Read the following.


It’s extracts from a brochure re-published by the Hannelore Kohl Stiftung written by Prof Andreas Zieger for relatives of persons with (very severe) brain injuries, persons who might still be in a coma or coma-like state.

Even people with severe injuries can recover because the brain is a social organ. The interaction with other people is essential for the patient to perceive him or himself again. (…) Only an understanding and empathetic surrounding can detect and interpret even small signs of revitalisation and recovery. These physical reaction, often first observed by relatives, can be of vital prognostic importance. (…) There are still may treating physicians who ignore them.

The experience with patients in early rehabilitation or at the coma ward has shown that loving care, consolation and support can promote early remission.

Relatives know the characteristics and the personality of the patient and often are the first ones to detect hinted movements and changes in facial expressions, breathing, heart beat, skin colour, eye opening and eye movements, It is not unusual that these early observations of little signs and primitive reactions are contradictory to the observations of the nursing staff. Some relatives have filmed the reactions to prove their observations.

All these observations indicate that coma (…) patients try to communicate with their environment earlier than previously assumed by responding in their own specific manner. The objective must therefore be to draw on these ways of expression and reaction, behavioural responses and self-actualisation and to establish a communication code through sighing, blinking, hand signals and other expressions. With your (the family/friends) presence and loving care you establish the essential trust bond and communication your loved-one needs to survive.

It has further been established that early intensive caring and communication can avoid severe forms of long-term coma or persistent vegetative state (…).

Swedish, Anlo-American and German studies have shown that as many as two-thirds of the patients can be socially reintegrated by an early and well-structured therapy programme with multi-sensory stimulation and close communication. It is especially in familiar and domestic surroundings that patients make surprising progress and become more communicable, more independent and autonomous.

The reason for staying trapped in a coma or persistent vegetative state may not only be the brain injury itself, but also additional traumas and a lack of sensory stimulation, caring, and communication.

(Prof. Andreas Zieger, Coma and vegetative state – a guide for relatives, ZNS – Hannelore Kohl Stiftung, 2015)

You might imagine what I felt when I read this.

Contrast this with the current praxis of treating persons with (very severe) acquired brain injuries. If what Prof Zieger describes has been established by researchers and practitioners, and there is no reason to doubt what he is saying, then sending people into nursing homes as a matter of course (not an exception), denying people regular and ongoing therapies, ‘managing’ their condition instead of addressing it appropriately – is neglect in my opinion.

I wonder if anyone in the professions in Ireland – from doctors to carers – is aware of what Prof Ziegler says has been established for quite some time now?

We need to make sure they are!

So that they can help us to adequately help our friends and relatives with severe Acquired Brain Injuries!