor what they would do if this were their family member. Not as a trap, but because it often gives you the clearest summary of where the team's thinking is.
- Ask about the goal of each intervention. "If we do this, what is the realistic best outcome? What is the likely outcome? What does it not do?" A ventilator, a dialysis run, a surgery — each has a specific goal. Understanding the goal helps you decide if it aligns with what your parent would want.
- Ask what your parent said they wanted. If there's any record of their wishes — a conversation, a document — bring it into the discussion. Indian law does not currently have a strong advance directive framework, but a doctor who knows what a patient valued will try to honour it.
- Know that "doing everything" is not always the same as doing the right thing. Aggressive intervention that cannot help can prolong suffering. You are not abandoning your parent by asking honest questions about what treatment will achieve.
- You don't have to decide everything immediately. Ask the team what is time-critical and what can wait 12 or 24 hours. Most decisions are not as immediate as they feel in the moment.
- If the situation is deteriorating rapidly, consider the flight. If the team says the next 24–48 hours are critical, being there often matters more than anything else you could do remotely. See the emergency India visit guide.
On ventilators and withdrawing support: If the team is discussing removing a ventilator because treatment is no longer helping, this is a medically and ethically legitimate option — not giving up. It is the team saying that the machine is no longer helping your parent and may be prolonging discomfort. This conversation deserves time, a direct call with the intensivist, and if possible, the support of a trusted doctor or friend who can help you process it.
Staying in the loop from abroad
- Ask the hospital's patient relations / help desk to facilitate a video call with the intensivist — many Indian hospitals now support this, especially for NRI families.
- Your person on the ground should call you immediately after each round or briefing, while the information is fresh.
- Keep a running WhatsApp message thread or note of what each doctor says — who said it, when, and what they said. Memory fails under stress.
- If you're getting conflicting information from different sources, ask the charge nurse or head of ICU to clarify — too many people relaying information creates confusion.
Costs and insurance
ICU care in India is expensive. A single day in a private hospital ICU can range from ₹15,000 to ₹80,000 or more depending on city, hospital, and level of care. Start managing this from day one:
- Get the hospital's insurance/TPA desk to begin cashless pre-authorisation immediately — delays cost money and cause discharge problems.
- For Ayushman Bharat (70+ scheme): confirm the hospital is empanelled and the claim is registered. Helpline 14555.
- Keep every receipt, every bill, every prescription — from minute one. Claiming later without documentation is very hard.
- Ask for a cost estimate and an itemised bill daily. Some hospitals add charges that can be disputed.
- See the Ayushman guide and health insurance guide for more.
Looking after yourself
You are not going to be useful to anyone — your parent, the person on the ground, the rest of the family — if you completely fall apart. This is not a small thing to say. Caregiver collapse during a parent's ICU stay is common and real.
- Sleep when you can. Even two or three hours matters.
- Eat something. Set an alarm for it if you have to.
- Tell your employer what's happening. Most people are more understanding than you expect.
- Limit the number of family members you speak to. One update call per day, not twenty individual calls. Repeating devastating information is its own trauma.
- Talk to someone outside the family — a friend, a GP, a counsellor. If you're in Australia: askmygp.com.au can guide you to support. For mental health resources: helplines.com.au.
Whatever happens — whatever you decide, whatever the outcome — you made the best decisions you could with the information you had, from where you were. That's all anyone can do. The love that got you reading this guide at whatever hour you're reading it is real and it counts.
Frequently Asked Questions
What questions should I ask when my parent is in the ICU in India?
Key questions for the intensivist: What is the primary diagnosis and what are we treating? What is the goal — cure, stabilisation, or comfort? What does each machine or tube do? What are the realistic outcomes? How quickly might things change? Who do I call if something changes urgently? Can we do a daily family call?
How do NRI families communicate with ICU doctors in India?
Ask for a designated family point person who can attend rounds or get a daily update call. Most Indian ICUs have daily family briefings, usually morning or evening. Ask the ward coordinator or hospital patient relations team to arrange a scheduled video call with the intensivist. Keep one family member as the primary contact to avoid multiple people calling.
What does it mean when a parent is on a ventilator in India?
A ventilator breathes for someone who cannot breathe effectively on their own. It is a life support measure, not a cure. The team will assess daily whether the person can breathe without it — this is called a weaning trial. Being on a ventilator does not mean the situation is hopeless, but it does mean it is serious. Ask the team about the plan and the realistic timeline for weaning.
What does PRVC mode mean on a ventilator?
PRVC stands for Pressure-Regulated Volume Control, one of the most commonly used ventilator modes. It means the machine targets a set breath size but automatically adjusts how much pressure it uses to reach it, breath by breath, aiming to protect the lungs while still delivering enough air. Other mode names you may hear include SIMV and AC/VC. The specific mode name matters less than the direction it is moving in — ask the team whether the current settings mean more or less machine support than the day before.
How do I make decisions about ICU care from abroad?
Designate one family member to communicate with the medical team. Ensure a Power of Attorney or trusted local family member can make decisions if needed. Ask the team clearly about prognosis and what each intervention will and won't achieve. It is appropriate to ask about comfort-focused care if aggressive treatment is unlikely to help. You do not have to decide everything immediately — ask the team what is time-sensitive and what can wait.
Your toolkit
Blood group, conditions, medicines — share with the ICU team.
How to ask the hospital, and a ready-to-send request message.
Cashless insurance, deposits, questions to ask.
If you need to get there fast.
The rage, fear and confusion of the wait itself — named, and made a little more bearable.
Why consultations feel different here, and what actually helps.
The broader guide for managing a hospitalisation.
For making decisions on your parent's behalf.
The practical steps, gently.
Warm, ready-to-send messages for the "just visiting" pressure.
This is general information, not medical advice. Every ICU situation is different and changes rapidly. Follow the treating team's guidance. In India: 112 (emergency) · 108 (ambulance).