Facts About Vegetative and Minimally Conscious States After Severe Brain Injury

Mark Sherer, Ph.D., Monica Vaccaro, M.S., John Whyte, MD, Ph.D., Joseph T. Giacino, Ph.D., and the Consciousness Consortium, Model Systems Knowledge Translation Center
Facts About the Vegetative and Minimally Conscious States After Severe Brain Injury

Severe brain injury causes a change in consciousness. Consciousness refers to awareness of the self and the environment. Brain injury can cause a wide range of disturbances of consciousness. Some injuries are mild and may cause relatively minor changes in consciousness such as brief confusion or disorientation.

The most severe injuries cause profound disturbance of consciousness. Twenty to 40% of persons with injuries this severe do not survive. Some persons who survive have a period of time of complete unconsciousness with no awareness of themselves or the world around them. The diagnosis given these people depends on whether their eyes are always closed or whether they have periods when their eyes are open. The state of complete unconsciousness with no eye opening is called coma. The state of complete unconsciousness with some eye opening and periods of wakefulness and sleep is called the vegetative state. As people recover from severe brain injury, they usually pass through various phases of recovery. Recovery can stop at any one of these phases.

Characteristics of coma

  • No eye-opening
  • Unable to follow instructions
  • No speech or other forms of communication
  • No purposeful movement

Characteristics of the vegetative state

  • Return of a sleep-wake cycle with periods of eye opening and eye closing
  • May moan or make other sounds especially when tight muscles are stretched
  • May cry or smile or make other facial expressions without apparent cause
  • May briefly move eyes toward persons or objects
  • May react to a loud sound with a startle
  • Unable to follow instructions
  • No speech or other forms of communication
  • No purposeful movement

Persons in coma or vegetative state require extensive care that may include:

  • Feeding using a feeding tube
  • Turning in bed to prevent pressure sores
  • Special bedding to help prevent pressure sores
  • Assistance with bowel and bladder relief using catheter and/or diapers
  • Management of breathing such as suctioning of secretions; this may include care for a tracheostomy tube
  • Management of muscle tone (excessive tightness of muscles)
  • Special equipment that may include a wheelchair or special bedding to help with proper posture and decrease muscle tightness
  • Management of infections such as pneumonia or urinary tract infections
  • Management of other medical issues such as fever, seizures, etc.

What happens after coma and vegetative state?

When people start to regain consciousness, they may:

  • follow simple instructions from others such as, “Open your eyes,” “Squeeze my hand,” “Say your name,” etc.;
  • communicate by speaking words or by indicating yes or no by head nods or gestures; and/or
  • use a common object in a normal way such as brushing hair with a brush, using a straw to drink, holding a phone to the ear, etc.

Persons with brain injury transition through the period of unconsciousness and subsequent stages of recovery at a slower or faster rate, largely depending on the severity of injury. Those with less severe injuries may transition through these stages more rapidly and some of the stages described here may be poorly recognized or not occur at all. Those with very severe injuries may stall at one or another stage and not be able to make the transition to a higher level of recovery.

For persons with more prolonged periods of unconsciousness, emergence from unconsciousness is a gradual process. Coma rarely lasts more than 4 weeks. Some patients move from coma to the vegetative state but others may move from coma to a period of partial consciousness. It would be very rare for a person to move directly from coma, or vegetative state, to a state of full consciousness.

Persons who have shorter periods of unconsciousness likely had less severe brain injuries initially. Consequently, they are likely to go on to make better recoveries than persons who had longer periods of unconsciousness.

Traumatic brain injury refers to damage to the brain caused by external force such as a car crash or a fall. About 50% of persons who are in a vegetative state one month after traumatic brain injury eventually recover consciousness. They are likely to have a slow course of recovery and usually have some ongoing cognitive and physical impairments and disabilities. People in a vegetative state due to stroke, loss of oxygen to the brain (anoxia) or some types of severe medical illness may not recover as well as those with traumatic brain injury. Those few persons who remain in a prolonged vegetative state may survive for an extended period of time but they often experience medical complications such as pneumonia, respiratory failure, infections, etc. which may reduce life expectancy.

People who have a slow recovery of consciousness continue to have a reduced level of self-awareness or awareness of the world around them. They have inconsistent and limited ability to respond and communicate. This condition of limited awareness is called the minimally conscious state.


Characteristics of the minimally conscious state

  • Sometimes follows simple instructions
  • May communicate yes or no by talking or gesturing
  • May speak some understandable words or phrases
  • May respond to people, things, or other events by:
    • crying, smiling, or laughing;
    • making sounds or gesturing;
    • reaching for objects;
    • trying to hold or use an object or
    • keeping the eyes focused on people or things for a sustained period of time whether they are moving or staying still.

People in a minimally conscious state do these things inconsistently. For example, one time the person might be able to follow a simple instruction and another time they might not be able to follow any instructions at all. This makes it difficult to distinguish the vegetative state from the minimally conscious state.

While in a minimally conscious state, people need extensive care similar to that needed by people in a vegetative state.


