Coma Communication: A living will, also known as an advance directive, often contains a declaration that one does not wish to have one’s life prolonged by artificial means. However, once in a coma or state of altered consciousness, we may have a different opinion about our advance directive instructions; many people have life changing experiences in coma while others need time to work through personal, spiritual, family, and relationship concerns.

A coma is a state of deep unconsciousness where the person cannot by aroused. It is generally characterized by the absence of spontaneous eye movements, response to painful stimuli, and vocalization. Loss of consciousness typically involves injuries to the brain stem, the oldest part of the brain, which is responsible for basic life functions such as alertness, arousal, heartbeat, and breathing. A patient's degree of consciousness is often used to determine the severity of his/her brain injury.

People who are in coma cannot obey commands. They may move, however, in response to touch or pain, or even on their own. EXTENSOR POSTURING is commonly seen in patients in coma. This is characterized by marked stiffness of the legs, arms and neck in a characteristic posture with the legs straight out and feet pointed downward, and the arms straight out at the sides with the wrist bend down and the fist clenched. This posture is often worsened by touch or pain.

The most common misdiagnosis of coma is blindness coupled with inability to speak. Another is so called “locked in syndrome” in which the person is completely paralyzed, or nearly so, though their mental faculties remain normal. These possibilities should be thoroughly checked.

Coma is a state of profound unconsciousness where a person cannot be aroused. A person may recover from a coma as well as a brain injury. Brain death is the permanent loss of all functions of the brain, including the brain stem. Brain death is death.

NO! ABI has many levels of intensity. It is possible that someone can acquire a brain injury without loss of consciousness or external bruising or tangible confirmation (i.e., CAT Scans, Skull X-rays, EEGs, etc.) Individuals who have even a mild brain injury may continue to experience a wide variety of symptoms that can have life-changing implications. However, each injury is different and unique for each person.

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People in coma sometimes show signs that they are able to hear and understand. Often these signs are just simple reflexes -- like squeezing a hand, or sucking, in response to a touch. Occasionally people in coma seem to become calm when they hear a familiar voice. Since they almost never remember these events, it is impossible to decide if they actually recognized a void or understand what was said.

Coma Communication: Always assume the person in coma can hear. Hearing is usually the last sensory faculty to deteriorate when people are dying. Occasionally someone hard of hearing in their normal state can hear better in their altered consciousness. ~ If you want to speak about sensitive matters, assume your patient can hear, please, leave the room and close the door behind you. When the coma person’s eyes are open they may well be able to see.

Coma Communication: Touch is almost always beneficial. It is comforting and breaks the sense of isolation of the one in altered consciousness. Please introduce yourself and ask permission first! Tell the person what you are going to do and report as you are touching. For instance, “Now I’m going to touch your right forearm. Here comes. There.” And then notice feedback. All human rights apply to a person in coma.

Coma is a state of unconsciousness that occurs because the brain is injured in some way. The brain still functions and this can be seen in the tests that are performed. The person will be able to breathe on his own without the help of a respirator. The brain, in fact, may heal.

The term coma is generally used to describe a person whose ability to respond to stimuli is significantly reduced. However the term can be misleading. In some cases, the significant alterations of consciousness that we see in severe brain injury persist. The term persistent vegetative state is used to describe individuals who do not recover from coma following their injuries. Little is known about what people hear or see while in a coma.

Being in coma may be compared to being under anesthesia. People in coma may well react to pain by moving, or even groaning, but most often have no memory of pain.

Coma Communication: We have always gotten responses from the hundreds of people we have worked with. We believe that everyone is trying to communicate. We even consider supposed “reflex reactions” and stiff muscles and tendons as communication patterns that we can relate through. As coma helpers we learn to interact with patients’ nonverbal language and to respond in tune with their communication styles.

Coma Communication: At Coma Communication we work with people in coma and altered consciousness resulting from many causes. With all causes we use coma work techniques to communicate with clients, to enable them to complete inner work, reach the outside world when they are ready to, make life and death decisions, and help educate brain and body functions. We believe that as long as there is breath there is consciousness that can be communicated with.

Coma Communication: We believe that some level of consciousness is present as long as there is breath. And that we can communicate with people in any state of consciousness, including sleep or supposed unconsciousness. People with traumatic brain injury usually remain in a so called true coma for about two weeks to a month, where they have no sleep/wake cycle.