My brother who is 59yrs old went into a diabectic coma and was considered brain dead, was put on life support and while the family was trying to decide when to take him off, he somehow removed the breathing tube during the night and has continued for the last four months to breath on his own, he has been given a feeding tube and although his eyes are open, he smiles and he follows us around the room with his eyes, i am not sure that he actually recgonizes us or if he is smiling as a newborn would. My main question is how long will a feeding tube in an adult sustain life? His weight has dropped tremendously in the past months, and is there anything that we can have done to know how much he understands.
How long will a feeding tube in an adult sustain life?: Decades. I have worked with adults with brain injury who have lived at home for coming up to 20 years with feeding tubes. He may be losing weight as if he were on a diet if he was overweight to begin with -- they would be giving the calories needed for a healthy diet, not to maintain his current weight if overweight, if you see what I mean.
Is there anything that we can have done to know how much he understands: You might try seeing if you can establish some kind of yes//no signal with him (e.g., blinking) and then asking simple simple questions.
You could ask him to try moving different body parts (e.g. move your thumb; open your mouth; close your mouth; close your eyes; open your eyes; move your hand -- this one (tapping). Give him plenty of time - up to 30 seconds - without giving any new directions - you can repeat the old one. If he doesn't do it, but looks like he is trying (facial tension for example), tap that body part (to help him "find it"), then if he still can't do it, move it gently in the expected direction, if he still can't do it, make the movement for him and ask him to do it again. If you do his whole body from head to toe, this will take quite a while, but you will find out:
1) if he understands any of the directions (if he can do them or at least tries to do them)
2) if there is a body part you can use with him most easly as a signal for your other questions.
If you know someone who has a simple "GSR" device for relaxation (it has a little tone that goes up and down based on skin resistance/stress levels) you might also be able to use that to see if he responds differently to people he knows well (family, old friends) vs not (nurses, other visitors). You could also use pictures of people he knows vs strangers from magazines -- but pictures can be harder for all of us.
Just some ideas -- hope it helps. Some psychologists or OTs are trained to work with people at this level, but if they're not, they tend to miss the important indicators so you can start on your own without worries -- he will tend to respond best to family anyway.
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