Emergence from the minimally conscious state

Once a person can communicate, follow instruc tions, or use an object such as a comb or pencil consistently, they are no longer in a minimally conscious state. Some people remain minimally conscious indefinitely, but many improve. The longer a person remains in a minimally conscious state, the more permanent impairments he or she is likely to have. This is because vegetative and minimally conscious states are caused by severe damage to multiple brain areas. Following emergence from the minimally conscious state, people almost always experience confusion. Sometimes people move directly from coma to this confusional state.


Comparison of Coma, Vegetative State, and Minimally Conscious State

 

Coma

Vegetative State

Minimally Conscious State

Eye Opening

No

Yes

Yes

Sleep/Wake Cycles

No

Yes

Yes

Visual Tracking

No

No

Often

Object Recognition

No

No

Inconsistent

Command Following

No

No

Inconsistent

Communication

No

No

Inconsistent

Contingent Emotion

No

No

Inconsistent


Characteristics of the confusional state

  • Disorientation (inability to keep track of the correct date and place)
  • Severe impairment in attention, memory and other mental abilities
  • Fluctuation in level of responsiveness
  • Restlessness
  • Nighttime sleep disturbance
  • 6. Excessive drowsiness and sleeping during the day
  • Delusions or hallucinations

As with the vegetative and minimally conscious states, the rate and extent of recovery from the confused state vary from person to person. However, almost all people who reach the confused state go on to make further progress. The main factors that determine the eventual degree of recovery are the initial severity of the brain injury and some types of additional medical problems. The shorter the time the person is in the confused state, the better the eventual recovery will be. Mild medical complications such as sleep disturbance or urinary tract infection may prolong the confused state but do not necessarily influence the final outcome.

Once the confusional state resolves, people are usually much better able to pay attention, orient themselves to place and time, and retain memories for day to day experiences. Nevertheless, they are very likely to have some significant cognitive problems such as impaired memory or slowed thinking. These cognitive problems are likely to continue to improve as time passes. Some people make limited progress, while others make a good deal of progress.


Patterns of recovery after very severe brain injury

Some individuals rapidly emerge from coma and briefly remain in the minimally conscious state before recovering a higher level of consciousness with mild impairments. Others may have a longer period in the minimally conscious state after emerging from the vegetative state and then usually have a greater degree of long-term impairment. Occasionally, persons remain in the vegetative or minimally conscious state for an extended period of time and, in rare cases, these conditions may be permanent.

What treatments are used with people in the vegetative or minimally conscious state?

Currently, there is no treatment that has been proven to speed up or improve recovery from the vegetative or minimally conscious state. However, there is general agreement that the primary focus of medical care is to prevent or treat any factors that might hinder recovery (such as hydrocephalus, a build up of fluid on the brain, or use of sedating drugs for other conditions), and to preserve bodily health (such as treating infections or stiffness of joints). Medical facilities and clinicians vary in the extent to which they try various treatments such as medications or sensory stimulation to promote recovery of consciousness. Because the amount of recovery from disorders of consciousness varies so greatly, it is difficult to judge the value of these and other treatments outside of research studies. You can inquire about your physician or program’s philosophy about using these types of treatments.

Transitions to different levels of care

At various points in the process of recovery, persons in the minimally conscious or vegetative state may receive care in a wide range of settings. Initially, the person with severely impaired consciousness is most likely to be treated in an acute care hospital where the focus is primarily on saving his/her life and stabilizing him/her medically. Once that is achieved, the next focus is on recovery of function to whatever level is possible. Sometimes this happens in an acute rehabilitation hospital, which provides a high intensity program of rehabilitation services, including physical therapy, occupational therapy, speech and language therapy, recreational therapy, neuropsychological services and medical services.

Some patients do not transition from the acute care hospital to an acute rehabilitation program. These people may go directly to a skilled nursing facility, a sub-acute rehabilitation program, a nursing home, or even home with family. Persons discharged from an acute rehabilitation program usually go to one of these places as well. Skilled nursing facilities, sub-acute rehabilitation programs, and nursing homes vary widely in the quantity and quality of medical management, nursing care, and rehabilitation therapy services they provide.

Many factors influence decisions about where a person with severe impairment of consciousness or other severe impairments may go after discharge from the acute care hospital or discharge from the acute rehabilitation program. Some of these factors are the person’s medical condition, health insurance coverage and other benefits, the person’s ability to tolerate rehabilitation therapies, the doctor’s philosophy about where people should go to continue to recover after severe injuries, the family’s ability to care for the person at home, the family’s wishes, and practical matters such as that the distance the family has to travel to visit the person at the facility.

The names used to describe levels of care and the settings in which they are provided, vary across the country. It is helpful to work with a social worker or case manager in the facility where your loved one is currently receiving services to plan whatever transitions are necessary. Do not be afraid to ask questions to make sure that you obtain the information you need to help you make the best possible decision.

