Recovery and rehabilitation – early stages

Once your relative has emerged from coma and their PTA has passed it is natural to want to know about how much recovery they can be expected to make.  It can be impossible to make definite predictions about this, especially in the early stages.

Unlike most other cells in the body, brain cells do not regenerate when they are destroyed, so brain injuries can’t heal as such.  However, the brain does have the capacity to reorganise itself in order to compensate for lost function.  This means that improvement can be made after even the most severe injuries.  It is, therefore, vitally important that specialist rehabilitation takes place as early as possible in order to maximise the potential for recovery.

Early rehabilitation

The staff team, often referred to as a Multidisciplinary Team (MDT), consists of a wide range of professionals.  The MDT will assess your relative and plan rehabilitation to help them recover.  From the beginning, even if your relative is still unconscious, the MDT will be involved in their care and will assess your relative in order to put a rehabilitation programme in place.  Rehabilitation actually starts with basic stimulation like washing, and cleaning teeth.

Rehabilitation can be quite exhausting.  You can help by planning your visits to maximise the benefits of therapy.  Ask about when your relative needs to rest and how you can support the therapists.  Remember, it is important not to overtire your relative or yourself.

Who’s who of professionals?

The variety of professionals involved can be confusing.  To help, here is a summary of some of the different specialities in the MDT:

Physiotherapists work with people who have problems with movement and function, aiming to maximise their potential following ill health, trauma or disability.  Physiotherapists work in a wide range of clinical settings from intensive care units caring for acutely ill patients, to out-patient departments working with people living independently at home.  Physiotherapists use movement and exercise, manual therapy, education and advice to encourage development and facilitate recovery

An Occupational Therapist (OT) will work with you and your relative to find out what is important them and their lifestyle. They will assess your relative’s ability to perform daily occupations including self care, cognitive abilities such as memory, concentration and problem solving; they will devise activities and coping strategies with you to help manage these problems. The focus of intervention is to promote individuals’ independence, choice, dignity and wellbeing whilst in hospital and upon their return to the community.

Speech and Language Therapists (SALT) assess and treat patients for swallowing difficulties and decide if the patient is able to start eating and drinking.  If this is a problem, a Dietician will make sure the patient is properly nourished.  Sometimes this may involve having a Percutaneous Endoscopic Gastronomy (PEG) tube fitted.  A Speech and Language Therapist will also assess if the brain injury has affected language and communication skills and will be able to help your relative to communicate.

When necessary a neuropsychologist or neuropsychiatrist will carry out specialised assessments of cognitive (thinking) processes and emotional and behavioural difficulties.