Update - 3/24/06
It has come to our attention that there may be some misconceptions about Matthew's condition and what the future holds. Yes, there are lots of positive things happening and the doctors are very happy with Matthew's responses, but things are very serious and the road Matthew must "travel" is very, very long. Those who have a brain injury do not quickly go back to being the person they were before.
Pastor and Brenda Kurz have asked me to share the following information with you. There is a scale called The Rancho Los Amigos Scale of Cognitive Functioning. This scale is a tool that describes the eight stages that a person with brain injury goes through with gradual progression from a deep coma to appropriate behavior and cognitive functioning. Right now Matthew is at Level IV.
Level I: No Response. The patient is unconscious. He appears to be sleeping. He does not respond to any stimuli presented to him. This comatose state can last for seconds, minutes, hours, days, weeks or even months.
Level II: Generalized Response. Here, the patient will react, but inconsistently and without purpose. His response, often a gross body movement or a garbled vocalization, is usually the same, regardless of what Glasgow stimulus is used. But his first response is activated, more times than not, from deep pain.
Level III: Localized Response. The patient is improving. He will react more specifically to different stimuli, but his response will be inconsistent. For example, he may occasionally turn his head in the direction of a speaker's voice. He may have a vague awareness of his body. He may inconsistently follow simple commands such as "close your eyes" or "squeeze my hand."
Level IV: Confused-Agitated. The patient has become very active, but he is not yet able to understand what's going on. His behavior might become bizarre; he might cry out or try to remove his feeding tube. He may be hostile and uncooperative, but he is not acting out of malice. It's a reaction to his overwhelming confusion.
Level V: Confused-Inappropriate. The patient has become less agitated; he will respond to simple commands in a more consistent manner. But if the commands are more complex, he gets confused and gives random, incorrect responses. He may become agitated if he is in a noisy or "busy" environment. He will not take the initiative. He will respond best to his body's aches and pains, to his own comfort, and to close family members. His memory is severly impaired, and he is unable to learn new information. At this level, he is in danger of "wandering off" the ward.
Level VI: Confused-Appropriate. Things are looking up. The patient is motivated, but still depends on others to lead the way toward his goals. His reactions will be more appropriate. If he is uncomfortable he will complain. He is beginning to recognize therapy staff members, and is much more aware of himself and his family. He can easily follow simple directions. His memory of the past has improved greatly, but his memory of recent events is still impaired.
Level VII: Automatic-Appropriate. The patient seems to act appropriately in the hospital and at home. He is now oriented to person, place, and time in these settings. All seems well, but things are still not completely right. He may go through his daily routines automatically. Although he can dress, wash, and feed himself independently, he needs supervision to ensure his safety. His judgment and problem-solving skills are still impaired, and he cannot make realistic plans for his future.
Level VIII: Purposeful and Appropriate. At last! The patient can integrate the past with recent events. He is independent and functional in society. However, he may have subtle difficulties with reasoning, judgment, and processing information, especially in high stress, unusual, or emergency situations. He may be actively involved in a vocational rehabilitation program, learning a new way to live in his new world.
Living with Brain Injury: A Guide for Families continues with the following information: "This hierarchy of levels looks simple and straightforward. But in real life, not every brain-injured survivor moves smoothly through each level. A patient may move from Level II to IV and never demonstrate any true Level III behaviors. Or, a patient may reach Level III and never progress beyond that point. Even if your loved one reaches Level VIII, it won't necessarily mean he is exactly as he once was. As mentioned earlier, he will most likely be changed - in ways that are subtle or not so subtle."
Matthew has been very active and agitated lately. They had to give him a "buzz" haircut because he was pulling and tugging at his hair. He has poked his own eye and scratched himself. Sometimes it takes several people to hold Matthew down to keep him from injurying himself. These things may sound disturbing, but in the long run they are good because it indicates that Matthew is progressing. This is very serious condition and the Kurz family needs our prayers as they live day-to-day helping Matthew through recovery.
Matthew can have visitors, but for short periods of time and only a few people at a time. If you are able to stop in and see him at Rusk, please remember to keep things quiet, because too much noise or activity is disturbing for Matthew.