Things to look for when considering a setting to care for your loved one:

At various points in the process of recovery, persons in the minimally conscious or vegetative state may receive care in a wide range of settings. These include in-patient rehabilitation facilities, skilled nursing facilities, and long-term acute care facilities. The following are some considerations for selecting a place for care:

  • Your family member’s current treatment team has had good experiences with the program when they have referred others there.
  • The staff at the facility makes you feel comfortable, is accessible to talk with about your concerns, and answers your questions.
  • The program and medical staff have experience working with the same kinds of problems that your family member has.
  • The facility is informed about the specifics of the care your loved one needs and is able to meet these care needs. You can have a role in ensuring that a detailed nursing plan of care is developed.
  • The program includes case management to assist in planning for the next level of service, whether it is transition to a rehabilitation program, a facility for long-term care, or home.
  • The program provides education and training for future caregivers.
  • The program uses specific procedures to measure progress.

If support services can be arranged, some persons in the minimally conscious or vegetative state can be cared for at home.


Thoughts from families who have been there

Family members who have a loved one in a minimally conscious or vegetative state have identified a number of important issues:

  • Communicating with healthcare providers
    Be sure to ask questions, share your observations, and express your opinions.
  • Managing medical equipment and supplies
    It is important to be knowledgeable about your loved one’s equipment and supplies, and know how to communicate with the companies who provide these items.
  • Providing care
    Family members often provide some of the care for their loved ones. The amount of care you provide will depend on your role in providing care (this can range from providing most of the care yourself to simply directing the care provided by others), the people such as sitters, attendants, nurses, and family members who are available to help you with providing care, the setting (this could be your home or a skilled nursing facility), and the guidance you receive from health care providers. It is desirable to obtain as much training as possible to provide whatever elements of care you chose to provide and are able to manage. These might include bathing, grooming, bowel and bladder management, mobility, range of motion, and other medical issues that your loved one may have.
  • Learning about financial resources
    You may initially feel overwhelmed when you start to learn about various financial resources that may be appropriate for your loved one. However, with patience, persistence, and some help from others, you will be able to figure out which programs apply and find your way through the application processes.

    Programs you will want to learn about include:

    • Healthcare programs such as Medicare and Medicaid.
    • Income replacement or financial assistance programs such as SSDI (Social Security Disability Insurance), SSI (Supplemental Security Income), or possibly disability insurance policies that you loved one may have had through work.
    • Services to help with community living such as state agencies that assist people in these areas.

    It might not be possible to find someone who knows everything about how to access these various services and programs. The key is to keep asking questions and following up to make sure that you and your loved one get all the benefits that are available. People who may be helpful to you are social workers, therapists, case managers, the local social security office, your state brain injury association chapter, family members or friends who are disabled or who have family who are disabled, or the human resources (personnel) department at your loved one’s employer.

  • Guardianship
    Since your loved one is not able to fully make decisions for himself or herself, it may be helpful for you, or someone else, to be appointed guardian. This may make it easier to handle medical decision making or management of your loved one’s financial matters. If you think that your loved one may need to have a guardian appointed, you will need to contact an attorney to get assistance. Guardianship can be reversed when it is no longer needed.

How to interact with your loved one who is unconsciousness or at a low level of responsiveness

The most natural way of interacting is to talk to your loved one, even though he or she may not respond or understand. Simple things like telling him or her about recent events in your life, what is going on in your family or neighborhood, or the latest news might make you feel a sense of connection. Talking with your loved one about what you are doing as you provide care can increase your comfort with the process of care giving. For example, telling your loved one that you are going to move his or her arms and legs to help prevent joint tightness might make you feel more comfortable with this task. Only do this “range of motion” type activity if you have been instructed to do so by the doctor, nurse, or therapist.

Physical touch is another way of having a sense of connection. Some family members have said that the act of giving a massage or applying lotion to the hands or face helps them to feel close to their loved one. It is also important to avoid the risk of overstimulation as this may result in rapid breathing, tightening of the muscles, grinding of the teeth, restlessness and fatigue.


Taking care of yourself and other family members

Family members of a person in a vegetative or minimally conscious state often feel a sense of loss or grief for the relationship they had prior to the injury. There can be a number of ways to cope with these feelings. A person in a minimally conscious or vegetative state may make very slow progress or go for periods of time with no apparent progress. Sometimes keeping a journal of the changes you have observed may be comforting. This may give you a chance to look back and see ways in which he or she is more able to respond than he or she was at an earlier point in time.

Having a loved one who is in a vegetative or minimally conscious state can be physically and emotionally draining. Managing this alone can be too much to ask of one person. It is important to rely on support from others, looking to existing supports and developing new ones. You might find help from supports you have relied on in the past, such as family, friends, and religious groups.

Other resources to consider include support groups, support agencies, and the Internet. A good way to learn more about these possible supports is to make a contact with the Brain Injury Association of America’s National Brain Injury Information Center (www.biausa.org, 1-800-444-6443) and obtain contact information for the closest state brain injury association (BIAA) chapter. Health care providers such as doctors, therapists, social workers and others can be good sources of information about supports available to you.

Even the most committed caregiver needs to have some private time. If your loved one is at home, this can range from having a friend or family member give you a 2 hour break to go do something for yourself to having full time caregivers for a week or having your loved one spend a brief time in a nursing care facility or hospital. If your loved one is still in the hospital or living in a nursing care facility, having a rotating visitation schedule can give you some breaks while giving other friends and family a chance to spend time with him or her.

