Consciousness is the state of being awake and aware of one’s internal being and the external environment. Notably, it focuses on the ability of an individual to effectively control the system of mind to experience both external objects and have a sense of selfhood. Accordingly, consciousness is associated with several disorders such as coma, vegetative state, locked-in syndrome, minimal conscious state, and brain death. All these conditions have varied effects on communication. This paper explicates consciousness disorders and their relationship to communication.
Coma is one of the most significant disorders of consciousness. In this state, the patient does not respond to light, painful stimuli, and sound. More so, patients in coma do not have a sense of awareness and sleep-wake cycles. Schiff and Laureys (2009) confirm that its relationship to the ability to communicate could be explained in relation to the significance of the gray matter and the cerebral cortex. During coma, the cerebral cortex or the gray matter is usually damaged, which makes it difficult for patients to communicate verbally or engage in reflexive responses. Therefore, comatose patients cannot communicate because of the damage of the gray matter or cerebral cortex.
Another significant disorder is the vegetative state. The vegetative stage is characterized by sleep-wake cycles that could be explained from the alternating opening of the eyes. The patient breaths without assistance, but is not aware of his external and internal state. Young and Wijdicks (2008) confirm that the presence of cortical and thalamic injuries diminishes metabolism in the brain and makes it difficult for patients to communicate. This means that the vegetative state affects the ability of individuals to engage in verbal communication while allowing them to perform movements such as swallowing, moving eyes, smiling, and groaning.
The third vital disorder is brain death. It is associated with the irreversible loss of all reflexes found in the brainstem. More so, it is characterized by the end of brain functioning and the inability to breath. Young and Wijdicks (2008) reiterate that the death of the brain means that the patient does not have any sense of awareness and sleep-wake cycles. With this state, there is no verbal communication, because the brain is dead and the individual does not exhibit awareness. He/she lacks response to reflexes and all other forms of communication.
The fourth disorder is the minimal conscious state. It comes with inconsistencies in wakefulness and awareness of the environment. A person is not consistently aware of himself or their environment. Schiff and Laureys (2009) agree that in this state, patients are not able to communicate functionally, but respond effectively to verbal commands. For instance, they would be able to smile, laugh, or cry as a reaction to the information passed verbally. The reduction of the cerebral metabolic activity affects the ability of these patients to engage in functional verbal communication.
The last significant disorder that affects communication is locked-in syndrome. It is also referred to as the pseudo coma. In this state, patients possess awareness and follow sleep-wake cycles. They also exhibit behaviors such as eye blinking. Schiff and Laureys (2009) are of the view that despite being aware of the external and internal environment, the patient cannot engage in verbal communication because of the overall paralysis of all voluntary muscles except the eye muscles.
In conclusion, the various disorders of consciousness affect the ability of the patient to engage in verbal communication. The inability to communicate is mostly caused by injuries of the parts of the brain such as the cerebral cortex and the thalamus. Conditions such as brain death lead to the complete stoppage of brain functioning hence leaving no chance of verbal communication. The paralysis of voluntary muscles by the locked-in syndrome impairs the ability to communicate verbally.
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