Toronto ABI Network

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Info for Families

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In Acute Care

In acute care, care focuses on a person’s urgent medical issues and the first stages of rehabilitation.

A person with ABI can receive acute care in a local community hospital. For more serious cases, the person may be transferred to one of Toronto's trauma centres or teaching hospitals.

Once a person is medically stable, they will move to a rehabilitation hospital, or receive outpatient or community-based rehabilitation if they need more rehabilitation. The health care team will “make a referral” to the type of rehabilitation they need. In the Greater Toronto Area, the Toronto ABI Network coordinates referrals to publicly-funded services so that the process is smooth and efficient.

Frequently Asked Questions in Acute Care

How serious is my family member's brain injury?

It often takes some time to tell how serious the brain injury is. The seriousness of the injury depends on where the brain is injured, how much of the brain is injured and the amount of swelling that occurs. Doctors use a variety of tools to help determine the severity of the injury.

How long will it take for my family member to recover?

The length of time it takes to recover from a brain injury is different for every person. More serious brain injuries take longer to heal and are most likely to have lasting effects. Even minor damage to the brain can cause changes in a person's thinking, memory or movement.

As a rule, the greatest improvement is seen in the first few weeks and months after the brain injury. It may be several months to several years before you will know all of the effects of the brain injury.

What will my family member's long-term recovery be?

This question is the most important question and the hardest to answer.

Recovery is often most rapid in the early weeks and early months after the brain injury or after the coma lightens and the person becomes more aware.

After the acute phase, some recovery takes place on its own. This recovery is different for everyone. Your family member may have to relearn many skills, which may take a long time. Your family member will continue to improve over a number of months or years, but improvement will happen more slowly.

As time passes, the health care team working with you may be able to tell you more about the recovery. As a rule, the longer the coma, the longer it will take for your family member to get better.

What is a coma?

A coma is caused by the brain injury. It is a decreased level of consciousness or a sleep-like condition. A person in a coma cannot open his or her eyes, obey commands, or speak. When a person opens his or her eyes and begins to speak or follow commands, he or she is no longer in a coma. Comas last for different amounts of time for different people.

When will my family member wake up from the coma?

An unconscious person rarely wakes up all at once, like it happens on television. Instead, the process of waking up from a coma is often long. The process is different for every person and can take days to months.

Waking up depends on how badly the brain has been injured. Usually a person with a brain injury wakens little by little. The levels of coma tend to lighten and deepen, then lighten again for different lengths of time. (Lighten means more like being awake. And deepen means more like being asleep.)

When the coma begins to lighten, you may find your family member confused and restless. They may have trouble remembering things. This condition is called amnesia, sometimes called post-traumatic amnesia or PTA. PTA is common in persons waking up from a coma.

How will my family member act when s/he wakes up from a coma?

People coming out of a coma often move restlessly, swear, cry and have other problem behaviours. At this time they are neither in a coma nor fully awake. They are not in control of what they do or say. These behaviours do not mean that the person is permanently changed or that he or she is in pain.

This state can last for different lengths of time. Although you may find this behaviour very upsetting, try to be patient and wait for further recovery.