Disorders of Consciousness Program
Brain Injury Rehabilitation at Shepherd Center
Shepherd Center's Disorders of Consciousness (DOC) Program provides a short-term three-to-five-week program for patients who are semi-comatose or minimally conscious (Rancho I-III). In this program, patients receive one and a half hours of therapy daily. The design of this program incorporates the understanding that these patients often show a slow response to therapeutic intervention for recovery.
Key components of this program include reducing medical acuity, preventing medical complications and continually measuring arousal and attention to the environment. The program also addresses neuropharmacological management, nutritional management, maximizing mobility, and family education and training.
Download a PDF of our Disorders of Consciousness Program Fact Sheet.
Our Approach to Disorders of Consciousness Rehabilitation
The interdisciplinary team works closely to facilitate the patient's recovery by offering an individualized plan of care that balances medication management, therapies, environmental stimulation and rest. At Shepherd Center, we believe in educating each family to help you care for your loved if he or she is not ready for active rehabilitation.
Treatment team members include physiatrists and other medical consultants, nurses, case managers, physical therapists, occupational therapists, speech-language pathologists, neuropsychologists, family counselors, recreational therapists, activities-based therapists, dietitians, respiratory therapists, chaplains and behavioral specialists.
Disorders of Consciousness Patient Treatment
Patients who are in a reduced or minimally conscious state following a traumatic brain injury are often not ready to begin an active rehabilitation program. However, Shepherd Center believes it is critical to optimize recovery until the patient emerges and to educate and train the family and/or caregivers about expectations and care.
For these patients, Shepherd Center's specialized Disorders of Consciousness (DOC) Program provides pre-rehabilitation and education services. Patients receive about one and a half hours of daily therapy. The design of this therapeutic approach accommodates a slower response and the need for rest and structure for these patients.
Shepherd Center’s DOC Program focuses on preventing medical complications and continually measuring arousal and attention to the environment. Other key components of this program include:
- Pharmacological management
- Positioning and seating
- Cognition and communication
- Maximizing mobility
- Family/caregiver support and education
Shepherd Center’s specially trained staff uses the Coma Recovery Scale-Revised to assess the patient’s rate of emergence and response to his or her environment. The interdisciplinary team works closely to facilitate the patient’s recovery by offering an individualized plan of care that balances medication management, therapies, environmental stimulation and rest.
Family-Centered Care Treatment for Disorders of Consciousness
Family and caregiver education is critical to a patient’s recovery during and after the DOC Program. At Shepherd Center, we make sure you feel involved in the care, ask for your recovery goals and expectations, and encourage you to ask questions. The program will provide many opportunities for education and training to help you feel comfortable in caring for your loved one at home. Training may include, but is not limited to:
- Medication management
- Tube feeding – nutritional management
- Bowel and bladder care
- Respiratory care
- Diabetic care
- Safety management and care
- Community education and reintegration
- Transfer and retraining
- Skin care
- Coma Recovery Scale training
Brain Injury Rehabilitation Program Family/Caregiver Activities
- Medical conferences with your physician and case manager
- Neuropsychology education/counseling for understanding your loved one’s recovery
- Goal-setting with your treatment team
- Scheduled hands-on training with nurses and therapists
- Support groups
- Peer visitors
- Community outings
Disorders of Consciousness Discharge Support
During the inpatient stay, the patient receives a Transition Support Coordinator (TSC) from the Transition Support Program. The TSC supports the family for 60 days post-discharge as they transition to home. The TSC makes contact regularly to address any questions the family has. This creates a smooth transition home as family members provide care in the home and assist in monitoring their loved one’s cognitive recovery.
Disorders of Consciousness Program Resources
For additional educational and training information, visit MyShepherdConnection.org. Get more information about choosing a rehabilitation program and hospital for your loved one by visiting our Hope Beyond Injury page.
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