"Oh, the depth of the riches of the wisdom and knowledge of God! How unsearchable his judgments, and his paths beyond tracing out! For from him and through him and to him are all things. To him be the glory forever! Amen" (Romans 11:33, 36)
Rachel Asburry
Matthew's godmother
Pastor and Brenda Kurz have asked me to share the following information with you. There is a scale called The Rancho Los Amigos Scale of Cognitive Functioning. This scale is a tool that describes the eight stages that a person with brain injury goes through with gradual progression from a deep coma to appropriate behavior and cognitive functioning. Right now Matthew is at Level IV.
Level I: No Response. The patient is unconscious. He appears to be sleeping. He does not respond to any stimuli presented to him. This comatose state can last for seconds, minutes, hours, days, weeks or even months.
Level II: Generalized Response. Here, the patient will react, but inconsistently and without purpose. His response, often a gross body movement or a garbled vocalization, is usually the same, regardless of what Glasgow stimulus is used. But his first response is activated, more times than not, from deep pain.
Level III: Localized Response. The patient is improving. He will react more specifically to different stimuli, but his response will be inconsistent. For example, he may occasionally turn his head in the direction of a speaker's voice. He may have a vague awareness of his body. He may inconsistently follow simple commands such as "close your eyes" or "squeeze my hand."
Level IV: Confused-Agitated. The patient has become very active, but he is not yet able to understand what's going on. His behavior might become bizarre; he might cry out or try to remove his feeding tube. He may be hostile and uncooperative, but he is not acting out of malice. It's a reaction to his overwhelming confusion.
Level V: Confused-Inappropriate. The patient has become less agitated; he will respond to simple commands in a more consistent manner. But if the commands are more complex, he gets confused and gives random, incorrect responses. He may become agitated if he is in a noisy or "busy" environment. He will not take the initiative. He will respond best to his body's aches and pains, to his own comfort, and to close family members. His memory is severly impaired, and he is unable to learn new information. At this level, he is in danger of "wandering off" the ward.
Level VI: Confused-Appropriate. Things are looking up. The patient is motivated, but still depends on others to lead the way toward his goals. His reactions will be more appropriate. If he is uncomfortable he will complain. He is beginning to recognize therapy staff members, and is much more aware of himself and his family. He can easily follow simple directions. His memory of the past has improved greatly, but his memory of recent events is still impaired.
Level VII: Automatic-Appropriate. The patient seems to act appropriately in the hospital and at home. He is now oriented to person, place, and time in these settings. All seems well, but things are still not completely right. He may go through his daily routines automatically. Although he can dress, wash, and feed himself independently, he needs supervision to ensure his safety. His judgment and problem-solving skills are still impaired, and he cannot make realistic plans for his future.
Level VIII: Purposeful and Appropriate. At last! The patient can integrate the past with recent events. He is independent and functional in society. However, he may have subtle difficulties with reasoning, judgment, and processing information, especially in high stress, unusual, or emergency situations. He may be actively involved in a vocational rehabilitation program, learning a new way to live in his new world.
Living with Brain Injury: A Guide for Families continues with the following information: "This hierarchy of levels looks simple and straightforward. But in real life, not every brain-injured survivor moves smoothly through each level. A patient may move from Level II to IV and never demonstrate any true Level III behaviors. Or, a patient may reach Level III and never progress beyond that point. Even if your loved one reaches Level VIII, it won't necessarily mean he is exactly as he once was. As mentioned earlier, he will most likely be changed - in ways that are subtle or not so subtle."
Matthew has been very active and agitated lately. They had to give him a "buzz" haircut because he was pulling and tugging at his hair. He has poked his own eye and scratched himself. Sometimes it takes several people to hold Matthew down to keep him from injurying himself. These things may sound disturbing, but in the long run they are good because it indicates that Matthew is progressing. This is very serious condition and the Kurz family needs our prayers as they live day-to-day helping Matthew through recovery.
Matthew can have visitors, but for short periods of time and only a few people at a time. If you are able to stop in and see him at Rusk, please remember to keep things quiet, because too much noise or activity is disturbing for Matthew.
"Oh, the depth of the riches of the wisdom and knowledge of God! How unsearchable his judgments, and his paths beyond tracing out! For from him and through him and to him are all things. To him be the glory forever! Amen" (Romans 11:33, 36)
Rachel Asburry
Matthew's godmother
posted by Randy Asburry @ 6:42 PM
1 Comments:
At 7:15 PM,
Anonymous said…
dear rachel..thanks for sharing the info on Matthew...i'm sending my love, prayers, and hope to all of you tonight, quite simply, in His name...the one name that stands above all the rest....most sincerely, mrs. lithebe xoxoxoxo
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