Memory is one of my favorite things to work on with patients. I love teaching compensatory strategies. Maybe it's because I need them so badly for myself?
Image courtesy of: http://mainepi.org/ALZ/Cafes.html
I usually start out each session with a quick memory quiz (What did you have for breakfast? What was you first therapy session this morning? Who is your nurse? What was for dinner last night? What time did your wife leave/arrive?) We also use the O-log and the Cog-Log protocols around here quite a bit.
Here are a couple of books I use a lot:
- WALC 10
- HELP for Memory
- The Source for Memory Exercises
- One of my blog commentators recommended: "Memory Rehabilitation: Integrating Theory and Practice" by Barbara Wilson
Apps I like for short-term memory:
- Calendar App
- Flick Flag (I have the patient come up with a memory "trick" (association, elaboration, visualization, etc.) for each flag as we study them, then we play the game to see what they can remember. It's great for learning how to come up with effective "tricks."
- Simon (remember this memory game from the 80's?? Love it.
- Brain Baseline has a couple of tasks for memory (and a lot of great tasks for improving processing speed!)
Much of the therapy focuses on compensatory strategy training.
We practice using the tools they will use in their home: calendars, calendar apps, day planner, notebook, post-its, alarms, association "tricks"/mnemonics, elaboration, chinking, rehearsal, visualization...
Other fun tasks:
- Index cards with faces on one side and names on the back. Again, we focus on associations to help remember the names (e.g., Nyla never likes to smile-a). I make sure they are effective (e.g., she looks like another Allison I know) vs ineffective (Tyler starts with T, tooth starts with T-- Tyler has big teeth! There are too many names that start with T.) I also like to try it the first time with no strategies so that they can see what a difference the strategies make.
- Objects - I'll show a photo or drawing of several objects (or anything! A magazine picture with a bunch of foods...). I'll have them study it for 1-2 minutes and remember all they can. Then we'll list them out. Then I have them do it again with some strategies and associations (e.g., make up a story using the objects, or group them into meaningful categories). THEN, I'll do yes no questions to see what they can remember (e.g., Was there a hammer? Was there a beach ball? Was there a shoe?).
- Sometimes I'll read a story/article/bit of information and have them answer questions afterward.
- Prospective memory tasks: Prospective memory involves remembering to do something at a certain time or in a certain situation. Such as remembering to take a pill or feed your dog. I will give the patient tasks to remember at a certain time. This could be anything from remembering to hand my a paperclip every 5 minutes on the clock, to remembering to tell me the 3 facts I taught them about their favorite hobby (I pick facts they don't already know) at the beginning of our next therapy session. Etc., etc. There are a million ways to do this one. I could go on and on but you get the idea. They key here is that they try to initiate the task without my help. If needed, we add compensatory strategies or reminders.
Image courtesy of http://cognitivepsyc.tripod.com/id10.html
Well, I could say more. But I would LOVE to hear your ideas! Do you have any to add? Post them, por favor, in the comments below.
Until next time,
Kristin
I've been doing a lot of these tasks in my cognitive therapy sessions, but it's great to get some new ideas for how to use the same task! Love the index cards for people's names, definitely going to try that one!
ReplyDeleteIf this can resolve removal of left temporal lobe, such as short term memory and auditory, I will greatly appreciate it. I will share it with foundations and clinics I staff, when it helps me. I feel God is showing something. Thank you!
ReplyDeleteThanks for reading! Glad you are liking the ideas!
ReplyDeleteMy brother has lost his short term memory from a heart attack and long medical induced coma - what / how can we help him? Please help
ReplyDeleteNicolette, do you have any resources for getting some speech therapy? Is there a university near you? If they have a speech therapy student clinic you may also be able to get some help without insurance at a relatively low price. Otherwise, helping him come up with a good system for calendaring, writing things down, setting alarms, creating a daily journal log book are good places to start!
DeleteI just evaluated a teen with a TBI from a frontal lobe tumor. She scored pretty high in 5 of 10 cog areas on the assessment, moderately impaired on a few, but then *boom* she plummets to <1% in Recall of General Information. I'm going to use Spaced Retrieval Therapy to build immediate memory, but am trying to get inspired for tasks to address "recall of general information".... The subtlest questions were things like "Who is our president? governor? Name two political parties, who was our first president?" Etc.
ReplyDeleteAny help is greatly appreciated.
Becky Mitchum, MS, CCC-SLP
Becky, how did she perform on short-term memory tasks? Usually this is the area that needs to be addressed- working memory, prospective memory. Immediate memory and long-term memory deficit are less common (seen in patients with severe deficits, amnesia, dementia). Is she able to recall evens from the pat 24 hours? What she ate? What she's been taught? Poor recall of general information is not really a cognitive skill- it's a task-specific performance. What skill is she lacking? Is it short term memory, reasoning, attention, word-finding? Also, did she really know these answers prior to her tumor? Many patients never know these simple things-- especially the governor. Sounds like you were administering the RIPA, yes? Sometimes to further assess this area, I try questions you KNOW she knew the answer to. Though I must admit I don't love this section of the RIPA and don't find it functionally valid in many cases. If this truly is a memory issue, consider (instead of trying to re-build her general knowledge) teaching her strategies to find information when she can't recall it, or having her write things down. Have key knowledge she needs or uses frequently in a notebook or planner or app. Hope this helps Becky. Thanks for reading!
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