Memory and Attention Changes

Introduction

Welcome to Module 5, where we will be looking at how you can manage changes to your memory and attention after a brain injury.

We will explore how much you know and understand about your memory and attention problems. We will see how they can affect your everyday life, and look at what you can do to help yourself.

Some important information before we get started

When you see this, you will need a pen and paper to make some notes.

This is to remind you of something important.

This means there is an activity for you to do.

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Write down what you think we mean when we talk about memory.

What do we mean by memory?

Memory is about your brain being able to gather, store, and remember information from the world around you

There are two main types of memory: short term and long term.

There is also something called prospective memory. This is “the memory for intentions”, which means remembering to do a task in the future. For example, you may have often said to yourself “I must remember to post that birthday card” – this is a prospective memory.

How might this affect me?

Your short-term memory is usually more affected than your long-term memory after a brain injury. This is because your brain stores long-term memories in a different way to short term memories. You might find that you:

Memory problems are normally caused by your brain injury (see glossary for full meaning). This means that something physical has happened to your brain that is now affecting your memory. This can often be very frustrating for you.

Write down how memory issues have affected you since your brain injury, and how this impacts your day.

It can also be a bit of a challenge trying to get your friends and family to understand your memory problems. Get them involved in working out ways to help you. This can be anything from texting you to remind you about appointments, to helping you set up a smart speaker.

Headway has a useful section on their website for your friends and family. It might help them to understand how they can support you: Someone I know has a brain injury | Headway

It is important to have the support of your family and friends after a brain injury, as this will make the road to your recovery much easier.

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Write down what you think we mean when we talk about attention.

What do we mean by attention?

Attention is about being able to focus on a task, object, or person for a length of time.

There are two main types of attention – sustained and divided.

Sustained attention means focusing on one thing at a time. For example, watching your favourite soap on the television.

Divided attention mean focusing on more than one thing at a time. For example, watching your favourite soap on the television and talking to someone at the same time.

How might this affect me?

People who suffer from memory problems after a brain injury usually also have other problems, such as reduced attention.

You may notice that your attention, or concentration span, is a lot less than it was before your brain injury. You may find that you struggle to:

• follow a television programme
• concentrate on and follow a conversation
• start and finish a task
• read a lot of information

You might find that you miss bits of information and make errors if you are struggling with your attention. This might be worse when you are tired. See Module 2: Coping with fatigue for more details.

Write down how reduced attention has affected you since your brain injury, and how this impacts your day.

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Source: Initially Resistant to Memory Strategies, MSKTC

Now that you have identified what you struggle with, let’s look at what you can do to help yourself.

There are a number of different techniques, or strategies, to help manage your memory and attention problems on a day to day basis:

• Stick to a daily routine – do the same things, at the same time, every day
  • For example, get up every morning at the same time, do your physio exercises every day before lunch
• Write down important things that you want to remember – use a notebook or a diary
• Keep things you use all the time in the same place so they are easy to find
• Make a “to-do” list and tick tasks off as you go
• Only focus on one task at a time
• Reduce background distractions to allow you to focus
  • Turn the television off
  • Turn off the radio
  • Take yourself off to a quiet spot

This video talks about memory and attention problems, and different strategies to help manage them from the point of view of someone who has had a brain injury:

Memory and Attention St. Joseph’s Health Care London

There are a number of different ways you can help manage your memory and attention problems, both low-tech and high-tech.

Here are some low-tech examples:

• Use a physical diary or calendar to write down appointments.
• Use a planner to help plan out your daily routine (this is also helpful when it comes to fatigue management! See Module 2: Coping with fatigue for full details). Download our blank planner.
• Use a checklist of tasks that you need to complete each day, and tick them off as you complete them.
• Use post-it notes or a notebook to write down important information (or any information!) when you think of it.
  • This can also be helpful if you are talking about something specific and can’t remember a certain detail. Write it down when it comes back to you and you can tell the person next time you see them.
• Keep a pad by the phone, so you can write down any important information as you are told it.
• Don’t be afraid to ask the person you are speaking with to repeat information!
• Ask someone for help if needed.
• A whiteboard is a great all-rounder. Just remember to put it where you will easily see it!
  • You can write down appointments
  • Use it as a daily or weekly planner
  • Write down important information that you don’t want to forget
  • Attach important letters to it

Play games! Studies have shown that playing games helps to increase your attention span, and improve your memory (¹Mitjana 2022, ²Noda et al 2019). Board games give your brain the chance to get some exercise. The more you play them, the stronger your brain will get! Games are also a great way to involve other people in your recovery.

