Réveil d'un Coma

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Making a Comeback: What happens after the coma?

What will I face when the person ‘wakes up’ from a coma?

Every head injury is unique. The brain is the greatest wonder and a very complicated organ. Therefore it cannot be expected to heal as fast as a broken leg. It takes time to heal. A traumatic Brain Injury survivor might go through different and sometimes upsetting stages of recovery.

Physical Needs:

Like a new-born baby, the survivor might wake up in the night, put things in their mouths, have problems knowing when they need to use the toilet and struggle with balance. It takes time for normal functions to come back.

Emotional Needs:

Sometimes the survivor may have outbursts of anger. This is difficult to handle and some family members may get angry or scared in response. However, after the outburst the survivor usually can’t remember what they have said – it was the brain injury shouting, not the person you love and care for. It is a waste of time and energy to argue with them or take what they said personally, because at this stage they can’t take responsibility for their moods.

Mental Needs:

The recovering patient has to relearn so much – imagine having to relearn how to talk, walk and eat. Therefore this process should be taken slowly. Talk about one thing at a time, don’t allow too many visitors at once. The survivor tires easily. They might talk ‘nonsense’ and be restless at times, forgetful and make unreasonable demands. Be patient as they progress through all these struggles.

Take each day as a new day.

Try not to think back about “what if this or that did not happen”; the situation is as it is. Take every day in stages and finish each step little by little. Be prepared for ‘ups’ and ‘downs’, good days and bad days. No-one knows how your family member will progress.

How do I treat my injured family member?

It is of the utmost importance that the injured person is treated with RESPECT at all times. Although a person might not talk properly, they can still hear you and have feelings. Never talk about them, but rather with them, ask their opinion about situations which affect them. Be patient, they are living life in the slow lane.

Don’t be afraid to ask for help

As time passes, situations might arise which disrupt family life. The survivor may express anger, suspicious behaviour and abnormal expressions of sexuality. Don’t be alone in these situations.
Contact your social worker at your hospital or clinic before your family suffers too much. The injured person is not the only one who might need professional care. Therefore it is a good idea for the whole family to go for counselling and to join a support group.

Practical Tips:

Family	Involve every family member and create a loving, caring environment for the survivor. A set routine is essential.
Movement	Hospitals and pharmacies rent out wheelchairs if movement is difficult. The Occupational Therapist can give you advice about other supporting aides. Movements can be slow, so patience is a keyword.
Cleanliness	A plastic chair in the washing area helps with problems of balance. Men should keep a urinal in the room.
Safety	Restlessness may cause falls and injuries, so put bedding on the floor. Those survivors who have been independent may begin to feel “unsafe” as they are not sure of their body and the space around it. Night sounds may frighten them if they are alone – you might have to sleep in the room with the person. Physical touch has a calming effect; even touching their back or hand makes a difference.
Confusion	Brain surgery can affect the survivor’s sense of time and place. You can gently remind them of the day and date, if you do not have a special clock.
Vision	A magnifying glass can be used. In case of double vision, the person can be taught to close or cover one eye and focus with the other.
Hearing	The person can have hearing disturbances and be sensitive to loud noises or background noises. Be aware of noisy radios and televisions.
Exhaustion	People with brain injuries tire easily, it can be very exhausting to even walk just 10 steps. Thinking also drains a lot of energy, so REST is very important! Rest is advisable after lunch but not for too long in case it stops night sleep. Exercise and rehabilitation is best after a rest period. Follow the recommended programme.
Eating, drinking and smoking	The best possible nutritious food will help them get strong again. Coffee is not good as it interferes with sleep. Smokers should have one ashtray to calculate how many they have smoked during the day. Smoking is not recommended. Alcohol is a NO-NO. It has a destructive effect on recovering brain cells.
Rehabilitation	Therapists will prescribe a programme while they are in hospital, and it is vital to stick to it. They can begin to help in the home, but each activity must be done separately to avoid confusion. If possible, they can attend their place of work for a short while per day. This will help with social interaction, self-esteem, self-worth and give them a reason to get up daily.
Public Reaction	If people stare at them because they walk, talk or act differently, it is OK. They have a second chance in life and are busy learning to adapt which is very courageous. The community at large is not informed about brain injury, and this is your opportunity to inform and educate them.
Self-Worth and Independence	It is good to get the person’s view when making a decision about daily activities such as dressing, buying food, etc. If the daily routine is changed, communicate with them and tell them why. It is advisable to limit choices to avoid confusion and anxiety. They can be encouraged to write a journal. Even if they can’t speak, you can write information down to help them feel more in control.
To Remember: the S-Strategy	Structure his day Silence Sleep Stimulation: in short bursts of time, slow and steadily raised. Socialisation: slow and steadily raised. Not too many people and not all at once.

Source: ComaCare