Palliative Care Eases Suffering After Head Trauma

Palliative Care Treats Head Trauma Symptoms for Improved Quality of Life

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Palliative care is a medical specialty focused on relieving the symptoms of an illness or injury, clarifying medical wishes, and improving quality of life. Palliative care professionals work with individuals of all ages facing complex medical problems. It is often provided to patients sick enough to be hospitalized, although there are also outpatient palliative care providers.

Some believe that palliative care is synonymous with end-of-life care, or hospice, but this is not correct.

Palliative care providers regularly work with individuals expected to complete a full lifespan despite their illness or injury. These individuals just need some additional symptom control so they function better and feel happier. In fact, research shows that people live longer when symptoms such as nausea, pain and depression are relieved.

Palliative care providers are also specially trained to help patients and their loved ones prepare for and cope with terminal conditions.

Head trauma patients suffer from a wide range immediate and long-term symptoms that affect quality of life. Meeting with palliative care helps streamline recovery with a more whole-person approach that also involves the patient’s personal support system.

Your Mild to Moderate Head Trauma Symptoms

Palliative care can ease the suffering associated with the physical, emotional and psychological damage of head trauma and traumatic brain injury.

When palliative care gets on board, the providers aren’t only analyzing the symptoms you’re experiencing at the time of the initial consult; they are also trying to determine your risk of developing additional head trauma related symptoms weeks, months or years later.

Discussing the risk of depression, insomnia, pain, and PTSD early, putting together a plan to treat existing symptoms, and learning how to identify new symptoms right when they emerge, makes it possible to reduce and even prevent some of these complications over the years.

Who is on the Palliative Care Team?

Palliative care works closely with a variety of experts. The first person you meet is the palliative care specialist. He or she will admit you to the service and take an initial history. Based on the needs you identify, social work, physical medicine, and a source of spiritual support, such as a chaplain, may come to see you next. Palliative care also works closely with related fields such as anesthesia and psychotherapy.

Some palliative care programs provide complementary treatments such as healing touch, guided imagery, mindfulness training, and culturally appropriate therapies for those who are interested. Research demonstrates that these modalities increase trust, relieve anxiety and reduce pain.

What Happens During a Palliative Care Consult?

Each head trauma survivor has a unique set of injuries, a different social and medical background and distinct risk factors. The palliative care team encourages you to be as involved as possible in developing your treatment plan.

The initial palliative care consult aims to exchange information and build trust. Palliative care practitioners want to understand who you are, what gives your life meaning, what makes you happy, and how head trauma impacted your quality of life.

If you are experiencing specific symptoms they will ask detailed questions such as what makes your symptoms worse or better, and how your symptoms affect your ability to participate in both essential and enjoyable activities.

For example, if you love playing sports and miss the physical and social stimulation it provides, palliative care can collaborate with occupational therapy and neurology so sports-related exercises are provided. This will accomplish two things at once. First, you will receive an important therapy that stimulates your brain and body to regain skills lost as a result of the brain injury. Second, you will enjoy yourself, and this results in higher quality of life.

When therapies are directed toward personal interests it’s more likely that someone will participate in them regularly and get better.

Other questions you may hear from palliative care team members include:

  • what is bothering you most right now?
  • describe your physical and psychological symptoms in detail
  • what are you afraid of as a result of this illness/accident?
  • what does good quality of life mean to you?
  • what medical treatments don’t you want?

Once the provider has a good sense of how you feel, what worries you, what makes you happy he or she will identify the best treatments for your recovery.

Palliative Care Treatments

The palliative care provider will order medications, refer to therapists, suggest alternative treatments, and provide resources that benefit both you and your family. Here are some key treatments provided by palliative care for specific symptoms:

Pain- Pain can be looked at as short term and long term. Short term pain is often related to physical injuries or surgical wounds sustained during the head trauma accident; this pain is expected to go away with time.

Long term pain may never completely go away, and can result from nerve damage, contracted limbs, or tissue injuries that are resistant to repair.

There are a number of ways to treat physical pain after head trauma. Narcotic medications can play an important role, but providers have to be mindful of how they affect things such as your ability to think, and your digestive tract. 