When your loved one was first injured you were likely to be in crisis mode, focusing on the problems and putting the rest of life on hold. As time goes by, you will need to shift from crisis management mode, and begin to take care of the concerns of everyday life such as paying bills, maintaining relationships with other family members, and taking care of your own physical and mental health. While it is natural to focus on your injured loved one, other members of your family will have needs too. For some people, formal counseling with a therapist or member of the clergy can be an important part of making adjustments to life changes that have occurred as a result of your loved one’s injury.

While caring for a person in a vegetative or minimally conscious state is an enormous challenge, use of appropriate resources, as described above, can be a big help. Each person will respond differently to this challenge, but almost everyone can cope and move forward. Many family members have a deep sense of personal satisfaction in making life as comfortable and pleasant as possible for a loved one who has sustained a severe injury.


VS-MCS brochure authorship and acknowledgement:

Written by: Mark Sherer, Ph.D., Monica Vaccaro, M.S., John Whyte, MD, Ph.D., Joseph T. Giacino, Ph.D., and the Consciousness Consortium. Members of the Consciousness Consortium include:

  • JFK Johnson Rehabilitation Institute, NJ (Lead Center)–Joseph T. Giacino, Ph.D., P.I.
  • Moss Rehabilitation Research Institute, PA (Co-Lead Center)–John Whyte, MD, Ph.D., P.I. and Sooja Cho, MD, Site P.I.
  • Methodist Rehabilitation Center, MS–Stuart A. Yablon, MD, P.I.
  • Braintree Rehabilitation Hospital, MA–Douglas Katz, MD, P.I.
  • Sunnyview Hospital & Rehabilitation Center, NY–Paul Novak, MS, OTR, P.I.
  • Bryn Mawr Rehab Hospital, PA–David Long, MD, P.I.
  • Texas NeuroRehab Center, TX–Nancy Childs, MD, P.I.
  • Fachkrankenhaus Neresheim, Germany–Bernd Eifert, MD, Ph.D., P.I.

Acknowledgements: Funding for writing and publication of this brochure was provided by National Institute on Disability and Rehabilitation Research grant #H133A031713 (A Multicenter Prospective Randomized Controlled Trial of the Effectiveness of Amantadine Hydrochloride in Promoting Recovery of Function Following Severe Traumatic Brain Injury).

The Brain Injury Association of America (BIAA; www.biausa.org) provided feedback from the consumer perspective for the content of this brochure and is assisting with dissemination of these materials.

Several family members of persons with TBI generously gave their time and valuable insights to assist with the writing of this brochure.

Posted on BrainLine March 25, 2010. Reviewed March 28, 2019.
About the Authors

The Model Systems Knowledge Translation Center is operated by American Institutes for Research (AIR) and is funded by the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) under grant number 90DP0082. Four additional organizations support AIR in executing the work of the MSKTC, including George Mason University's Center for Chronic Illness and Disability, WETA's BrainLine, University of Alabama, INOVA, and American Association of People with Disabilities.

Sherer M, Vaccaro M, Whyte J, Giacino JT, & the Consciousness Consortium. Facts about the Vegetative and Minimally Conscious States after Severe Brain Injury 2007. Houston: The Consciousness Consortium. Copyright © 2018 by University of Washington/MSKTC. 

Please check the MSKTC site for any recent updates on this article.

Comments (252)

Please remember, we are not able to give medical or legal advice. If you have medical concerns, please consult your doctor. All posted comments are the views and opinions of the poster only.

My mum is currently in hospital she had a brain aneurysm the bleed was very bad she is breathing on here own but no body movement its been 10 days now she will open here eye when asked but not looking to words u, I'm so worried we are not getting told much on what will be the outcome. I'm praying every night .

My huband can wiggle toe follow commands. Can i obtain a power of atty. If he acknowledges thats his wish?

Hi everyone, Reading these comments break my heart. My mother suffered a brain aneurysm last October. She was on the road to recovery but 5 days later, suffered vascospasms (stroke) which put her in a minimum vegetative state. These past 8-9 months have been the most difficult times of mine and my families lives! Some days, she does well and other days she declines. I've read so many of your stories and my heart goes out to EVERYONE here! I just recently read that ambien can help some people in a vegetative state become more aware and conscious. If anyone would like to talk, or if anyone needs a friend or needs someone who is going through something similar, please feel free to email me. KARYNALBERTO@ICLOUD.COM

Thanks for providing this info I have a 21 daughter who is in pvs and i look for help only find that their is not any.

My love was in a terrible car accident June 20th 2015 and has been in a vegetative state since he's has made progress but very little ! He always told me he never wanted to live like that not knowing it would happen to him so now we're facing a difficult choice on letting him go or keeping him in the hopes that he will get better. It's a very hard thing to go through. Keeping everyone in my prayers

Thank you very much for the given knowledge. One of my friend is now on persistent vegetative stage. It happened due to a blood colt during a Thyroid surgery. Now its more than 2 months. I hope for the best recovery of her. Is there any thing we can do for her??

