Cognitive Corner

Dave Anders CBIS
Speech Language Pathologist

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Memory Mishaps

As my kids were opening Christmas presents this year, I realized that I needed a screwdriver from the garage in order to remove one of my son’s toys from its packaging. As I stepped into the garage, I noticed that shoes were strewn around the entry to the house, so I spent a couple of minutes placing the shoes neatly on the shoe rack. Pleased with my organizational skills, I re-entered the house and sat back down in the living room….at which point I realized that I had forgotten the screwdriver!

Later during the Christmas weekend I had multiple episodes in which I would walk into a given room of the house and realize that I had no idea whatsoever why I had walked into the room. I vaguely remembered that I needed something from the room, but…in between embarking toward the room and arriving at the room, the purpose for the trip was lost. I would then have to re-trace my footsteps in order to remember what I had needed from the room.
I think most of you can probably relate to these two scenarios. Whether you’ve had a brain injury or not, there are times in which memory “mishaps” such as the ones I described above occur. For those of us who have not sustained a brain injury, episodes such as these allow us to have just a small glimpse into the world of brain injury. Can you imagine having episodes like this all day long…in multiple situations? The little twinge of frustration I experienced in realizing I had forgotten the screwdriver and having to go back out into the garage is multiplied many times per day for those who deal with memory problems as a result of brain injury. Can you imagine having to deal with that kind of frustration every day?

So why do these frustrating episodes occur? Why is it worse after brain injury? In order to answer these questions, we have to look not only at memory itself, but also at how distractions affect our ability to store and retrieve memories. Distractions are the culprits in my two examples. I was interrupted by both an external distractor (the shoes distracted me from getting a screwdriver in my first example) and an internal distractor (my mind wandered as I was going to get what I needed in my second example). The fact that it was busy in the house (causing me some extra stress), I had a lot on my mind, and that I was tired all contributed to my memory mishaps as well.

Even in mild brain injury, concentration and distraction problems cause an increase in trouble staying focused and losing one's place when interrupted. These problems significantly worsen when the survivor is stressed, busy, sick, or tired. As a survivor, you may also notice an increase in the number of these episodes at times when you are out of your usual routine (such as around the holidays).

During therapy sessions, the first step in addressing these problems is to help the survivor develop some insight into his increased distractability. Once the survivor understands that the problem exists, he can start to control his environment to minimize these distractions. Some other helpful strategies include:

• Focus on only one thing at a time.
• Use a system of to-do lists, checklists, calendars, and reminders.
• Get organized. The more organized your environment, the fewer distractions there will be. As you organize, make a very specific place for everything (keys, purse, wallet, glasses, etc.) KEEP EACH ITEM IN ITS DESIGNATED PLACE!
• Repeat….Repeat…Repeat.
• Develop a routine and stick to it.
• Get plenty of rest. If you are fatigued, you will be more distractable.

Even if you follow all of these rules, there are still going to be times in which memory mishaps occur. No strategy is perfect for every situation. Your job as a survivor or caregiver is to develop the best strategies for you and practice them until they are habits.

Have a safe and happy new year. I’ll talk to you next month.