Edited by Marilyn Lash, M.S.W.
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WHAT IS MEMORY ANYWAY? Changes in memory are one of the most common symptoms and consequences of brain injury reported by survivors. They can affect everything from the remembering an appointment to the ability to hold a job. The frustration can also be felt by families and caregivers who tire of hearing, “I don’t remember” reminders are ignored. Too often, memory is explained by two types – short-term and long-term. For example, there is the person who can’t remember what he did yesterday (short-term), but can remember his wedding 30 years ago (long-term).
It’s a lot more complicated than that. As Dr. McKay Moore Sohlberg explains in Memory after a Brain Injury, there are different types of memory and they rely on different systems within the brain. The brain does not process all information in the same way.
Different types of brain injuries or diseases can affect memory in different ways. For example, persons with memory difficulties caused by a lack of oxygen to the brain because of a near drowning or heart attack are likely to quickly forget what they are told or have done. The brain has trouble storing new information.
On the other hand, a person with damage to the frontal lobes of the brain from a car accident may be able to learn new information but cannot retrieve it without prompting. This person may have difficulty organizing information in memory and have more difficulty retrieving information that was previously stored in their memory. Here are some of the different types of memory that can be affected when the brain has been damaged by an illness or injury.
- Episodic memory — This involves memory for events that are tied to a time and place. Examples are difficulty remembering what one did the previous day or not recalling a visit from a friend.
- Semantic memory — This involves facts that a person learns over time. Learning phone numbers used on a daily basis or learning the state capitals or planets in the solar system are examples of semantic memory. This type of memory is often less affected in people with brain injuries than episodic memory.
- Procedural memory — This is memory for well established sequences of activity that often involve motor movement. The person does not have to consciously recall information as the activity is done automatically. Examples are riding a bicycle, or opening a computer program. This type of memory is often quite strong in people with brain injury and helps them in rehabilitation.
- Retrograde memory — This is memory for events in a person’s life that occurred before the brain injury, such as a graduation, wedding or trip. Most people can remember things that occurred before their brain injury better than they can remember things that happened after their brain injury.
The above section is an excerpt from Memory after a Brain Injury by McKay Moore Sohlberg, Ph.D.
If you’d like to read what “A Typical Day with a Brain Injury” can be like when memory is affected, Bill Jarvis describes how complicated a simple journey to the grocery store can be in Brain Injury Isn’t Funny (But Humor Helps You Cope).
The process of forming and storing memories is complicated. Two parts are essential – memory registration and memory recall.
What is memory registration?
It simply means that information gets into your brain. This is not always easy for survivors of a brain injury….The information has to get into your brain before you can pull it out or recall it.
Tips for improving memory registration
- Create a schedule for daily tasks and repeat them in the same order every day. This helps you remember until you can do them automatically.
- Use an alarm for appointment reminders and times to take medications.
- Keep track of medications by using pillboxes marked with days of the week.
- Talk quietly to yourself while performing tasks.
- Take time to write down some important things in your life to remember and create a memory tool.
- Repeat doing things as many times as you need to such as…
- Listening to phone messages.
- Reading and rereading material.
- Watching a movie more than once.
- Work on one thing at a time and you will have better memory retention.
- Try not to answer the phone or perform any other task while cooking.
- Take your time. If you work too fast for your brain to keep up, you are likely to feel confused.
- Avoid doing anything else while watching
- Use visual cues to help you remember where things are. For instance…
- Label cabinets and drawers.
- Put up sticky notes or photos where you’ll be sure to see them before you leave the house as visual reminders.
- Keep eyeglasses and keys in the same place.
- Put things you need to work on today on the table to remind you of what you want to do.
What is memory recall?
Simply put, this involves retrieving information from the brain that is already stored in your memory. Remember – if it doesn’t get in, it can’t come out!
Tips for improving memory recall
- Check your planner/organizer or calendar and “To Do” Lists first thing in the morning.
- Pick specific places for important items like medications, car keys, wallet/purse, etc. Always put them away in the same place, so you know where to find them.