My father sadly passed away in hospital April 16th 2015 after treating a blood clot in his lungs the blood thinners apparently gave him a stroke in the brain which left him in a vegatative state, they took out his feeding and dehydration tube and died 9 days later. Still cannot fathom what has happened.

I have a sister who is in vegetative state for a month now. she has amniotic fluid embolism, a very rare case for pregnant women with the data 1:80,000 who is about to deliver their baby. after the emergency CS doctors need to remove her uterus because of continuous bleeding. after the 2 operation she was transferred to the ICU for her recovery but after 2 hours she had cardiac arrest. it was  very hard, she has 2 beautiful daughters who is waiting for her and misses her. my prayers is for all families who is experiencing the same way. always trust in the Lord coz He is the real doctor, a healer and we should always hold on His promise that He will never leave nor forsake us.

One of my close friends just passed away on yesterday at the age of 24 after being in a coma for several days after a terrible head injury obtained while having a seizure. Thank you for the very helpful informative information. I was able to gain sight of this condition. Thanks!

This information has been very helpful.I share the suffering all those loved ones are going through.My nephew 35 year old had a serious  head injury in Fiji when his rental truck was hit by a government vehicle on 26 april.He was airlifted to Auckland hospital on life support.After 5 days he was again air lifted to vancouver canada on life support.Four weeks ago he start breathing on his own.He is opening his eyes and started to move left arm and leg.No movement on right side According to the doctors his brain had been jolted badly.Now he is in the grace of god  sal vancouver canada

Thank you for the straightforward information. I am 21 years old and am my mom's only next of kin. My mom has been in the hospital for 5 months now and I hope that she will recover. My heart goes out to everyone who is in a difficult time in their lives right now.

My father suffered anoxic brain injury on May 7, 2015. Its been 6 weeks and after a period of no eye opening, he opens his eyes a little more now. He grunts and says things like "uh uh" while his eyes are open. He stares at my mother and follows voices in the room with his eyes. He cries when I play certain songs. Is he in a vegetative state or is minimally conscious? Thank you all for giving me any feedback. P.S. He moves his left arm a lot, but can move his right hand. If I tickle his feet, he doesn't like it. Doctor is very negative and telling me its all reflex.

The doctors also told me it's a relfex but I don't thing so. All the doctors I have dealt with after my father's stroke have been very negative.....I try not to let them get to me and keep praying.....I know and feel inside that it's not just reflex

My heart goes out to these people who are suffering like me

Stay strong. My father went thru this and recovered far beyond what even the doctors expected or could understand. It is a long road for recovery but working with Dad he has come very far. God works in mysterious ways. I wish you the best with your mother. Saying a prayer for you.

May God will be done in our lives. My mother have been in a vegetative state since 4/8 2015 . Our family also believe in miracles. Its in God hand let miracles continue for God is the same who performed all great things long ago. Prayer also changes things also let love take you through. Family who also trust and stand on faith.

God bless you all. You and your families are in my prayers. Stay positive and keep your heads up

I understand your thoughts of not wanting your loved one to suffer. My husband is in a vegetative state and tomorrow hes being moved to a long-term care facility. My heart hasn't ever felt so hollow. Prayer is powerful so are miracles. I hope we both get one. Be encouraged!!! My husband's name is Cedric.

My brother is on life support right now with minimal brain activity the doctors said there's no chance of him waking up because of the severe brain trauma and I can't seem to give up on him. I don't know what to do the doctors said there's no hope. But I want to leave it in God's hands because I seen him make miracles but then I don't want him to suffer

My mother had a massive stroke yesterday, she is 63. She had her first massive stroke back in 1984, an aneurysm, and survived after being comatose for over 6 months. Originally her stroke was on the right side of her brain which affected and paralyzed her left side of her body. However yesterday's stroke happened on the left side of her brain which is now affecting her rights side of her body along with her speech. Currently she is in a vegetative state, but I see it more as a coma. She has no periods of being awake or responsive to anything. I am a 34 year old single mom and I have spent the last 31 years taking care of my mom. There's nothing I wouldn't do to be able to continue caring for her. However, I just want my mom to no longer suffer or be in pain. I want my mom to be in peace. Unfortunately today I had to sign a DNR and honor her wishes...it nearly destroyed me. But at the same time my mom deserves to be at peace. Please pray for my mom, Pat. We could use all the help we can get. Thoughts and prayers to all who are going through or have gone through this.

My condolences to all of the people caring for loved ones in the above-described states.  About 30 years ago I was in a serious car accident that led to a TBI and a lot of broken bones, including a cracked skull and 3 broken vertebrae.  Due to my head and back injury (I think), I was kept sedated for at least 1 week.  I'm writing to share that I had some level of consciousness even though I could not communicate, and it may be helpful to consider that with your loved ones, too. During my stay in ICU, I remember a doctor told my dad I might be vegetative or paralyzed, that they just did not know.  I later confirmed with my dad that this happened.  It's been very challenging since that time in a lot of ways, but I was able to get through school (including a master's program) by working harder than most of the people I knew to just get by in my classes. 

