Dementia in Head 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.
Medical Treatment for Dementia After a Head Injury
The head-injured person who has become demented will benefit from any of the following:
- Behavior modification
- Cognitive rehabilitation
- Medication for specific symptoms
- Family or network intervention
- Social services
One goal of these interventions is to help the head-injured person adapt to his or her injury mentally and emotionally. Another is to help the person master skills and behaviors that will help him or her reach personal goals. These interventions also help family members learn ways that they can help the head-injured person and themselves cope with the challenges a head injury poses.
These interventions can be especially important in establishing realistic expectations for outcome and pace of improvement.