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Reducing brain over-stimulation

  • Over-stimulation

    To help your loved one recover from a brain injury, it's important to help him or her not get over-stimulated.

    His or her brain is unable to make sense of all of the information coming in such as sounds, lights, touches and smells.

    In the early stages of rehabilitation, it is important to provide an environment that reduces brain over-stimulation so he or she can participate in rehabilitation.

    Members of the health care team will work to keep your loved one on a regular schedule and plan his or her care in a quiet, dimly lit environment. Without this, your loved one may become overwhelmed and more confused. He or she may withdraw and shut down or even become aggressive.

    The amount of stimulation your loved one receives will increase as he or she improves.

    Signs to watch for

    Signs your loved one may be over-stimulated:

    • being restless or trying to move around
    • repeating the same words or sounds
    • having a lack of attention
    • being easily distracted
    • being confused, irritated or being verbally aggressive
    • being physically aggressive
    • not wanting to be touched or withdrawing from interactions with staff or visitors

    Tell a member of the health care team if you think your loved one is over-stimulated.

    How to help your loved one

    • Limit visitors to no more than two at a time.
    • Limit visits to 10 to 15 minutes, unless you are just sitting with your loved one and not talking or doing an activity.
    • Keep your conversations brief and clear. Give just one piece of information at a time.
    • Do not use your phone when your loved one is in the room. If you need to use your phone, go into the hallway.
    • If the room phone keeps ringing, talk with a nurse about options.
    • Keep the television, music and computer off unless you know your loved one enjoys it. Limit screen and music time to no more than 20 minutes.
    • You may put up a few family photos in your loved one's room. Limit cards, balloons and flowers. Consider putting photos and cards in a small album.
    • Remove clutter in your loved one's room.
    • Speak slowly with a calm, quiet voice. Give your loved one time to respond.
    • Check with staff before giving your loved one anything to eat or drink.
    • Please share these tips with others who visit.

    Talk with any member of your loved one's health care team if you have any questions or concerns.

    Environmental Management System

    Courage Kenny Rehabilitation Institute uses a system of communication that identifies how the environment should be managed for each person based on where he or she is in the rehabilitation process. This is called the environmental management system (EMS).

    The system is based on a traffic light:

    • red light: full restrictions
    • yellow light: some restrictions
    • green light: limited or no restrictions

    The level may change based on your loved one's needs and health care team's advice.

      Red Light Yellow Light Green Light
    Lighting
    • dim/dark at night
    • natural light during the day
    • as he or she can tolerate
    • no restrictions
    Noise
    • completely quiet
    • avoid loud, annoying, or ongoing noises
    • no restrictions
    Room décor
    • none or very limited
    • a small amount is OK
    • avoid violent or sexual content
    • avoid busy or active posters
    • no restrictions

    TV, video, music

    • none
    • no more than 20 minutes at a time (not during scheduled rest breaks)
    • no restrictions
    Visitors
    • family only
    • one visitor at a time
    • limit visit to 10 minutes or less
    • family, close friends, and clergy
    • no more than one or two visitors at a time
    • limit visits to 15 minutes or less
    • no restrictions
    • must follow the hospital visitation policy

    Touch, handling

    • limit touch and handling except as absolutely needed for medical care
    • as he or she can tolerate
    • no restrictions

    Treatment location

    • in the room or in a private treatment area
    • in a private or semi-private treatment area
    • anywhere
    Notes
    • These help prevent agitation later, help your loved one tolerate and benefit from rehabilitation therapies and keep your loved one safe and comfortable.
    • Red light restrictions will be used at the first sign(s) of agitation or withdrawal.
    • These provide cues to help your loved one recognize symptoms of overload, understand what adds to it and understand how to reduce stimulation.
  • Source: Allina Health Patient EducationUnderstanding Stroke, fifth edition, neuro-ahc-90662
    Reviewed by: Allina Health Patient Education experts
    First published: 02/01/2006
    Last reviewed: 05/01/2018