I learned later that a good friend stayed at the hospital throughout this period, only leaving to return home for a shower and change of clothes.  She read to me, talked and acted as though I was awake and responsive.  I'm no expert in TBI, but believe that some of my recovery was a direct result of her care and attention to my mind while ICU staff cared for my body.

Very good description... My Mom is in Vegetative state.. and it almost 2 months of her Brain Surgery (Subarchanoid Haemorrage).. We all are praying for her better recovery.

God bless you

My husband had a vehicular accident last november 13, 2014 and until now he is in a vegetative state.the doctor refuse to make an operation to him because of the place of his blood clot.it is in the center of his brain.now he is in our home, we just take care of him and do our best to help him and let him feel that we love him very much.we hope and pray that he will recover for his three children.please email me if you can share your thoughts if you experience the same case as mine.thank you ang God bless us all.. jackyjeth_08@yahoo.com.ph

My father is in Vegetative Stage now...2 months of unconsciousness..he had a diabetes for many years, badly brain damage from unable to control sugar level ...I am still hoping for the miracle ...wishing for recovery ...

First of all my deepest condolences and prayers for the people and their loved ones who have had such experiences. My father aged 52 years is himself a doctor and was hit by a motorcycle while crossing a road on 6th march '14. He was immediately admitted to the ICU and after a brief examination the doctors told us that he had suffered several contusions to his brain and a hairline fracture to his skull. He was unconscious for a few weeks and it took almost 1.5 months for him to be fit enough to be taken home. The first 6 months after he came home were a nightmare for us. He just wouldn't stop shouting and would continuously be agitated throwing things, shouting, refusing to take his meds, etc. It really embarrassed us among neighbors as this would go on at late nights also. He barely slept for an hour a day and the rest of the time he would be in the state as stated above. These six months seemed to be a decade long for us and we were almost becoming hopeless for his recovery. Gradually after 6 months his state improved and he started recognizing us. He slowly became aware of his surroundings and that what had happened with him. He resumed his daily routines and started doing almost all the basic things by himself such as bathing, eating, brushing his teeth, combing his hair, taking his meds,etc. But one night almost 9 months after the accident he suffered a seizure which caused a swelling in his brain and rewinded a part of his cognitive recovery. It was later found that the doctor had forgotten to prescribe an important drug (epsulin) in the last routine visit which caused the seizure. But he recovered back to the stage he was before the seizure in a few weeks only.Today its been almost a year and he has come a long way from last year. He is now able to speak some basic words, recognize many distant relative also, and is almost aware of everything around him. Though he is still not able to remember names of any object or person. Each time we have to make him remember the name then only he could speak it. Moreover he is not yet able to read anything. Though we have sometimes seen him recognizing some famous names from the newspaper. He very keenly watches movies but we have a doubt that he fully understands them. Most of the days are peaceful but some days he would still get agitated and angry over nothing. He has changed as a person. He has become more emotionally connected with his family and often cries asking when would he be fully fit. We had neither seen nor expected in our lives anything like this before. We've suffered tremendously the past year but we thank god to have saved his life and pray everyday for his recovery. I hope this post strengthens your hopes too for the recovery of your loved ones. The most important thing to remember is that nothing but your love and care gives the strength to your loved one to recover.

Hi ,my wife is 35 and she had a bad stroke on April 1st 2014 she is currently fighting for life on life support,its been almost a year now and we just discovered that she has a huge hole in her brain, the drs said that she will never recover from this they also said to pull the plug. i refused being that god is above all,and his ways is better then ours,till this day my wife remains on life support at a nursing home,she's unable to respond to anything,just opening of her eyes but the dr says she's in a vegetative state,,,,,please pray for her and my two boys elijah n tyrefr....we are deeply saddened but we're remaining strong in god,no matter which way it goes...god is good,trust faith and believe,,,,,,

My brother, 31, had brain aneurysm in November, last year. There was massive bleeding in his brain and doctors operated and removed the bleeding. He was unconscious and He is now in vegetative state. We saw him cry and his tears. We asked him to open his eyes if he hears us. He opened his eyes. I think he knows but he cannot responds or follow command. I love my brother very much. I hope he will improve from vegetative state. As per doctors, if he stays in this state for next 6 months, it might become a permanent. I dont want to hear negative. Please pray for him. 

My daughter in law just passed away on Wednesday. She was found unconscious and not breathing the Wednesday before after suffering a seizure. She was hospitalized in nuero trauma icu. Her health directive was no artificial life support. Her life support was removed and she went to heaven surrounded by family 20 minutes later.

My sister has been in a coma for 12 days after suffering continuous seizures from end stage renal failure......dont know if recovery is possible sadly

My brother sugar had dropped to 40 and he went I to a coma after 4 days he opened his eyes he has said very few words like ouch and yes.and moves his head and arm occasionally. Will he get better? What is going on? Anybody familiar with the symptoms?

