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Disorders of Consciousness: Rehabilitation for Coma and Vegetative State

disorders of consciousness program

A disorder of consciousness (DOC) is a condition of altered consciousness in which patients have severely impaired levels of awareness and wakefulness. It is often seen following a severe traumatic brain injury, an anoxic brain injury or stroke. Examples include patients who are in coma, a vegetative state, or a minimally conscious state.

The TIRR Memorial Hermann Disorders of Consciousness Program focuses on patients in a vegetative or minimally conscious state. Although these patients are often not ready to begin a traditional rehabilitation program, they can significantly benefit from a program that specializes in treating disorders of consciousness. The DOC Program applies state-of-the-art advances to assess and treat these patients in order to maximize their potential recovery and outcome.

The DOC Program treats patients who are still unconscious or have just recovered consciousness. These include patients who:

  • Are not yet communicating or following commands
  • Have just begun to communicate or follow commands, but do so inconsistently

We develop personalized goals together with patients and families. Goals of the Program include:

  • Perform advanced assessment of the current level of consciousness
  • Evaluate for treatable medical or neurological barriers to the recovery of consciousness
  • Improve level of alertness through medications and other therapeutic interventions
  • Identify ways to establish consistent communication
  • Initiate an intensive mobility program, beginning with sitting in a wheelchair and progressing to standing
  • Address spasticity and contractures to maximize potential for functional recovery
  • Utilize recent technological advances, as needed, to enhance outcomes
  • Prevent secondary complications and reduce the risk of recurrent hospitalizations
  • Offer specialized education, training and support for families and caregivers
  • Provide opportunities to participate in the latest research on assessing and treating disorders of consciousness

The DOC Program is supported by an interdisciplinary team of clinicians who specialize in treating this patient population.

The treatment team consists of:

  • Rehabilitation physician
  • Physical therapist
  • Occupational therapist
  • Speech pathologist
  • Clinical dietitians
  • Pharmacists
  • Chaplains
  • Rehabilitation nurse
  • Neuropsychologist
  • Music therapist
  • Therapeutic recreation specialist
  • Case managers
  • Social workers
  • Respiratory therapists
  • Behavioral Neurology & Neuropsychiatry specialists

Patient Stories

John Keller thumbWhen 33-year-old John Keller was first admitted to TIRR Memorial Hermann on March 26, 2008, he was in a vegetative state. Two hospitalizations and less than a year later, on January 29, 2009, he left the rehabilitation hospital walking and talking. Read the story »

To make a referral or learn more about the Disorders of Consciousness Program, please call 1 (800) 44-REHAB (73422) , (713) 797-5942 or fax (713)797-5988.