On With Life at Ankeny’s Program for Persons in a Coma/Minimally Responsive State

On With Life at Ankeny began accepting individuals in a coma/minimally responsive state in 1994. This program has two primary components:

1. Aggressive maintenance of the individual’s physical condition to promote medical stability, to avoid contractures and skin breakdown, and to improve the ease of providing care to individuals as long as they remain in a dependent state.

2. Stimulation of the brain and the central nervous system to promote development and prevent further deterioration that might prove to be irreversible.

A person is considered in a coma/minimally responsive state when he/she can not demonstrate consistent responsiveness to standardized assessment instruments and is unable to meaningfully interact with the environment.

A person in a minimally responsive state receives daily physical, occupational, and speech therapies. In addition, the person participates in daily sensory stimulation groups where he/she receives multimodal stimulation in the form of auditory, visual, olfactory, taste, touch, vestibular, and oral motor stimuli. Supplemental stimulation protocols are also carried out by members of the Rehabilitation Nursing Staff, Therapeutic Recreation, and Music Therapists.

On With Life involves family/support system members as much and as often as feasible in each person’s rehabilitation program. Family/support systems are provided with structured opportunities to provide input into the development of their loved one’s program. Family and friends are encouraged to visit frequently and to participate in therapy sessions as appropriate, learning sensory stimulation activities to continue outside of therapy sessions as their loved one is able to tolerate them.

On With Life at Ankeny is one of a very limited number of CARF accredited rehabilitation programs committed to providing programs for minimally responsive persons. Our goal is to provide intense and repetitive stimulation so that the individual (person served) will awaken and return to a high level of functioning through development of an awareness of self and the environment. The medical and rehabilitation staff recognizes the challenges of serving individuals with more complex medical needs and continues to expand skills to meet and exceed the expectations of our customers.
To be eligible for this program, a person must meet the following criteria:

• Be medically stable (not requiring daily doctor supervision);
• Be without a terminal diagnosis;
• Have suffered a traumatic or anoxic brain injury within the past three months;
• Be able to tolerate a minimum of 2 hours of therapy per day.

A person is discharged from this program when he/she:

• Demonstrates consistent responsiveness to standardized assessments and is able to interact meaningfully with the environment, or
• Fails to meet the criteria for responsivity and interaction six months following a traumatic brain injury or three months following an anoxic brain injury.

A person will be transferred to our regular rehabilitation program when he/she can consistently respond to the environment. For a person unable to emerge, a long-term care option will be secured.

To make a referral to On With Life’s Program for Persons in a Coma/Minimally Responsive State, contact Kathy Herring at 515-965-1339 Ext. 118.

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