Memory booklet Occupational therapy RDaSH leading the way with care
Contents Introduction 3 What is memory? 3 The memory process 4 Different types of memory 4 Everyday difficulties 5 Memory strategies 6 External 6 Internal 9 Further help 10 2 Memory booklet
Introduction This booklet is intended to explain the memory process and will give practical tips to aid your memory. It is normal to forget things from time to time, as no one s memory is perfect. Often what stays in our memory depends on how important or interesting that information is. Stroke, head injury, brain infection or disease can all lead to memory impairment. Sometimes the stress of initial diagnosis e.g. Multiple Sclerosis can make memory difficulties appear worse, but as things settle down, your ability to use your memory will improve. What is memory? Memory is located in more than one place in the brain and is a complex process, which involves a number of skills and stages. Memory can be illustrated by thinking of a music system where cassettes and CDs are recorded and stored and then retrieved from storage and replayed when needed. There are three key stages to memory: - 1) Information comes into the brain from any of the five senses i.e. touch, taste, hearing, sight and smell. This information goes into the memory where it is held for a short time, usually a few seconds. 2) This information is processed by the brain and stored in the short term (working) memory just long enough to be used. It may be a few minutes, hours or days. 3) Information from the short term memory is processed and transferred into the long term memory where it can remain for a lifetime, and be retrieved when required. You may have problems with your memory if any of the above stages are not functioning properly. www.rdash.nhs.uk 3
The memory process Information Processing System There are five stages involved: Attention information enters the brain. If you cannot concentrate on information it will not be understood and stored. Encoding registration of information at the time of learning. Emotional events or things you are interested in are usually more meaningful and therefore processed at a deeper level and become attached to existing memory structures. Storage once information is encoded it is stored in the long-term memory e.g. as in a filing system or catalogue. Consolidation information is repeated or practised otherwise it will be lost. Recall also called retrieval, it involves recalling information, which is stored in the long-term memory. Difficulties can occur at any of these five stages. Different types of memory Immediate memory (working memory) The first stage of memory where information is taken in through the senses. Short-term memory Information is stored here just long enough to be used. Long-term memory Memory for things that have happened to you in the past. It is sometimes also called episodic memory or autobiographical memory e.g. your first day at work or your wedding day. Prospective memory The ability to remember things for the future and involves planning. It is remembering what to do and when to do it. Prospective memory can be for routine or novel events 4 Memory booklet
e.g. remembering appointments or planning a holiday. Procedural memory This is remembering things such as how to ride a bike, how to switch on a computer etc. These activities involve automatic mental or motor skills, which can be retrieved and put into action without conscious awareness. Everyday difficulties Some of the most common difficulties experienced by people with memory problems are: Forgetting what they have been told Forgetting peoples names Forgetting where they have put things Getting lost in familiar and unfamiliar places Forgetting a change in routine Forgetting to do something important Forgetting whether or not they have done something Forgetting appointments Asking the same question repeatedly Repeating the same story over and over again Inability or difficulty learning new things Inability to recall events of the day before Tendency to become confused more easily Difficulty following a television programme or the plot of a book Forgetting to pass on important messages Inability to remember verbal messages or directions Difficulties following a map www.rdash.nhs.uk 5
Inability to remember episodes from family gatherings or events from life Difficulties remembering people s faces and where you ve met that person before. Memory strategies There isn t a way to restore lost memory, but it is possible to learn how to use strategies to aid your memory, these can be either external or internal strategies. When attempting to improve your memory use the following ideas to help you maximise your potential: Concentrate on only relevant information Reduce the level of distractions and noise Make associations by linking the information to something familiar Don t be too critical of yourself Use strategies to assist you (see below). External strategies External strategies are alterations to your environment or routines that help you to function better by providing you with prompts. The following are memory aids which we all use in daily life: Diary Shopping lists Writing on our hands Alarm clock Cooker timer Memos and lists Leaving objects in special places as reminders Asking others to remind you Use of memory aids on mobile phones Telecare products. We have expanded on some of these to give you some ideas of how to use them to aid your memory. 6 Memory booklet
