Dementia in Head Injury
Treatment for Dementia in Head Injury
Head injuries often bring an abrupt "coping crisis." The sudden adverse changes that go with a head injury inevitability cause many emotions. Anxiety is a common response, and the person may become demoralized or depressed. Damage to the brain may impair the person’s ability to cope at a time when the need to adapt is greatest. Persons with head injury typically are more distressed and have more difficulty coping with their injury than persons who have other types of injuries.
Usually, a particular family member assumes most of the responsibility for the injured person’s care. Ideally, more than one family member should be closely involved in caregiving. This helps family members share the burdens of providing care and helps the primary caregiver keep from becoming isolated or overwhelmed. Caregivers should be included in all significant interactions with health care professionals.
Caregivers must encourage and expect the injured person to be as independent and productive as possible. At the same time, caregivers need to be patient and tolerant. They should accept that the person may have real limitations and that these will likely worsen if the person is tired, ill, or stressed. Emphasizing what the person can still do, rather than what seems to be lost, is helpful.
With head injuries, the greatest improvement is expected in the first six months, but delayed improvement is possible as long as five years after the injury.
Home Care After a Head Injury
The extent to which a person with a head injury can care for himself at home depends on his disabilities. If self-care is possible, a plan should be developed with input from the professional care team and family members. The team should assess the person’s ability to function on his or her own and comply with medical treatment. In many cases, the person must be supervised by a caregiver to ensure compliance and safety.
The injured person's surroundings must be neither too calm nor too hectic. He or she should have regular routines of light and dark, eating, sleeping, relaxing, using the bathroom, and taking part in rehabilitation and leisure activities. This helps the injured person remain emotionally balanced and minimizes the caregiver’s burden.
- The environment should be made safe by taking away area rugs to reduce falls, removing hazards, providing tub bars, and putting child locks on cabinets or stove knobs if necessary.
- If the patient is capable of going out alone, he or she should know the route well, carry identification, wear a medic alert bracelet, and be able to use phones (especially cell phones) and public transportation.
Caregivers must decide whether the person should have access to checking accounts or credit cards. In general, the person should continue to handle his or her own money if he or she seems willing and able. The caretaker can get power of attorney to monitor the person's financial responsibility. If the person has markedly poor judgment or seems unable to handle financial matters, the caregiver should seek formal conservatorship, which gives legal authority to manage the person's resources.
Many over-the-counter (nonprescription) drugs can interfere with medications that might be prescribed by the health care team. These interactions can decrease how well the prescription drugs work and might worsen side effects. The person's care team must know what sorts of nonprescription medications the head-injured person uses.
Caregivers should seek help if the person has very disrupted sleep, does not eat enough, or eats too much, loses control of his or her bladder or bowels (incontinence), or becomes aggressive, or sexually inappropriate. Any marked change in behavior should prompt a call to the professional who is coordinating the person's care.