Synapse - reconnecting lives

Short-term memory is very common after a brain injury - thankfully there are plenty of coping strategies available.

Memory impairment is one of the most common effects of brain disorders such as traumatic brain injury. Sadly there are no cures available, but there are a number of ways of coping and making life easier. It is important to remember that using the strategies described here is not 'cheating' and will in no way prevent natural recovery or cause existing skills to be lost.

Why are short-term memories so common?

The region of the brain responsible for short-term memory sits over bony protusions in our skull, so a traumatic brain injury can mean these parts of the skull injure our brain in this vital are. 

Strategies to compensate for memory loss

You can minimise the impact of memory problems through:

• adapting the environment
• using external memory aids
• following a set routine
• combining several strategies to make a substitute 'memory system'
• improving general well-being.

Adapt the environment
One of the simplest ways to help people with memory problems is to adapt their environment so they rely on memory less. Some ideas for doing so which have helped others are:

• Keep a notepad by the phone to make a note of phone calls and messages
• Put essential information on a noticeboard
• Decide on a special place to keep important objects like keys, wallets or spectacles and always putting them back in the same place
• Attach important items to your person so they can't be mislaid e.g. using a neck cord for reading glasses
• Label cupboards and storage vessels as a reminder of where things are kept
• Label perishable food with the date it was opened
• Paint the toilet door a distinctive colour so it is easier to find
• Label doors as a reminder of which room is which.

Use external memory aids
Many people use external memory aids, regardless of whether they have a brain injury or not. External memory aids are particularly important for people with memory problems as they limit the work the memory has to do. Check with your local Brain Injury Association for places where you can buy memory aids. Some examples include:

• Smartphones and diary or calendar apps
• Diaries, filofaxes or datebooks
• Notebooks
• Lists, wall charts and calendars
• Alarm clocks and watches
• Tape recorders and dictaphones
• Electronic organisers
• Pagers
• Pill reminder boxes for medication
• Sticky-backed notes
• Photo albums
• Cameras.

Follow a set routine
Having a daily and weekly routine means that people with memory problems can get used to what to expect, which helps to reduce the demands on memory. Changes in routine are often necessary, but can be confusing. It is a good idea for relatives and carers to explain any changes in routine carefully and prepare the person with memory problems well in advance, giving plenty of spoken and written reminders.

You could also try the following reminder strategies in order to establish routines:

• Make a note of regular activities in a diary or on a calendar
• Make a chart of regular events, perhaps using pictures or photographs, on a notice board.

Combine several strategies to make a substitute memory system
Most people with memory problems find it useful to combine several aids and strategies.

A combination of two or three strategies can cover the areas where there would otherwise be problems and provide a safety net for things that must be remembered. Here are examples of the components of two such combination systems:

System one:

• Three lists - one showing routine tasks, one showing where to find files in the filing cabinet and showing key rules, such as when to do the filing each day
• A ring binder with sections on urgent tasks and long-term projects
• A notebook
• A telephone message pad to make notes of conversations
• A computer calendar and alarm
• Practising assertiveness techniques to 'buy time' instead of having to respond to requests immediately
• Simple relaxation and breathing techniques to reduce anxiety

System two:

• Filofax
• Journal
• Watch
• Dictaphone
• Various lists
• Sticky-backed notes
• Menu chart
• Keeping things in the same place
• Following routines.

Improving general well-being
Memory is very important in giving us a sense of our own identity. Memory problems often have major emotional effects, including feelings of loss, anger and increased levels of depression and anxiety. Some approaches to dealing with this are as follows:

• Follow the strategies outlined earlier - they can provide a measure of control which can relieve anxiety and depression
• Sharing your feelings with others can provide relief and reassurance - see if there are support groups in your area
• Identify activities you find enjoyable and relaxing, such as listening to music or exercising, and take the time to indulge in them.