I never knew the extent of Frontal Lobe behaviours until I had a patient who suffered from one. He was a 26-year-old male who got admitted to hospital due to a Motor Vehicle Accident. He had to undergo an emergency craniectory in the frontal lobe region of his skull to relieve the pressure that was building up in his brain due to swelling. This patient already had psychological care before the accident as he was suffering from Bipolar Disorder.
Initially, the patient seemed to be in a coma. He was not responsive to pain, touch or sound. He also had a very low GCS score and was nursed in the high dependency unit on the ward. Over time, when the swelling reduced in his brain, he started to have some response. He was able to open his eyes and listen to one word commands. About 1 week after his surgery, he started to be able to say a few words and recover some upper and lower function. It was a good sign as it showed that he was slowly recovering. We continued to treat him daily and monitor his progress.
After treatment had concluded, we took him back to his room. He suddenly did something very inappropriate that day. We were positioning the wheelchair to perform a transfer back into his chair. To do so, we had to bend down and to the side to put the brakes on and place the chair in a good position. The patient suddenly slapped the physio on her bottom! Both the physio and I were shocked! She asked the patient what he just did, and all he said was spanking and gave us a grin! We did not know what to say or whether to report this as the patient was sick and had no insight. He did not know what he did was socially inappropriate.
It was an experience for the physio and me. She never encountered anything like this before and was taken aback when it happened. From this, I learnt to make sure I do not put myself in a situation where I could be “taken advantage”! I learnt to make sure I have enough space to move around and do not have to bend over to reach for the brakes etc.
I hope no one else was as "lucky" as me to experience something so inappropriate like this situation.
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I was on a neuro ward where a patient was sexually inappropriate to one of my colleagues during a treatment session. He put his hand on her bottom and said he was 'shaking her ass'! Both of us reported it, but further down the track as his condition improved we realised it as due to his brain haemorrage resolving rather than being deliberately inappropriate. However, in situations like this you should never assume it's just because they're ill, there could be inappropriate behaviour in their past history etc. It's just a matter of self protection.
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