People who have brain damage due to head trauma and therefore fall into a coma may experience memory loss in the first days they wake up. In particular, the event that caused the traumatic event and the short-term memory just before it can be completely erased. Other than memory loss, the person may not know where they are, may be agitated, act impulsively or overly emotional. They may neglect social rules, speak inappropriately, swear, lose their ability to control themselves, and act like a child. A person who has just come out of a coma may act completely alien and strange to himself.
This period after a coma is a normal part of recovery. It is medically called post-traumatic amnesia (PTA). Post-traumatic amnesia or post-traumatic amnesia was defined in the past as a period in which the brain was unable to form daily memory after damage. More recently, however, the term has been expanded to include disorientation in time, space, and person. In other words, a person who wakes up from a coma after a brain injury may not know who he is, what happened to him, or where he is. He may not even remember basic information such as his name, the name of his relatives, the current season, the name of the head of state.
How Long Does PTA Take?
In general, post-traumatic amnesia lasts 3-4 times longer than the duration of the pre-coma. For example, in a person who is in a coma for 3 weeks, PTA may continue for 10 weeks or longer. PTA duration is one of the indicators used to predict long-term recovery results. Prolongation of the time was found to be associated with a reduced final cure rate.
In the period of memory loss after head trauma, the person responds in some way to what is happening around him, but is confused. He may not remember the activities he does every day. He may not be able to think and plan for the future. He goes from one place to another automatically or memorizes the tasks given by his therapist. If he can speak, he may ask the same questions over and over because he does not remember the answers. “Where have you been all day?” You can ask questions such as
Some memories of pre-injury or accident may be lost permanently or temporarily. For example, a teenager who graduated from university five months before the accident may think he is still in school. He may not remember family members or confuse healthcare workers with family members while trying to make sense of his surroundings. Usually this is temporary.
Patients who have just come out of a coma can be quite agitated and efforts to calm them down may not work. Psychotic symptoms, hallucinations may be seen. It may be necessary to give sedative medications to stop harmful behavior. Sometimes they can create a fantastic scenario, a mix of reality and fantasy, to explain their situation. Although it may seem illogical from the outside, these explanations can satisfy the person. Often patients imagine doctors and nurses as guards, believing they are imprisoned for their bad behavior.
How to behave?
The questions of the patient who has just come out of a coma should be answered in simple words and short sentences as much as possible. Complex questions should not be asked, except for questions that are sure to be answered easily. Asking the person questions they don’t answer can make them nervous or angry.
Waking up from a coma and transitioning to post-traumatic amnesia can be a source of happiness for the family, but it can also turn into a difficult process. The previously inactive, unresponsive patient wakes up and begins to move. His family and relatives are relieved. However, in this period, the patient’s behavior is mostly child-like or completely out of his character . This outlook may cause the family to panic, realizing that a long way to go for recovery is needed.
The patient experiencing PTA can acquire skills learned with ample repetition that do not require much attention during this early period of rehabilitation. It may show improvement in movement, walking and self-care activities. Behavior problems can be progressed by being consistent with the patient and not arguing with him.
Tips for Communicating with a Person with Amnesia
- Introduce yourself each time you enter the room.
- Tell him whether it is morning, noon, evening, or night so that he can orientate to time.
- Warn him before touching it.
- When you gain her trust, talk about the things she loves and the happy memories you had together.
- Talk about his life before the accident, but don’t mention the idea of rebuilding his life just yet.
- Show photos of people you know.
- Decorate her room with items she knows.
- Remind him that he had an accident and is in the hospital.
- Reassure him that he is in a safe place, that the danger has passed, that he will not be harmed.
- Keep a diary and note the changes and developments from day to day.
- Don’t ask him to try to remember the accident. He cannot do this and may be disappointed.
- Be patient. It can take a very long time for the brain to recover.
- Do not take the patient’s bad words or aggressive actions personally.
- A person with post-traumatic amnesia is not fully aware of what they are doing and should not be held responsible for their behavior.