Disorders of Consciousness Program

A caregiver in blue scrubs and gloves is examining a young person seated in a wheelchair, wearing a tracheostomy tube. They are in a bright room with a window showing green foliage outside.

The Disorders of Consciousness (DoC) Program at Shepherd Center provides specialized services for individuals in a minimally conscious or reduced consciousness state due to a severe brain injury. Since 2000, our program has been one of only a few dedicated programs nationwide to meet the needs of these patients.

What is a disorder of consciousness?

Consciousness is defined as wakefulness or alertness with awareness of one’s self and the environment. Severe brain injuries can result in a disorder of consciousness, leading to reduced arousal and abnormal or limited reactions to environmental stimuli. Disorders of Consciousness include conditions such as coma, unresponsive wakefulness syndrome, and minimally conscious state, which significantly impact a patient’s ability to respond and interact.

Key features of the Disorders of Consciousness program

The program provides highly individualized treatment plans tailored to the specific needs of each patient. The treatment focuses on medical stabilization, management of health needs (such as nutrition and neuropharmacology), facilitation of optimal positioning and mobility, and identification of environmental modifications that help facilitate arousal, communication, and cognitive recovery. A minimally conscious stimulation program is often used to enhance patient engagement.

Patients receive care from a consistent team of specialists, including physicians, case managers, therapists, neuropsychologists, and family counselors.

Each patient undergoes comprehensive assessments to determine medical status, mobility, muscle tone, arousal, communication, and cognitive functioning upon admission. Weekly assessments using the Coma Recovery Scale-Revised (CRS-R) track the patient’s progress to help guide treatment modifications toward greater levels of consciousness.

It was slow, but each day brought changes in what my son could comprehend. That he was able to recover and become independent, much of that is due to the care given to him at Shepherd Center.

La Ronda Forsey, Tennessee Mother of Patient with Disorder of Consciousness

A woman holding a clipboard smiles at a man in a yellow shirt next to a large blue exercise ball. In the background, another person in a blue shirt is seated, visibly focused on a task. The setting appears to be a therapy or rehabilitation room.

Family-centered care and support

Your involvement plays a vital role in your loved one’s recovery through the DoC Program. We support you with education, training, and resources to help you feel confident and included. You’ll have opportunities to share goals, ask questions, and take part in hands-on training. We also offer family orientation sessions, brain injury lectures, support groups, peer meetings, monthly events, therapy training, and community outings to keep you informed and connected throughout the journey.

88%

The percentage of patients who progress from a minimally conscious or unresponsive wakefulness to rehabilitation-level care and successfully transition home is 88%.

More DoC Patient Outcomes

Discharge planning and support

Toward the end of a patient’s stay, the case manager, along with other members of the DoC treatment team, works closely with the family to determine the best options moving forward. These options may include:

  • Progressing to a rehabilitation level of care: Patients who show improvements may transition to a more active rehabilitation program where they can continue working on functional recovery.
  • Discharging home with supportive services: Patients may be discharged home with supportive services. In such cases, a transition support coordinator will be available to the family for 60 days post-discharge to answer questions and provide support during the transition from hospital to home.
  • Discharging to a long-term care facility: If further specialized care is needed, the team will assist in transitioning the patient to an appropriate facility that can meet their ongoing needs.

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