- Jog your memory by checking your lists before beginning tasks.
- Try these tips when you have difficulty trying to remember a word, situation or place…
- Describe or define the word you’re trying to remember.
- Visualize the situation or place.
- Take a break. Check your planner when you can’t remember what you are doing. You could be preoccupied with too many thoughts and trying to do too many things at the same time
Note: This excerpt is from Memory Strategies after Brain Injury by Barbara Webster.
Resources on Memory
Barbara Webster has authored a workbook that includes tips on memory strategies and other issues called: Lost and Found: A survivor’s guide for reconstructing life after brain injury. Coping with life after brain injury is not easy. This practical and user friendly workbook and guide for survivors and their families is packed with everyday strategies, tips and accommodations to address the cognitive challenges of daily life.
Based on the author’s experience as a survivor and as facilitator of hundreds of support groups, Barbara Webster gives tools and methods for overcoming challenges, envisioning goals, and continuing the healing process at home and in the community. This collection of “brain injury survivor wisdom” gives users a wide array of compensatory strategies and cognitive techniques that can be used each day, no matter where one is in the journey of recovery. The workbook comes with a USB drive to print all forms and worksheets. This is the one book that every survivor of a brain injury and family should have. It is the most comprehensive, sensitive, insightful and thorough workbook available and is filled with hands on practical strategies aimed at helping the person with a brain injury navigate the complexities of daily life. By focusing on the cognitive changes that are so common after a traumatic brain injury, the author approaches each challenge with practical building blocks and strategies for continued rehabilitation at home and in the community. Her philosophy of problem solving and thinking about “how” to do something when a challenge is encountered is a continuous theme through all the chapters.
Living Life Fully after Brain Injury: A workbook for survivors, families and caregivers — Robert T. Fraser, Ph.D., CRC, Kurt L. Johnson, Ph.D., CRC, and Kathleen R. Bell, M.D., Editors, along with a impressive group of co-authors have compiled an impressive and practical workbook on the long journey of brain injury. Whether you are a civilian or veteran who has survived a brain injury, a family member or caregiver, a clinician, advocate, or direct care staff, you will find this workbook is a valuable resource and tool for living a full life after brain injury. It pulls together scientific information from evidence based research, a range of topics from coma to living in the community, compelling personal vignettes to illustrate content, tools for personal assessment and practical strategies, a USB drive with worksheets for personal and professional use. This is the publication that has been missing up to now in the field of acquired brain injury. With chapters by 19 national experts on brain injury, it is informative at a “cutting edge” level but presented in a format and writing style that is empowering and clear for individuals and families. A CD contains 46 worksheets that can be printed and used by survivors, families and clinicians. Click Here for an Interview with Dr. Robert Fraser.
MY BRAIN AND I — Jennifer Callaghan writes from personal experience on sustaining severe traumatic brain injury and its aftermath. She describes in poignant detail her struggles, obstacles, and frustrations, as well as the triumphs and gains over a 16-year period. Her story begins with a traumatic experience of being the victim of another person’s recklessness in traffic (speeding). She recounts vividly her immediate family’s capacity to cope with her trauma and debilitation, her own anger and irritability because of lost skills and abilities, and the loss of inhibitions developed from former lifestyle. As her journey continued, Jennifer reveals her thinking, feelings, and perceptions of the world around her. Her recall of these processes is attributable to a thoughtful doctor suggesting she journal what she was happening in her life, which seemed an insurmountable task. The journaling proved to be instructional and rewarding.
SURVIVAL KIT by Debbie Leonhardt, M.A. — Persons with brain injuries often have difficulty with planning and organization due to cognitive challenges. This new planner and organizer is filled with tools, strategies, checklists, schedules, reminders, logs, and charts. They are designed to help survivors develop compensatory strategies for everything from the tasks of daily living to organizing their household and routine. This new second edition of the popular Survival Kit is more compact, portable and affordable for easy use. The Survival Kit is ideal for use in rehabilitation, out-patient programs, residential settings, at work, at home and in the community. A USB Drive for the Survival Kit is included with files to print additional forms.