A patient participates in Brain Injury Rehabilitation alongside TIRR Memorial Hermann staffThe TIRR Memorial Hermann Disorders of Consciousness (DoC) Program focuses on patients in a vegetative or minimally conscious state. Although these patients are often not ready to begin a traditional rehabilitation program, they can significantly benefit from a program that specializes in treating disorders of consciousness. The Disorders of Consciousness Program applies state-of-the-art advances to assess and treat these patients to help maximize their potential recoveries and outcomes.

Studies have shown that 35 to 40% of patients with disorders of consciousness are misdiagnosed and undertreated. Frequently thought of as vegetative, many are either conscious or minimally conscious.1

What Are Disorders of Consciousness?

A disorder of consciousness is a condition of altered consciousness in which a patient has severely impaired levels of awareness and wakefulness. Examples include patients who are in coma, a vegetative state or a minimally conscious state.

What Causes Disorders of Consciousness?

A disorder of consciousness is often seen following a severe traumatic brain injury, an anoxic brain injury or stroke.

1 Advancing Best Practices in the Treatment of Patients with Disorders of Consciousness

Disorders of Consciousness: Family Panel

Four families tell their stories and experiences with TIRR Memorial Hermann and the Disorders of Consciousness Rehabilitation program.

Who Does the Disorders of Consciousness Program Treat?

The Disorders of Consciousness Program treats patients who are still unconscious or have just recovered consciousness. This includes patients who are not yet communicating or following commands, and patients who have just begun to communicate or follow commands but do so inconsistently.

Meet the TIRR Memorial Hermann Team

We have a knowledgeable outpatient interdisciplinary team that may include:

  • Physical therapist
  • Occupational therapist
  • Speech language pathologist
  • Neuropsychologist
  • Clinical social worker
  • Vocational counselor
  • Wheelchair seating and positioning specialist
  • Chaplain

Additional team members of an inpatient stay may include:

  • Affiliated rehabilitation physician
  • Rehabilitation nursing
  • Therapeutic recreation therapist
  • Music therapist
  • Clinical pharmacist
  • Case Manager
  • Nutritionist

What Are the Benefits of the Disorders of Consciousness Program?

The TIRR Memorial Hermann team works with patients and their families to:

  • Assess the patient’s current level of consciousness
  • Evaluate treatable medical or neurological barriers to the recovery of consciousness
  • Improve the patient’s level of alertness through medications and other therapeutic interventions
  • Identify ways to establish consistent communication
  • Initiate an intensive mobility program, beginning with sitting in a wheelchair and progressing to standing
  • Address spasticity and contractures to maximize potential for functional recovery
  • Utilize recent technological advances, as needed to enhance outcomes
  • Prevent secondary complications and reduce the risk of recurrent hospitalizations
  • Offer specialized education, training and support for families and caregivers
  • Provide opportunities to participate in the latest research on assessing and treating disorders of consciousness

Disorders of Consciousness Educational Resources

Online education resources for patients and professionals are available to you and your loved ones.

DoC Education Resources

Patient Stories

  • TIRR Memorial Hermann patient, Dallas Matamoros, walks down the aisle at his graduation from LSU.

    Dallas Matamoros: Graduation, Career and a New Best Friend

    April 11, 2024

    Dallas Matamoros was a college student at LSU when he was hit by a car, resulting in a traumatic brain injury. It was May 27, 2020, and the physicians at the acute care hospital he was taken to gave him little chance of survival. His family, unwilling to accept this fate, sought out the help of T...

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  • TIRR Memorial Hermann patient, Sierra, stands after rehabilitation.

    Sierra Tobia: From Brain Injury Patient to Nurse

    November 22, 2022

    When Sierra Tobia takes care of her patients at TIRR Memorial Hermann, she does so with a unique perspective. She first came to TIRR Memorial Hermann as a patient in 2014, and, today as a nurse at TIRR Memorial Hermann, she has first-hand knowledge and understanding of her patients’ journeys.

    Read More
  • Jack Rieger leaves TIRR Memorial Hermann with family and friends.

    Lucky to Have Him: A Testimony from the Family of Jack Rieger

    October 12, 2021

    Jack Rieger suffered a severe fall causing numerous injuries. After 9 months in UCLA intensive care, Jack was transferred to TIRR Memorial Hermann. From the therapy and education provided by the Disorders of Consciousness program, he was able to return safely home.

