Many brain injury patients may experience a period of confused agitation. During this phase of recovery, there may be increased falls, outbursts, and need for increased safety measures (example: one to one sitter/enclosure bed*). These incidents might occur because an injured brain is not able to filter out external/internal stimulation. The patient may display poor memory, disinhibition, lack of insight, poor judgment, disrupted sleep/wake cycle, and an inability to filter out noise (T.V., phone, and visitors.). Initial and continual treatment involves monitoring and adjusting external/internal stimulation specific to each individual.
The controlled stimulation protocol is based on a progression through the confused and agitated state and during this time stimuli will be added gradually based on the patients' improvement. Primary features of recovery include reduced agitation, improved sleep wake cycle, bowel/bladder continence and orientation (person/day/month/place).
An enclosure bed is an attachment to a regular hospital bed that provides an enclosed environment for the patient. It is usually made from vinyl or other soft material and is placed over the regular hospital bed. At Spalding Rehabilitation Hospital, enclosure beds are used to assist patients with planning, to help their injured brain filter out external stimuli that may cause agitation or impulsivity, until they are able to retain new memory. As they recover the bed is opened a little at a time to allow them to adjust.