Recovery from severe brain injury takes a long time. It usually happens in stages. A person with severe brain injury may remain in a disorder of consciousness (DoC) for a while.

After a severe brain injury, there is a wide range of possible outcomes. Every brain injury is different. Not every person improves at the same pace or to the same extent. Many, but not all people with a DoC will eventually “wake up” or regain consciousness. Some people regain consciousness quickly, within hours or days. Others may take weeks to months to improve. Some may get stuck in a stage and not ever become fully aware of themselves or their surroundings.

Experts often measure recovery after severe brain injury in terms of a person’s ability to move around on their own, communicate, and perform basic activities like washing their face, brushing their hair, and getting dressed. Some people with severe brain injury improve enough to be able to eventually return to school or work. But it may take many years for a person to improve to that level. Also, not everyone improves to that point. Many people who regain consciousness after a severe brain injury will still need a lot of help to perform daily tasks for the long term. Some people will remain in a low-level state permanently.

It may take months before experts can better understand how your loved one may progress over time as has been suggested by evidence and research. It can be hard to remain patient during this time of uncertainty. But, by learning more about what to expect and what behaviors to look for, you can play an active role in monitoring and supporting your loved one’s recovery. Some rehabilitation programs offer specialty care for people with DoCs. This is something you can discuss with your loved one’s care team. These programs can help maintain overall health, enhance recovery, and monitor for changes in level of function over time.

What can I expect during the recovery process?

Severe Traumatic Brain Injury Fact Sheet 
From Model Systems Knowledge Translation Center
This fact sheet will help you know what to expect for a person with DoC in the first days and weeks after severe brain injury. You can learn what behaviors may indicate your loved one is improving. There are also suggested questions to ask the care team and tips on how you can help support your loved one’s recovery.

Summary for Families and Caregivers on Disorders of Consciousness (PDF)
From Brain Injury Association of Virginia

Here is a summary of recommendations for doctors on how to diagnose and care for persons with DoCs. It also includes information about the factors found most helpful in predicting recovery. This summary was created especially for families and caregivers and is based on many years of research.

Disorders of Consciousness and Brain Injury Recovery 
From Craig Hospital

The Rancho Los Amigos (RLA) Scale describes the changes in thinking and behavior you may see as you loved one recovers from their brain injury. Levels I-VI describe the changes in behavior you may see at different points in your loved one recovery from a DoC. This guide for family caregivers includes videos that explain what to expect at each RLA level. It also includes suggestions for how you can interact with and support your loved one at each stage.

Understanding TBI - The Recovery Process 
From Model Systems Knowledge Translation Center
This fact sheet talks about the typical length of recovery after traumatic brain injury. It also provides information about what recovery may look like over the longer term.