Convalescent Rehabilitation Nurse's Care Records for Patients with Impaired Consciousness - Part 2: 'Small "I Can Do It" Moments Become a Beacon'

In this series, I am writing about my daily rehabilitation nursing practice, with a particular focus on the care of patients with impaired consciousness.

You can find the first article here👇️

And now, for this second installment,

I will share what I did to connect this "small intention" to spontaneous action🤔

What happens when you incorporate actions that shape a person's individuality into nursing care?

I would like to talk about the changes that occurred as a result of deepening my understanding of the patient and gradually cultivating a relationship between the patient and the nurse.

After I said I would be doing this series✨️, I had a hard time finding the time to write, and I thought the project might fall through😅
I am sooooo glad I was able to release the second part……!!

☕ The Great Plan to Have the Patient Brew Their Own Coffee

For a patient with impaired consciousness...?

Yes🙂‍↕️
For a patient with impaired consciousness, yes🙂‍↕️!! I'm a bit of a taskmaster💪

After all, they adjusted their own underwear, didn't they😑
If they can move their hands, they can brew coffee, right✨️
※Please take a look at the first part of the Convalescent Rehabilitation Nurse's Care Records for Patients with Impaired Consciousness😉

There are patients who lack spontaneity in their daily activities, aren't there?
Behind this apparent lack of spontaneity, there are various factors such as impaired consciousness, higher brain dysfunction, physical weakness, and confusion about the environment.

In the midst of this, I value searching for the trigger for "actions the patient wants to do."

I draw out reactions from the patient's interests😳, and thenconnect that to daily activities next🙂‍↕️

This time, when I asked the family of the patient with impaired consciousness in detail about their hobbies and life history,
I found out that they loved coffee☕ so much that they even taught themselves to get a barista certification.

Once I got my hands on such delicious🤭 information, of course I was going to do it!!🤣🤣

“That's it... I'll have them grind the beans with a mill🙂‍↕️”

🫘 Asking about the brand

That said, I don't know anything about coffee at all💦
I asked them quite casually, thinking it would be nice if it were something the patient wanted to drink🎵.

Me🐦️
“Hey? I'm going to have you grind the beans, so what kind would you like?”

Patient 😑
"Kilimanjaro--"

With almost no spontaneous speech and no response to the nurse's prompts, the patient, who usually communicates through nods, spoke with slurred speech.


"Kilimanjaro" of all things!!Yes, they specified the brand 🙂‍↕️

Alrighty then. So I just need to go buy that, right? 🛒
I went to the coffee shop with a light heart, but then...

Wait... ?!
Kilimanjaro...
Isn't it, like, expensive 💰?!

I have to get a grinder, a pot, and filters, and as I pay, I can see my money 💴 flying away into the sky 🪽...?

By the way, since I'm doing this care activity purely as a hobby, it doesn't count as an expense 🙂‍↕️
I'm not a researcher, after all 🤣🤣

☕ Let's brew some coffee!

I lined up all the coffee beans and tools I bought in a corner of the dining room.


The patient arrives in their wheelchair 🎉

The way they check the aroma as soon as I open the bag and hand it to them... as expected...
They can tell the difference.
It's Kilimanjaro. But 🫩

Me 🐦️
"You casually specified an expensive brand... didn't you? Just so you know, this is coming out of my own pocket!!"

Patient
"...🙂‍↔️"

This is it... 🫩
I know this.
It's not that there's no reaction, it's a deliberate lack of reaction...!!
...Well, that's fine 🫩🫩

With clear physical limitations like paralysis and contractures,

they can't move their hands as they wish.
Fine finger movements are difficult.

Even so,
the sight of the patient diligently preparing the coffee filter with awkward hand movements was impressive ✨️.

Since their grip strength is also low, I support the grinder body, and I have the patient focus on turning the handle.

...Grind, gri...nd...

It's extremely slow, but they started grinding the coffee beans themselves ✨️👏

Isn't that amazing?!
A patient who lacks spontaneity and receives assistance for all daily life activities is doing this!!

They can do it if they try... 😆✨️

That said, the movement was just so slowly...
It took so much time that when I took over the grinder halfway through,

"~~😳😡!!!!"

they opened their eyes wide and were angry 😅

No, but seriously💦?
If we keep going like this, the day will be over🌠. Even though it's only 10:00 AM🌅 right now.


Boil the water.
Fill the pot.
Set the ground coffee in the filter.

To prevent burns, we wrap towels around the pot and handle. Staff members stand by to provide support, ready to steady their hands from behind at any moment.

As part of the care, we carry this out while paying full attention to the patient's safety.

And now, it's the patient's turn.

With several staff members watching over them,
pouring the hot water with gusto🤣,
they brewed the coffee for us✨️👏

They didn't have the muscle strength to lift the pot when it was full of hot water.
And since their judgment hasn't fully recovered yet, they couldn't adjust things like the brewing strength, but that was fine.

This time, the goal was simply to have them experience

brewing the coffee☕ they always loved all by themselves✨️

, so that was perfectly okay😊

The three of us—the ward head nurse, the nurse in charge, and I—sat side-by-side to drink the first coffee the patient had brewed since getting sick☕✨️

"Delicious."

Just those few words from the patient touched my heart deeply🥹

It was a happy moment✨️

Usually, they don't speak much, but in moments like this, when they are truly moved, you can catch a glimpse of 'who they really are'.


I realized once again that I continue to be a nurse to witness these moments🙂‍↕️.


The patient is a black coffee drinker who loves Kilimanjaro.

A-N-D Y-E-T!!

"Can I add milk?"
"What happens if I add sugar?"
"Can I try it out?"

Head nurse?!?
I told you they drink it black, didn't I?!

But the interaction was so funny that I just let it be🤣 Watching over them is also a nursing skill✨️

The patient, who had been nodding along at first, eventually turned their face away and drank their coffee in silence lol
I guess we were being too noisy🤣

Starting from this day, we began to see changes in the patient's expressions and behavior.

By drawing out spontaneity through activities they were interested in, they started being able to do more and more in their daily life as well🤭

I will write about this in the third installment of the consciousness disorder care record.

💻 I also write articles like these ✨

🐦️ An article recommending naps to reduce the cognitive load on patients 👇
Nurses also need the skill of sneaking 🥷

🐦️ A story about turning on-site 'troubles' and 'can'ts' into 'cans' by getting creative with vinyl tape and masking tape 👇

🐦 You can send questions you'd like to ask Irodori or doubts from the field here 📫

The response article to the first set of questions ended up landing on 'Blood vessels are basically macaroni, right?' 😉 🤣

We are accepting questions for free on a trial basis until the end of June 💌