Dementia in Head Injury (cont.)
Julia Frank, MD
Nestor Galvez-Jimenez, MD
Francisco Talavera, PharmD, PhD
Helmi L Lutsep, MD
IN THIS ARTICLE
Self-Care at Home
The extent to which a person with a head injury can care for himself or herself at home depends on his or her disabilities. If self-care is possible, a plan should be developed with input from the professional care team and family members. The team should assess the person’s ability to function on his or her own and comply with medical treatment. In many cases, the person must be supervised by a caregiver to ensure compliance and safety.
The injured person's surroundings must be neither too calm nor too hectic. He or she should have regular routines of light and dark, eating, sleeping, relaxing, using the bathroom, and taking part in rehabilitation and leisure activities. This helps the injured person remain emotionally balanced and minimizes the caregiver’s burden.
Caregivers must decide whether the person should have access to checking accounts or credit cards. In general, the person should continue to handle his or her own money if he or she seems willing and able. The caretaker can get power of attorney to monitor the person's financial responsibility. If the person has markedly poor judgment or seems unable to handle financial matters, the caregiver should seek formal conservatorship, which gives legal authority to manage the person's resources.
Many over-the-counter (nonprescription) drugs can interfere with medications that might be prescribed by the health care team. These interactions can decrease how well the prescription drugs work and might worsen side effects. The person’s care team must know what sorts of nonprescription medications the head-injured person uses.
Caregivers should seek help if the person has very disrupted sleep, does not eat enough or eats too much, loses control of his or her bladder or bowels (incontinence), or becomes aggressive or sexually inappropriate. Any marked change in behavior should prompt a call to the professional who is coordinating the person’s care.
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Traumatic brain injury can lead to deficits in 5 general areas: (1) short-term memory impairment, (2) slowed processing speed, (3) impaired executive function, (4) disrupted abilities of attention and concentration (which likely contributes to the deficits noted in the first 3 categories), and (5) emotional dysregulation.
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