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Finding the Best Care for a Loved One in a Coma 

Typically, plans for discharge are addressed by a team of medical professionals and hospital staff. The patient may be referred to a rehabilitation facility which necessitates coordination with insurance companies and other sources of funding. You may want to consult with an attorney in regard to options for funding further rehabilitation.

Other plans may involve a return to a home setting. Outpatient programs may be arranged such as speech, occupational and/or physical therapy. A social worker may be involved to help locate community resources, nursing care, respite facilities, sheltered workshop settings, etc. You may need to arrange for treatment of behavioral problems.

You may be faced with the difficult decision of whether or not to place the patient in a more structured care environment, such as a nursing facility or a supported living facility. The discharge staff will help provide information on what options are available.

An extended coma may necessitate placement in a coma facility where the staff specializes in the special needs of the comatose patient.

These are all important decisions. You must try to be as well-informed as possible. Keep notes of meetings, or ask to record meetings so you can review them later. Don't be mislead into thinking that because a program exists you will be able to utilize it on a timely basis. Often there are long waiting lists for community resources and programs. Make sure you are informed of what the actual availability of a program is in your area. It may be difficult or impossible to arrange for the patient to be admitted to the rehabilitation facility of choice. The patient will be evaluated by the facility and some decisions must be made because of financial limitations.

If the patient is going home; does he/she need supervision, special access or special equipment? If he/she is involved in outpatient treatment; do you need to arrange for transportation? Is there community support within a reasonable distance if you should encounter any problems? Are there activities to keep the brain injured person involved? If you have difficulty locating community resources, you may have to coordinate with other people in your community faced with the same or similar problems. If you are involved with an area church, they may be able to provide some support options.

It is important when discussing and implementing plans for discharge that families put aside differences of opinion and concentrate on becoming a unified force directed at providing the most positive environment for the brain injured person as possible. If the brain injured person is returned to a home setting, the primary caregiver also deserves family support. This can be a stressful, difficult role which deserves respect, support and understanding. It is not beneficial to the brain injured person to be subjected to conflicts which may arise when family members disagree on approaches to treatment.

Use your judgment when choosing discharge options; review the options carefully, listen to professionals, talk to social workers, talk to others in your situation, listen to the patient, contact your local brain injury association, and be informed. This is a decision which needs time and energy and you will probably not be expected to make it quickly.

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