Memory Enhancement and Tips

Brain Injury Blog by Janet Cromer

March 29, 2011

Cognitive Rehab at Home

Part 2- Memory Enhancement Strategies

Last week I shared cognitive rehab strategies for language skills you can practice at home. This week we’ll focus on strategies to enhance memory.

Brain injury can cause serious problems with memory. The problems might include remembering events before the brain injury or after the brain injury. It might also include problems with making and working with new memories. What could be more frightening than not remembering your name, your life, or why you’re in the hospital surrounded by strangers?

After my husband Alan had a severe anoxic brain injury, he lost all memories of his life, loves, and accomplishments. His level of memory impairment also made it hard to relearn all the functional and cognitive skills he had lost. Along with his personal memories, he lost sixty-two years of accumulated knowledge. I wondered how so much knowledge could vaporize so fast.

And I wondered how we would ever put some of that knowledge back in place if Alan couldn’t remember what he’d just been told.

Fortunately, his speech-language pathologist (SLP) and other therapists taught us some memory strategies that helped Alan start to learn about himself and the world again. We practiced in the hospital and every day at home.

Here are ten memory enhancement strategies to try at home.

  • Believe what the survivor tells you. If she says she doesn’t remember an event or person, take her word for it. It can be painful to recognize that the survivor doesn’t recall treasured family memories. However, getting angry or nagging him/her to remember will only make the situation worse.
  • Put it in writing. Start a notebook for important information and a workbook for therapy worksheets. Write notes in short, clear sentences. Review the information often.
  • Tell stories to coax memories. When Alan asked me a question about our life together, I told him a story. Like a short bedtime story, only true. He found the stories fascinating and, over time, started remembering details.
  • Use all the senses to make memories. Look though a few old photographs and describe the event. Don’t overload him with too many photos. Watch home videos. When you’re in a favorite place, describe the smells, tastes, and sounds in simple words. Encourage the survivor to touch objects and describe them. That worked well for us when Alan was relearning the names and tastes of foods. When we visited the ocean, I described the smell of salt air and sound of seagull cries while we were there, and then later at home. He contributed his impressions, and made a memory of the day.
  • Write instructions in a few steps. Alan chose feeding our dog as his first job at home. We wrote four short steps on an index card he could refer to. At first, I read the steps as Alan carried them out- “Find dog food container beside stove…” Eventually he worked up to being able to refer to the card and feed Molly independently. We learned that instructions with more than four steps were too complicated for Alan.
  • Use external memory devices to enhance independence. Alan relied on external memory devices permanently. In addition to his logbook and instructions, we tried electronic alarm systems to remind him to take his pills. He kept a calendar by the bed and crossed off the day at bedtime. Each morning he wrote the day’s schedule on an index card and tucked it in his pocket.
  • Try a log book or journal. His log book was the simplest and most effective device. Every day Alan wrote at least three things he did that day, including places we went, conversations, and current event topics. He also wrote his plans for the next day before going to bed. The log book served as a memory prompt and reminded him that he had a good time. Writing took a lot of effort, but the information was relevant so he labored on. I encouraged him to write how he felt about a friend’s visit or news story. He was able to reflect on his feelings when he read what he had written.
  • Write your autobiography. Alan had to reconstruct his life story as he was learning to write again. He chose specific events from childhood and wrote short “chapters” for his autobiography. He interviewed his sister and brother about their memories and blended them into his story. He found that talking with them helped stimulate his own memories. When he had six chapters, we published the book at Kinko’s and gave it to the family for Christmas.
  • Build on the type of memory that’s still strong. Alan’s procedural memory for sports was the least affected. He remembered how to swim and kayak as well as before the injury. So, we joined an adaptive sports program for the added safety and camaraderie. He gained esteem by showing others how to swim better. Later, he wrote about the outing, and called his family to report his success. Both his procedural memory and working memory grew stronger from the exercise.
  • Be patient, very patient. Living with a person who has memory impairment can be challenging. Take a deep breath instead of reminding him that he should remember how to set the table. Alan asked perseverative questions about basic parts of our lives. I found it helpful to both of us to make a Frequently Asked Questions (FAQ) section in his logbook. When he asked, I could say, “Look at your notes.” As he read back the answer he said, “Oh yeah, I already knew that.”

Janet is the author of Professor Cromer Learns to Read: A Couple’s New Life after Brain Injury. See Janet’s website at http://janetcromer.com/ and her blog at http://janetcromer.com/blog.

5 responses to “Memory Enhancement and Tips”

  1. Yet another amazing article.

  2. Thumbprint Cookie Recipe says:

    Very good article. Looking forward to seeing you write more articles about this topic.

  3. Grest blog, keep up the good work

  4. Janet Cromer says:

    Thank you Louise!

  5. Louise says:

    These are excellent and would be great as tip cards for spouses, family or significant others of TBIers!

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