Use of a diary This needs to be portable and pocket sized, as it s of no use if it can t be carried wherever you go. The diary needs to be well structured, probably a page a day. The user must make a list of things to do that day and tick off the activity when it is achieved. At the end of the day what is not ticked off this could be put on the list for the next day. Calendars These can be used to keep track of appointments; they should be kept up to date and checked daily. The appointment information can then be transferred into a diary if you need to have it with you. Pin/notice board This used together with the post-it notes or lists can be a successful way of organising a routine. For example, jobs/activities which need to be done can be written on post it notes and divided into current jobs and jobs waiting to be done. Useful daily information or telephone numbers can be listed on this board for quick and easy reference. If you are unable to remember people s names or faces, relevant photographs can be placed on this board for constant reference. Timers and watches These can be set to bleep every half hour to give you an auditory prompt to check your diary as a reminder what you should be doing. Timers are very useful when cooking. Medication boxes Medication can be ordered from the chemist preset in the correct daily dose. Alternatively a carer or relative can set up a medi box. These have breakfast, lunch, tea and evening compartments that hold medication therefore making it easier to remember whether you ve taken your medication. www.rdash.nhs.uk 7
Answer machines, dictaphones and pagers Use of an answer machine reduces the problem of messages being forgotten. A dictaphone can be used when shopping as it can be preprogrammed to give you prompts of all the different shops etc you need to call at when in town. Pagers can be used like timers and can have messages written on them to remind you of specific things. Mobile phones Phones can be used to store information such as important phone numbers; it can be used as a diary, notebook, alarm and mini dictaphone. Notes/memos Write important things to remember on memos/notes and put them in a prominent place, e.g. turn off the cooker placed in the kitchen where you will easily see it as you leave the room as a reminder. Organising easily forgotten items Items such as glasses, keys, purses etc are easily mislaid. It may be helpful to have one particular place e.g. a drawer where you always put these items saving time from having to search for them. Another idea is to label cupboards to remind you where things are kept. External strategies work well as visual and auditory prompts but you need to practice the skills and be helped to get into a routine by the people who support you e.g. your carers, relatives and therapist. 8 Memory booklet
Internal strategies Internal strategies are things that you do inside your head to try and remember things. For example, trying to visualise something as a picture. The following are ideas to help you develop these internal strategies; you may need advice and support from your therapist to help you with this. Attention Focus on and pay attention to what is being said and try to reduce the background distractions Look at the person who is speaking Only hold one conversation at a time. Chunking/organising into categories Organise information into small amounts; break it down into chunks or categories rather than long streams of information This can be useful when remembering numbers e.g. 834564253 can be broken down into three small chunks 834 564 253 which may be easier to remember. This is useful with telephones numbers. Repeating/rehearsing information Repeating information over and over in your head may help you to remember it. Make links or associations Try to make mental associations in your mind by linking new ideas to existing information. Visualisation Converting words into pictures can help you remember what is said to you e.g. if a friend asks you to meet them outside the chemists at half past one, you could make a mental image of your friend standing outside the chemists with a clock showing 1.30pm. www.rdash.nhs.uk 9
5Ws If you are trying to remember something such as a magazine article ask yourself the five W questions. What? Where? When? Who? and Why? and break the information down into those categories. First letter cueing This is helpful for remembering somebody s name. Go through the letters of the alphabet one by one and when you reach the first letter of the person s name, it sometimes prompts you to remember it. Stories and rhymes Rhymes such as Richard Of York Gave Battle In Vain can help you to remember the colours of the rainbow Red, Orange, Yellow, Green, Blue, Indigo, Violet. Further help The aim of this leaflet was to provide you with information about memory problems and to give you ways of helping yourself to remember. To work out and use the best strategies to aid your memory you may require the help and support from your therapist, carer or relative. Your carers and relatives can help by being aware of how you remember things and by encouraging you to use the strategies you have developed with your therapist. 10 Memory booklet
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This information is correct at the time of publishing Last Reviewed: April 2013 get We are a smokefree organisation. Please provide a smoke free environment approved for your healthcare provider DP4578/01.18