Relieving pain includes reducing inflammation, fear and anxiety, and ensuring there is adequate rest. Therapies such as anti-depressants, non-narcotic pain meds, mindfulness meditation, healing touch, and slow stretching such as tai chi are demonstrated to relieve pain and other uncomfortable symptoms after trauma.

Depression- It is common to feel depressed after head trauma. There are known chemical changes to the cells in the brain that impair communication and affect mood. Feeling sad about losing physical or mental skills, worrying about losing one’s job and feeling inadequate because of an inability to care for family members is a significant contributor to depression after head trauma.

Some antidepressants work in ways that not only relieve the feelings of depression but also change one’s perception of pain, appetite, and ability to sleep. The right anti-depressant complements other therapies for the best possible effect. Working through anger, frustration, and grief with a trained therapist is helpful, and can involve loved ones.

Physical disability- Physical rehabilitation is integral to head trauma recovery. Getting moving is known to relieve muscle tension, burn off extra energy, and stimulate the mind to create new communication pathways. Working closely with the rehab team, palliative care can schedule appropriate medications so therapy is comfortable and provides the greatest physical benefit possible.

Involving Your Support System

Serious illness doesn’t only affect the survivor of an injury. It also involves the spouse, children, parents, and friends. Palliative care often sets up a meeting with you, your family and anyone else you would like to have present. This meeting includes the specialists involved in your care, such as the primary care doctor, a neurologist, a surgeon, therapists, and a case manager. The team explains the medical challenges to be overcome, and the benefits and risks of available treatments.

When important people in your life are brought together, provided the same information and encouraged to ask questions it clears up confusion and allows concerns to be addressed openly. It also helps your medical team better meet your needs. This meeting is an opportunity for you tell everyone what types of treatments you want, and what you do not want. 

If a patient is too sick to participate, then palliative care providers help families interpret advanced directives, or determine which treatments a patient would want based on their known quality of life preferences.

Difficult Decisions After Severe Head Trauma

In some cases, palliative care may be called if the head trauma victim is very sick, and not getting better. Head trauma victims may develop new complications such as infection, inflammation throughout their bodies, and breathing difficulties that require aggressive life support.

Physical damage to the brain can also affect the body’s ability to regulate blood pressure, temperature, and breathing. These complications prevent the medical team from weaning a patient off short-term life support measures, such as chemicals to maintain blood pressure or machines that control breathing.

In these cases palliative care meets with the family or designated medical representative to explain the seriousness of the injuries, and what life would be like if the patient survived those injuries. Providers may ask questions such as:

  • Is there an advanced directive on file that describes what the patient would want in case of life-threatening physical injury or illness?
  • Would this person want to be in a long-term care facility on a machine that breathes for them (a ventilator) for the rest of their lives?
  • Would this person want to be fed artificially through a tube that is surgically implanted into the stomach?
  • If the brain damage is so severe that the patient is not expected to speak/recognize family and have body control, would they want the medical team to use machines or chemicals to keep their bodies alive?

There are many factors that go into deciding whether or not to withdraw artificial life support from a patient after severe head trauma.

These may include:

  • age and ability to successfully recover
  • other health issues such as underlying cancer, lung disease, or severe heart disease
  • a patient’s advanced directive
  •  family knowledge of a patient’s wishes for medical care

If it is determined that the patient would not want to be kept alive on artificial life support, then palliative care helps family through the process of withdrawing support and allows the patient to die naturally. 

The focus then becomes on ensuring the patient is comfortable and is provided a peaceful and dignified death.

It is very important to talk about your medical wishes, in case you are ever injured in a serious accident. Writing and advanced directive can help your loved ones make the right decision if you are not able to speak for yourself.


American college of surgeons; many older trauma patients would benefit from palliative care. (2014). NewsRx Health, , 46. Retrieved from

Airosa, F., Falkenberg, T., Öhlén, G., & Arman, M. (2013). Original article: Tactile massage or healing touch: Caring touch for patients in emergency care – A qualitative study. European Journal Of Integrative Medicine, 5374-381. doi:10.1016/j.eujim.2013.03.003

Jahner, J., & Wolff, B. (2015). Palliative Care: Patient-Centered Assessment and Communication to Improve Quality of Life. New Mexico Nurse, ​60(4), 4-6 3p.

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