Recently, some family members of vegetative patients often ask us about home care methods, and we feel that many people have many misunderstandings. Therefore, we would like to introduce some methods that we often use in clinical practice and are more effective. Consciousness restoration exercise: 1, upright training In the process of human evolution, in order to adapt to the characteristics of standing and walking, most of the functional design (including the brain) is set in the upright premise. Normal people are usually upright when they are awake, so being upright puts the human brain at a better level of consciousness work. Many families believe that the condition is too severe to withstand the training of standing. This is not the case. As long as the patient is stable, he or she can stand with the help of another person or the use of a standing bed. If the patient is unable to stand, he or she can also use a wheelchair or a sitting position in a hospital bed. Regular standing or remaining in an upright position can help the patient to regain consciousness. The duration of training is determined by the patient’s condition. Protection is needed to prevent unnecessary injuries during training. Which state are you most likely to be in when you are lying down: awake, or asleep? 2. Environmental stimulation For patients with stable conditions, it is recommended that the patient’s wheelchair be pushed outdoors to a different environmental background on a daily basis to allow the patient to perceive changes in outside stationary or moving objects, air, temperature, and background sounds while performing sit-to-stand training. These messages from the outside world will stimulate the brain to work and keep it in a certain state of activation. It will facilitate the patient’s recovery. Frequent adaptation in different environments will also increase the patient’s resistance and will help prevent infections. Some inpatients where everything is fine, but the room is going to have a fever and pneumonia once a new patient is admitted, are just too poorly adapted to their environment. Normal people who are shut down in a closed environment all day can also lead to reduced cognitive function. We can often see the degradation of orphaned elderly or prisoners in terms of responsiveness and cognitive power. 3. Affectionate communication Insisting on talking, touching and gazing at the patient is helpful to the patient, which many family members are aware of. But persistence can be difficult. Our specific approach is to encourage loved ones to continue communication with the patient outside of the suggested regularity of listening to the patient’s family members, without having to deliberately go one-on-one, chatting between relatives by placing recording devices on the side, recording at will, and then playing it back to the patient repeatedly, the content can be updated frequently to keep the patient’s interest. The advantage of this is that family members do not have to search their hearts to say anything to the patient or take time out specifically to communicate. Just leave the sound to share with the patient in the accompanying comments. The voices recorded in such a situation are more natural, broader and more vivid, and more people are involved. Very close to what we would see in a normal setting. There is a lot of help for the patient’s recovery. 4, feeding training Should start early for the patient to swallow training, many family members think that the patient has a gastric tube, only the gastric tube to eat convenient, fast and not easy to cause choking and accidental aspiration, etc., in fact, it is not. The swallowing action involves several systems of the human body. The patient first perceives the presence of food in the mouth, feeds back to the brain, makes a judgment, and then issues a command to direct the corresponding muscle activity to complete the action, which is a very meaningful consciousness process and training. The brain of a vegetative person is dormant for a long time, and seizing any small residual function for the patient to exercise is very helpful for the patient’s consciousness recovery, and it can also lead to the recovery of other functions. The long-term lack of effective activities in the patient’s brain will lead to disuse degeneration and brain atrophy, increasing the difficulty of recovery. In the training process is very painful, the family must have great patience, the patient began to trainer with poor cooperation, and even choking and coughing, family members see very painful, and the process is long often make people lose patience, but remember one thing, the family do more, the patient can be better. Family members are lazy, the patient will suffer more. To encourage the patient to eat, you should choose food that tastes good and that the patient likes, so that the patient’s initiative to eat is much better. Also, train when the patient is hungry, has the desire and initiative to eat, and then inject the rest of the food through the gastric tube when he cannot cooperate. Do not wait until the patient is already full before training. When you are full, will you still want to eat? 5.Visual stimulation Often let the patient sit up or semi-sitting position to watch TV, the patient may not be watching, but leave him alone, the infant also does not know, but we also often talk to them. Do not think that the patient is not watching, they may be watching, just you do not know or he did not show it. Recent studies have found that many vegetative people are actually conscious, but they just don’t express this consciousness or are not detected by us. Scientists have used functional MRI to enable patients to answer questions correctly and achieve limited communication. The patient is not conscious, it may just be that our current level of science or methods do not have the means to detect it, not that the patient is not. The program should choose the content of the picture rich in color and change, such as gun battle movies, action movies, parties, etc. Do not choose the emotional and dramatic category, the visual impact is not good enough. 6, test the state of consciousness Regularly ask the patient some questions for him to answer, such as hunger? Does it hurt? If you are in pain, blink your eyes, or eyes look down the side, or move your hands. According to research, about 40% of vegetative patients have expressed consciousness, but this consciousness is so weak and unstable that it is often overlooked if not repeatedly tested. Once the patient is found to be responsive and conscious, then the approach to this treatment changes dramatically. This is because there are many methods of exercise that can accelerate the return of consciousness, but are completely ineffective for people who are not conscious. General care 7. Care of lung infection Except when the patient is sleeping, most of the time the patient is kept in a semi-recumbent position, the uprightness of the upper body can effectively reduce the symptoms of lung infection and relieve the lung infection. Because the lungs are in the best working condition when the body is upright, the magnitude of breathing and the cilia in the bronchi and small branches of the lungs can better expel the deep sputum outward. Always remember, both from the point of view of awareness and maintenance of the normal work of the body, upright position is the best position of the body. 8, the massage of the limbs Insist on giving the patient massage and limb activities, will effectively prevent joint contracture. The method is 3-4 times a day, each joint activity 3-5 times, the purpose of this exercise is not to maintain the patient’s motor function, but to prevent joint deformation contracture resulting in future loss of mobility due to joint abnormalities after recovery of consciousness. In addition, the contracture of joints and limbs may lead to pain and discomfort of the patient. 9. Use of antiepileptic and sedative drugs Patients usually take these drugs, but they need to be used correctly. Most patients in the early stage are accompanied by obvious limb convulsions or spastic seizures, which need to be controlled by medication, because excessive limb convulsions will increase the oxygen consumption of the brain, leading to ischemic and hypoxic damage to the brain, which will further aggravate the condition. The use of drugs can be minimized after the condition is stabilized. These drugs generally have strong sedative effects, which are not good for the patient’s recovery of consciousness. We normal people will be drowsy even after taking these drugs, let alone for a vegetative person who has serious problems with consciousness itself. How to look at new treatments Objectively speaking, there is no very effective treatment for vegetative patients worldwide. However, doctors are always trying new treatments, and there are many new treatments for vegetative patients on the Internet, and there is a lot of mixed information on how families should identify them. In view of the current medical environment in China, we recommend that when choosing new treatments, you try to focus on those that are being tried in regular, large, state-run hospitals, because their practices may be relatively more standardized, rigorous, and feasible in terms of the personal qualities of the doctors, their professional abilities, and the implementation of the medical system.