Kim’s game – How to play

1. Put 10 things from around the house on a tray – it could be things like a pencil, an orange, some cotton wool, a toy etc.
2. Look carefully at them for about thirty seconds, and then ask someone to take the tray away.
3. You will then call out what you remember.

Another way of playing the game is to cover the tray, ask someone to take one thing away, and then you need to spot what’s missing.
You can put more things on the tray as the game gets easier.

Here are some high-tech examples:

• Use the calendar app on your phone to keep track of appointments (see “How To Guide” below on how to complete this)
• Use the notes app on your phone to note down important information
• Use a smart speaker (e.g. Alexa or Google) to set up reminders for important information, e.g. appointments, tasks to be done each day, timers. Ask your family for help with this if you need it.
• Use an app to help with your daily tasks, i.e. to-do lists, daily routine

How To Guides

• How to – alarms (iPhone)
• How to – calendar (iPhone)
• How to – reminders (iPhone)

Have a think about what strategies you would like to try, and give them a go! It’s important to remember that what works for you might not work for someone else!

It’s also important to look after your physical, and mental health as this can affect your memory and attention problems. Here are some signs that your physical or mental health are getting worse:

• You’re struggling with your sleep
• You’re feeling very fatigued during the day
• You’re feeling unwell
• You’re feeling stressed
• You’re experiencing strong emotions, e.g. anxiety, depression, anger

Some medications may also affect your memory and attention. If this is something that you are worried about, speak to your GP about a medication review.

There are also a number of different apps that you can download to help work on improving your memory and attention. Two of the most popular ones are:

• Lumosity – Available on both Apple and Android. Free to download. You can pay to upgrade to “Pro” if you want.
• Peak – Available on both Apple and Android. Free to download. You can pay to upgrade to “Pro” if you want.

There are many more apps available on both Apple and Android. The quickest way to find these is to search “Memory Games” in the app store on your device. Finding an app that works best for you may be trial and error.

Let’s make a checklist of tasks that you need to complete each day

Here is an example of what you might include:

Start off with a small list of tasks. You can always add to it as you go. It’s important to pace yourself to make sure you don’t get too fatigued, Fatigue has a big impact on your memory and attention.

Now we are at the end of the module, let’s review what we have learned.

• What have you learned about memory?
• What have you learned about attention?
• What strategies do you think will work best for you?

Hopefully this module has helped to give you a better understanding of what memory and attention are, and how they can affect your day to day life.

Using the strategies discussed in this module will help you begin your journey to manage your problems, and give you the confidence to do so.

It’s important to remember that practice makes perfect and it’s okay to ask someone for help!

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• Attention – being able to focus on a task, object, or person for a length of time.
  • Divided Attention –focusing on more than one thing at a time. For example, watching your favourite soap on the television and talking about your day
  • Sustained Attention – focusing on one thing at a time. For example, watching your favourite soap on the television
• Brain Injury – any type of injury to the brain that occurs after birth. This can include damage caused by infection, disease, lack of oxygen or trauma to the head. Examples of trauma include road traffic accidents, assaults, falls and accidents at home or at work

• Memory – the process of your brain using the information gathered from the world around you, storing it, and then recalling it later
  • Long Term Memory – the process in the brain that takes information and creates long lasting memories
  • Short Term Memory – the process of storing a small amount of information in the mind and keeping it readily available for a short period of time

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Here are some further resources:

• www.headway.org.uk – this is a great resource for everybody involved in brain injury, from clinicians to the person with a brain injury and their friends/family
• Memory problems | Headway – this section of the Headway website specifically looks at memory and has some handy hints and tips
• www.mytherappy.co.uk/ – all apps listed on this website have been reviewed and approved by NHS, social care, and third sector clinicians

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All information on this site is adapted from a wide variety of sources:

• What is memory? (ucl.ac.uk)
• www.brainline.org
• www.headway.org.uk
• Benefits Of Games for the Memory in Older Adults (fairviewadc.com)
• What Games Help Improve Memory? | Iris Reading
• 1 – Seven of the Psychological Benefits of Playing Board Games (exploringyourmind.com)
• 2 – The effectiveness of intervention with board games: a systematic review | BioPsychoSocial Medicine | Full Text (biomedcentral.com)

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