Caring for Patients in Vegetative and Minimally Conscious States

Posted on November 29, 2021

A new guideline has been published on prolonged disorders of consciousness in the medical journal of AAN. This guide outlines the health outcomes and care for people with these conditions and also suggestions for improving diagnosis. 

People in a vegetative or minimally conscious state (MCS) have trouble being awake, aware, or both. An incorrect diagnosis can cause inadequate or improper treatment withdrawal. And failure to prescribe effective rehabilitative treatments. In many cases of severe brain injury, the patients’ relatives have to decide whether to put them on life-supporting treatment. 

Sometimes when a relative decides to take off life-sustaining equipment, the patient starts breathing on their own. And even recover fully to gain full consciousness. Surgery on the brain can cause the patient to go into a coma or a vegetative state. Even with a good decision-making process, the outcome can be something unexpected. 

On the road to recovery, from an MCS, the focus is on restoring as much function as possible. An acute rehab hospital includes a team of high-intensity services such as physical, occupational, recreational, and speech-language therapy, medical, nursing, and neuropsychological services. 

When such patients go home with family or hire caregiving services, your loved one’s doctor may speak to your insurance company about inpatient rehabilitation. Caregivers must be educated and trained for providing care for victims in a vegetative or MCS. 

Several important issues that have been identified with caring for patients in vegetative or minimally conscious states are:

Communication with healthcare professionals: Understand your loved ones’ requirements by asking questions, expressing your opinions, and sharing your observations. 

  • Taking care to prevent ‘pressure sores’, to be turned in bed often. 
  • Using a catheter or diapers to help with bladder and bowel relief. 
  • Muscle tone management: Help extremely tight muscles with motion and positioning exercises.
  • Treating infections such as UTIs or pneumonia.
  • Dealing with other health issues such as seizures or fevers

Managing medical supplies and equipment:

When providing caregiving, it is important to know how to handle special equipment and supplies. 

  • Providing nutrition through a feeding tube 
  • Special bedding to help with proper posture, bedsores, and reduce muscle tightness. 
  • Assistive devices around the house including a wheelchair.
  • To manage breathing, remove mucus from the airway and clean a tracheostomy tube.

Caregiving: Family members often provide care to their loved ones. Other people that may be involved in caregiving may include nurses, attendants, friends, and neighbors. Your house should be equipped with the necessary equipment and devices to make caregiving efficient. Managing activities of daily living must be learned so that your loved one is well taken care of.  

Finding out about financial resources: Having a loved one in a VS or MCS can be not only emotionally and physically draining, handling finances can cause additional stress. Therefore it is advisable to figure out some programs that can be available for your loved one. These include:

  • Medicare and Medicaid- health care programs
  • Financial assistance or income replacement programs such as SSI (Supplemental Security Income) or SSDI (Social Security Disability Insurance)
  • Community and State agencies that provide funding for in-home care and Medicaid waiver programs.

Assuming guardianship: Because your loved one may not be able to make financial decisions, a guardian who can be trusted to make decisions on their behalf.  

Interacting with a loved one even though they may not be able to respond by talking about events and activities going on around can make caregiving comforting.  

Recovering from VS or MCS can be a long journey, and even committed caregivers to need time for themselves. You can even hire caregivers for a week or have your loved one admitted to a nursing care facility or hospital.