    Read More
  • Nolan Whisenant, a TIRR Memorial Hermann patient, is photographed with his family.

    Never Give Up: A Testimony from the Family of Nolan Whisenant

    October 12, 2021

    Nolan had just graduated high school in 2016 when he was involved in a rollover auto accident. He was ejected from the vehicle and suffered a severe traumatic brain injury. Nolan had an all-star, rock-star-level health care team at TIRR Memorial Hermann. Dr. Sunil Kothari, TIRR Memorial Hermann D...

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  • Eric Smith, a TIRR Memorial Hermann patient, sits with his wife and dog in front of a Christmas tree.

    A Testimony from the Family of Eric Smith

    October 4, 2021

    While in the hospital in Washington, Eric’s neurologist suggested that the family look into the Disorders of Consciousness (DoC) Program at TIRR Memorial Hermann in Houston. Two weeks post discharge in May of 2018, Eric and Cheryl boarded a plane and traveled to Houston.

    Read More
  • TIRR Memorial Hermann brain injury patient Corey Nowlin

    Corey Nowlin: Learning to Communicate

    February 19, 2021

    In April 2020, Corey Nowlin suffered a severe head injury. Today, thanks to the TIRR Memorial Hermann’s Disorders of Consciousness program, he’s able to communicate again.

    Read More
  • Jaclyn Pelicotte smiling in front of a fountain

    Jaclyn Pellicotte: Small Steps Toward Her Goals

    September 30, 2019

    When Jaclyn was admitted to the TIRR Memorial Hermann Disorders of Consciousness (DoC) Program, she was not responding to any commands. But the first thing the therapist said when she arrived at TIRR Memorial Hermann was, ‘we’re going to get her up.’ At that point Jaclyn had bee...

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  • River Rasmussen with Aryia and his therapist

    River Rasmussen: A Family Finds Hope

    August 10, 2018

    After an automobile accident left him bedridden and unresponsive, River's sister found hope for him with the TIRR Memorial Hermann Disorders of Consciousness Rehabilitation Program.

    Read More
  • John Keller

    John Keller: Miracle in Progress

    December 31, 2014

    When 33-year-old John Keller was first admitted to TIRR Memorial Hermann on March 26, 2008, he was in a vegetative state. On impact, Keller suffered a fractured skull and pelvis and an intracranial hemorrhage resulting in a severe traumatic brain injury (TBI). Nine days later, he was transferred ...

    Read More

In The News

  • The National Library of Medicine Logo

    Determining the Hierarchy of Coma Recovery Scale-Revised Rating Scale Categories and Alignment with Aspen Consensus Criteria for Patients with Brain Injury: A Rasch Analysis

    (June 16, 2022)

    This study aimed to empirically evaluate the hierarchical structure of the Coma Recovery Scale-Revised (CRS-R) rating scale categories and their alignment with the Aspen consensus criteria for determining disorders of consciousness (DoC) following a severe brain injury.

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  • MDPI Logo

    Many Faces of the Hidden Souls: Medical and Neurological Complications and Comorbidities in Disorders of Consciousness

    HOUSTON (May 21, 2021)

    This is the first large retrospective cohort study on the primary medical and neurological complications and comorbidities in persons with DoC. A total of 146 patients admitted to a specialized inpatient DoC rehabilitation program from 1 January 2014 to 31 October 2018 were included.

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  • Wiley publication logo

    Spasticity Management in Persons with Disorders of Consciousness

    HOUSTON (July 20, 2020)

    Spasticity is one of the most frequent neurological impairments affecting persons with disorders of consciousness (DoC). If left untreated, it can mask signs of consciousness by inhibiting one's ability to interact with the environment. The lack of information about spasticity specific to patient...

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  • Houston Chronicle Logo

    Kothari: It’s time to talk about life, death and brain trauma

    HOUSTON (December 11, 2017)

    Thousands of people are wrongly labeled unconscious after severe brain injuries each year. Some have their life support withdrawn; some are sent to nursing homes and left to lay in bed, aware but unable to show it. A fortunate few make it to a Houston rehab hospital, where those with even the wor...

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  • Houston Chronicle logo

    Alive inside: How a Houston hospital restores patients with severe brain injuries

    HOUSTON (December 11, 2017)

    Across the country, thousands of people with severe brain injuries are wrongly labeled as unconscious each year. Among them, a small number make it to a Houston rehab hospital, where those with even the worst injuries get a shot at recovery.

    Read More

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