Expectations and experience regarding ordinary injury and illness, is a temporary reduction in general functioning. This is usually followed by a gradual returning to normalcy. People go to hospitals when they are sick, and recover. When bones are broken, there is a period when casts have to be applied. After some months, muscle strength is regained and the scars fade away. However, brain trauma recovery is somewhat different.
A great amount of harm comes from head injuries. Healing of these injuries does not follow the conventional path. Most patients hardly recover entirely, and the deficits are residual, important and last almost forever. Most families expect that recovery will be continual, and this leads to unnatural planning. There are usually new limitations for which awareness is necessary and for successful rehabilitation, a person with head injuries must be accepted into the family with these limitations.
Physicians usually tell the families that maximum recovery would be made in first twelve months. They usually do this based on their observations that progress made by patients in these first months is a reasonable indication of the future. However, these observations are based on statistical data, and do not represent healing for all patients. Additionally, families usually misunderstand this and conclude that after one year there will be no further healing.
However, this is far from the truth. Research has shown that duration of healing varies directly to the severity of the injury. Those who improved more quickly had fewer severe injuries to their heads. Those with more severe injuries took longer to improve. Although statistical results predicted one year, there were individuals who recovered more within one year.
There have been cases of functional spurts in improvement caused by environmental changes that have taken place years later. This ability of improvement in functioning is not the same as cognitive or neurological status. Sometimes, the demise of a parent or partner, or the formation of another relationship could lead to a sudden improvement in patients who have not shown any improvement for long.
Therefore, the notion that recovery will take place in one year is a myth. This usually leads to families believing that there would be full healing in a year, irrespective of the severity of the injury. When this does not happen, or does not happen to the level of expectation, there is a general feeling of disappointment for both the patient and their families.
There is also a myth of a plateau concept. In general, recovery follows an up going trend, then slows and starts leveling off. This is the period where not much of improvement happens. It is true that most of the improvement happens rapidly in the earliest stages. Later, the changes proceed gradually. At this time, the plateau concept may cause the maximum harm.
Whenever a plateau is observed, there is a tendency for the families to write off the patient. When the rate of change decreases, a general feeling of despair takes over. This may lead to the services of therapists being terminated. As a result, the client stops progressing entirely and even falling back. Families must understand that brain trauma recovery does not follow a straight path.
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