My wife of 26 years suffered an anoxic brain injury after a witnessed arrest and CPR. Hypothermic protocol followed. To make a long story short, she emerged from a coma, a vegetative state to a minimally conscious state. Maybe even better as she was able to do math flash cards, speak (simple words), follow commands, squeeze hands, wiggle toes etc. The appalling thing is that the hospital staff decided to do "nothing curative" as they basically gave up. The recommended protocols are just an illusion if you don't have big money. They moved to sedate her with morphine and "sell" me on her vegetative state. She passed away because they refused to address her underlying cardiac needs. This is such a tragedy as she was aware that she was targeted for euthanasia. I can't imagine what she was thinking as she lay dying for lack of a simple cardiac intervention. Was this an unusual experience or are anyone else experiencing this callous denial of care? I'd be glad to discuss this with anyone who would like to talk about it with me. 

        Mark Jarnot

​        505 Elmwood Ave. Apt 8H

        Buffalo, NY 14222

Send me a letter with your phone number and I will promise to call you and share my experiences and possibly help your loved one navigate these treacherous medical waters. There are things that can be done. No one but God has the ultimate answers, certainly not a doctor. If he acts like he is God ask him to forgive your sins or stop the wind. Ultimately you have to accept the outcome and embrace your loved one with unconditional love, regardless of the degree of progress made. Stay strong and don't capitulate to the hospital administrations prognosis. God calls the shots, not the accountants. Don't let your loved ones life slip away to disregard for precious human life. You have to take action to combat these well oiled death machines. God bless you and your loved one and feel free to contact me.

                                            Mark

If anyone can comment on this, please do so. My cousin appears to be in vegetative state. She was admitted and found to have Diabetes with very high blood sugar. After having been treated two days ago, and the sugar was brought under control, she lapsed into a vegetative state. Open eyes, complaining to pain. Las thing she responded to was right before they put the IV in, she said "No, no no!" and that was it. She awakens but does not respond to anyone. Any suggestion would be helpful. I had a similar experience many years ago with a blood sugar of almost 1,400, but I remained conscious throughout the ordeal. Can someone come out of this vegetative state? Thanks so much. I am going to see her tomorrow and don't know if there's anything that we can do.

My brother David has been diagnosed with ALS for a little more than a year. He showed signs of it for close to three years and no Doctor was able to figure out what was wrong, until my sister whom he had been living with kept trying to bring him to each doctor ---- finally found a doctor who recognized almost immediately that he had ALS. He has been taking medication that was made available to him only through a medical grant funding from those who have donated to the continuing research for a possible cure. He has slowed down in the progression, but without side effects.

This content is written very well. Your use of formatting when making your points makes your observations very clear and easy to understand. google

Brother had a brain tumor size of lemon. Neuro- Surgeon operated the following day after diagnosis. We went from a possible droopy eye and left side of face to a coma. Never waking up after surgery. This article helped me tremendously. We try to get all the information possible through the surgeon and now after the surgery is not as compassionate to our family or seems less confident in providing the family information. I will always seek a second opinion after all my brother and family have been through. Praying everyday to have him back to normal or that he even wakes up. This guy was ordering a pepsi an hour and 2 meals at a time the day before the surgery and now nothing.

Blessings to all of you out there with your personal family stories of pain surrounding someone you love having brain damage.

My daughter struggled with anorexia for 4 years, but as an adult no one, including her would let me help her.  At age 21, she suffered massive seizures and her brain went without oxygen for a long time, leaving her in a non-cognitive, vegetative state.  The doctors gave no hope at all.  We did stay in a sub-acute hospital for one year and finally were able to bring her to care for her at home.  

We had a what I call a miracle in that they told me she'd be bedridden for life...and after one year she could stand and take a few steps with human assistance at all times.  This has been huge is stopping her from curling and atrophying as is common with this severe of a brain injury.  However, her brain remains like a 6-month-old baby.  She is 100% helpless, cannot obey any commands, flails a lot with her arms and legs and screams a lot (while still smiling at you).  She will turn 26 this month, so we are coming up on 5 years.

What I would like to share with you other parents especially is that NO ONE has any answers but that does not mean you can't find inner peace.  It is important that we are parents, caregivers, are at peace, are calm, have joy and can still celebrate life even with this tragedy.  It is best for your child and for you.

Yes, I hope for more miracles and will always believe - we have a strong faith. BUT, I am firmly living in today accepting things as they are now and I can say I am happy and at peace, by choice.  I have my 'moments'  when I cry my guts out, yes, but day to day I have embraced this thing that happened to us 'in the blink of an eye' and I let my daughter see a peaceful, smiling mama that has only love to pour over her.  

I technically (or mentally) had to let the girl I raised, who I was so close with, go and accept to see her right now as the baby she is and just love that baby and see her sweet spirit.  It has taken time, so I do not want to paint a picture that is not realistic as we are very human.  But, life has been doable and even enjoyable (even though HARD) living this way.  And, of course every day I also have hope that it could get better.

But, I didn't want to be waiting for tomorrow to be whole again.

My prayer for each of you is that you find the tools that work for you to be the best you can to yourself and your loved one even after a tragedy has come into your life. To have anger or fear or bitterness living inside is just a killer to all and so I hope you, too, can get free to still live your life fully.

If anyone wants to correspond with me, my email is castrogiovanni007@yahoo.com.

