Module 3: What to expect in the early days of recovery

Why am I in hospital?

Waking up in a hospital can be quite a frightening experience. You might not remember what happened and why you are in hospital, or how long it has been.

TBI is considered a medical emergency. When you have a TBI, you are immediately sent to hospital. Your doctors will work rapidly to assess your condition and treat you to prevent potentially life-threatening complications.

Here you will have a large medical team around you which includes doctors, nurses, physiotherapists, occupational therapists, speech pathologists, dieticians, therapy assistants, social workers, and possibly many more. It can be confusing to understand who is working with you, and what are they helping you with.

If you are feeling confused, ask the person “Can you tell me your name and what you are helping me with?”

In the first days and weeks of your hospital stay, your medical team will focus on treating your physical condition, including:

• Normalising your intracranial pressure – this is the pressure on your brain from the fluid inside the skull (21),
• Stabilising your breathing, oxygen levels, circulation, temperature and fluid levels,
• Helping manage your pain,
• Monitoring your memory and coma,
• Monitoring for deterioration,
• Give you medications promptly.

Once your condition is stable, you will start some rehabilitation. There will be more on rehabilitation later in Module 5: What does recovery look like?

I don’t like hospitals!

You’re not alone. Waking up and finding yourself in hospital can be very scary. For most people, the hospital is an unfamiliar place. Routines will be different to what you are used to. You might not have access to things that make you comfortable. Some people might want different types of food. Some might want to worship or talk to pastoral care.

The hospital has many rules in place to keep you safe. There are specific visiting hours and times for you to rest or do rehabilitation exercises so you can recover and return home as quickly as possible.

Let hospital staff know if you have any special requests to make yourself more comfortable during your admission – the staff are there to help you.

Staff can also connect you with speciality services within the hospital – such as Aboriginal Health Liaison Officers, Centre for Wellbeing (pastoral and spiritual care) or Interpreters.

Many people find it easy to become overstimulated by the environment after a TBI (22). Hospital wards are full of people coming and going, machines beeping, and bright fluorescent lighting.

Let hospital staff if know if you experience sensory overstimulation. They can adjust the environment so that you can get a more comfortable rest.

Needing help with personal care

When you are in hospital, different staff will help you do daily activities that you would normally do on your own. This includes personal care such as dressing, showering and going to the toilet.

Some people appreciate the assistance from hospital staff. For others, not being able to do your usual activities on your own may be frustrating. You might even feel discomfort or a loss of privacy having a stranger help you with your personal care.

Some daily activities you may need help from hospital staff to complete include:

• Having a shower,
• Going to the toilet,
• Getting dressed,
• Eating,
• Walking,
• Talking,
• Remembering events.

Why do I need help from others?

It can be hard to need help from others to do the things you would normally do on your own. When you eventually leave the hospital, you will likely need help with your daily activities for some time as well. You might feel mixed emotions from having to depend on others for help, including:

• Helplessness.
• Upset at yourself or the situation,
• Shock,
• Anger,
• Extreme distress,

Getting help from other people is normal after TBI to keep you safe.

As your brain has been injured, you might have difficulties remembering how to do certain tasks.

Sometimes you might be able to do the activities, but you may be at a risk of accidents if you were left alone. For example, you may be at risk of falling due to poor balance. This can cause a new injury and prolong your recovery. This is

Why it’s important to have someone to help you.

Sometimes you might feel as though there’s nothing wrong and might not understand why you need help from another person. It can be frustrating not being allowed to do things on your own. This is a common experience after brain injury. Many people with brain injury have trouble recognising they have certain deficits or difficulties (23). This is caused by damage to specific parts of the brain – most commonly the right parietal lobe.

Having to depend on others and not being able to do the things you used to do on your own can lead to a feeling of loss of identity. This means you are finding it difficult to know yourself and understand who you are after your injury. You may feel like you are not in control of your own body or self, which can be quite scary.

If you find yourself in this situation, it can be helpful to talk to a trusted family member or friend, or your doctor or nurse, who can put you in touch with a counsellor or psychologist to talk about your feelings.

There will be more on loss of identity in Module 11: Finding meaning in life after TBI.

References

1. Kreitzer N, Rath K, Kurowski BG, Bakas T, Hart K, Lindsell CJ, et al. Rehabilitation practices in patients with moderate and severe traumatic brain injury. The Journal of head trauma rehabilitation. 2019;34(5):E66.
2. Downing MG, Hicks AJ, Braaf S, Myles DB, Gabbe BJ, Ponsford J. “It’s been a long hard road”: challenges faced in the first three years following traumatic brain injury. Disability and rehabilitation. 2022;44(24):7439-48.
3. Prigatano GP, Schacter DL. Awareness of deficit after brain injury: Clinical and theoretical issues: Oxford University Press; 1991.