<p>First let me say I’m so sorry. I worked in a TBI and neurobehavioral unit for years, and continue to work as an occupational therapists, though now with children. Let me say first, it’s still VERY early in his injury. I tell families all the time, it takes 6 months for the brain to heal, absorb blood that may have been released through bleeding or bruising, and for the swelling to go down completely. So any recovery that occurs during that time is cake. Then after 6 months, you get the icing. also, it’s a layer cake, so you will keep adding to it! I have seen people with catastrophic brain injuries make full, or near full recoveries, and patients with what appeared to be mild injuries have longer or incomplete recoveries. My favorite doctor on our TBI team used to say this “the medical tests and literature tell us ‘X’ … We hope your dad/wife/child proves us wrong more than anything”. After hearing how he’s doing, I really feel he’s going to do very well. You will need lots of patience. But please update when you can!</p>
<p>Just an update for you generous folks who reassured me. Dad is still in the TBI rehab center, getting great care. </p>
<p>Brain injuries are so complex I am realizing. He is less agitated in general, although on nights when he cannot sleep he is pretty grumpy. All of his long term memory is intact, as well as most of his vocabulary and analytical mind. He has had in-depth political conversations with me and in fact I saw some completed crossword puzzles he had done. Yet he cannot remember that he has to stay in the facility and he has trouble reading the clock, thinking it is 8:45 when it is 2:45.</p>
<p>We are learning to take one step at a time and just have patience. </p>
<p>If this just happened a week or so ago, agree that its very early in the recovery phase, and there are many variables that will influence degree, course and rate of improvement. Was there a loss of consciousness? If so, for how long? Is there any anterograde or retrograde amnesia? How old is he? Was it a closed head injury and if so, was there an epidural or subdural hematoma? Did they have to put a pressure gauge in to relieve any intracranial pressure? What is his underlying health status? What meds is he on? Where did he hit his head (location on his head? Was there a contracoup injury? </p>
<p>The nighttime confusion is common in older adults- “Sundowning”: is typically a term used to refer to nighttime confusion in dementia patients, not really TBI patients unless there is an underlying dementia. A lot of good information can be founbd here:
<a href=“http://www.biausa.org/”>http://www.biausa.org/</a></p>
<p>Hang in there!</p>
<p>"His nighttime confusion is what is known as ‘sundowning.’ "</p>
<p>Yes, I also have a family member who experienced sundowning. It can be very distressing, and we found that it helped control her anxiety a little if a family member was present when the incident began. If she was alone or only hospital staff were present, she panicked more. </p>
<p>She might know full well who I was one moment, but the next was sure I was her sister (not). We would politely correct her, but after a while that became distressing to her too, if the same correction was repeated too many times. It helped if we could keep things light, and if she could summon her sense of humor she would eventually say “you’re not [sister’s name], are you?” In addition, she hallucinated from time to time. She would laugh and say “I can see those pots and pans hanging from the ceiling in the hall. I know they aren’t there, but I can see them.” Then we would laugh and come up with a crazy story about the pots and pans and although she would have a little anxiety about what was happening to her, the levity seemed to help her get through it and a few minutes later, I was myself and the pots and pans were gone. </p>
<p>I wish the best for you and your family, surfcity. One thing that our family learned was important was keeping track of and understanding all of the medications being given. There were times when conflicting side effects were detrimental to recovery. You wouldn’t think that could happen in this day of modern medicine, but it does.</p>
<p>"f this just happened a week or so ago, agree that its very early in the recovery phase, and there are many variables that will influence degree, course and rate of improvement. Was there a loss of consciousness? If so, for how long? Is there any anterograde or retrograde amnesia? How old is he? Was it a closed head injury and if so, was there an epidural or subdural hematoma? Did they have to put a pressure gauge in to relieve any intracranial pressure? What is his underlying health status? What meds is he on? Where did he hit his head (location on his head? Was there a contracoup injury?</p>
<p>The nighttime confusion is common in older adults- “Sundowning”: is typically a term used to refer to nighttime confusion in dementia patients, not really TBI patients unless there is an underlying dementia. A lot of good information can be founbd here:
<a href=“http://www.biausa.org/”>http://www.biausa.org/</a></p>
<p>Hang in there!"</p>
<p>The accident was about 3 weeks ago - 1 week in the hospital and 2 in rehab so far. He was very briefly unconscious, and all his memories prior to the accident are intact. He has a classed head injury and there was a small amount of brain bleeding - he had one “dose” of platelets the night of the accident and subsequent CT scans showed no change. He has a wound on the back left of his head so we assume that is where he made contact (no one saw as it happened in a split second).</p>
<p>He is 78 but in great shape - cognitively sharp as a tack, was in the middle of writing a book, does the NYT crossword every day etc etc. Currently he is not on any meds for the accident, but had been on an anti seizure drug in the hospital. They tried Haldol but felt it did not work. He is not sleeping great, although he was not a great sleeper prior to the accident, so they have been giving him Ambien but may change that as it is not working regularly.</p>
<p>All of the docs have told us “sundowning” does not relate to TBI patients, but all the nurses have told us they absolutely see it in TBI patients. We do notice that he is almost himself, cognitively, during the day, but as dinner approaches he starts to ask why he can’t leave with us etc. Forgets he is injured. He is not combative any more, but can ramble at night, talking, sometimes. I see a good upward trend so I feel a lot better than when I started this thread.</p>