Q, given earlier: Hw do u help someone in the vegetative state:  Read to them, something u know they wld like preferably, also some thing u like, -> u add extra umph, when u read someting u like.  #1: Short stories, maybe poetry, News articles, activities they were involved in: sports, school, church etc.  They'll 'be back', maybe not too soon, but help 'em out by trying to keep them in tune.  Been There.   written(12/4/2014)

Very informative...I pray my 29 yr old son progresses to a good recovery.  I also pray for everyone who is going through a brain injury. It has been six months since his vehicle accident.  He was diagnosed with diffuse axonal injury with multiple fractures.  I believe he may be in the minimally conscious state.  He can occasionally give a thumbs up, but doesn't lift his arms. He also looks at me slowly when I tell him to, He moves his right leg a lot...not sure if this is spasticity or not, and he has no movement on his left side.  If anyone has any advice please email me at scttethridge@yahoo.com  Praying and hoping 

This morning my son Asim told me that our company CEO got heart attack in Dubai but shocking news was that he went in coma. I am in Jeddah. Immediately I left for umera prayed for him and for other patients as well. May Allah almighty give them health. Ameen.

I feel so desperately bad and i pray for every patient and their families who suffer from severe TBI. My brother was in a car accident Jan. 6 2014. He is still fighting to recover from TBI. I will continue to pray for every family as well as mine. No one is alone in this world. Life is to short so while we're all here we have to appreciate each and every moment with the people we love.

My 45 year old husband of 26 years married the love of my life. He had a massive heart attack and while they worked on him for over 25min he lost blood flow to the brain. Now they give me little hope. He's in a vegetative stage. But the Dr's aren't God and my heart is hurting so bad that I can't even breathe at times. I pray for everyone going thru this because I never knew there could be so much pain. No matter I will praise God thru it all. I find my boys 25 and 20 to be my rocks along with family. Leaning on them truly helps.

This article has been very helpful for understanding the medical condition of our loved one. Thanks for sharing!

Very informative article.. My sister is 20 yes old and suffer an anoxic brain injury from the loss of oxygen. Her air ways collapsed after a week of chemotherapy from leukemia, this happened 12/23/13. Although we have heard nothing but negativity, I am believing God for a recovery in her health. She has been in a vegetative state since last December..

How do u help a vegetative patient with his recovery

My Mom is in Coma since 1st August 2014, after having the MRI Scan done we got to know the Final Diagnosis as Basilar Artery Thrombosis with Bilateral Cerebellar Infarct and Right PCA Infarct. I understand these are multiple brain clots which occur as we did not precautionary measures in regards to blood pressures , never had check up for blood pressure regularly. Please pray for my mom and advice in regards to her speedy recovery from coma.  Anand Pillay 9922617714.

My mom is in the same state, but I am confident that praying always work. Do not Fear and Trust God.

My thoughts and prayers go out to all the family and friends of people in a coma or vegetative state. My brother in law, Eric is 54 years old and he is in a permanent vegetative state after a liver transplant. He had been diagnosed with cirrhosis of the liver a year ago. On his last hospital visit with an encelopathy episode (which is where ammonia backs up into his brain); he lapsed into a coma. He was transferred to another hospital to await a liver transplant. On transport he suffered a stroke , and remained in the coma state. The Doctors decided to proceed with the liver transplant as he was in a severely declining state. We asked why they would give a new liver to him when he was comatose and they said he would die without it. 

He remained in a coma after the operation. We were told he might possibly come out of it once the new liver kicked in. We noticed positive health changes almost immediately. However, he was still comatose. Then he was put on dialysis because his kidneys were failing. He had several MRI's, CT scans and other exploratory procedures. Every week there was something different that needed attention.

After a few weeks he opened his eyes. But there was no tracking or response to stimulation. Nothing really has changed in 4 months. He was transferred to a sub-acute hospital. And has had to return to the transplant hospital on subsequent occasions.

My sister and I feel he would not want to be in this condition. His family is on opposite ideals. They keep saying he wanted his liver transplant more than anything so he would be able to live a fuller life with his family. I believe life expectancy for liver transplants is only 5 years in most cases. The family keeps saying things like, "Oh...he moves his hands. He can move his head. etc. Once my sister and I played a song by the Beach Boys and we noticed a single tear in his eye. We hoped it was in response to the song which used to be one of his favorites. But we have been told he is just having normal reflexes and is not conscious of his actions. 

Eric was a champion wrestler. He was supposed to go to the Olympics the year President Carter cancelled USA involvement in the games. He has always been a loving and kind man. I know he indeed did everything possible by the book to be able to receive his liver transplant. But I can also say for sure he would not want to be in a vegetative state and unable to function. No one would.

I guess my main question is in regards to the patient's state of being. Are they in a deep sleep of nothingness? Or is their spirit caught between two worlds...one where they are in a hospital bed , unable to communicate to their loved ones and the Doctors...or are they halfway in the next dimension? I would prefer to believe Eric is in Heaven, hanging out with his Mother and his favorite dogs. 

May God Bless each one of you. You are warriors for your loved ones.

So kind of your valuable information Thx & regards

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