Changes in Memory and Thought

“Dad seems to be more and more forgetful. He often forgets what day it is and can’t keep track of his medications. He also has a hard time answering questions and following simple commands. At first I thought he was acting like this on purpose, but now I am not so sure. Is this normal for stroke patients?”

Stroke causes damage to sections of the brain depending on the location and severity of the stroke. This damage is going to cause changes in the way a person thinks and behaves. The stroke has broken or caused damage to connections between parts of the brain. These connections are what allow us to think, respond, remember, and function normally. When damage occurs, messages do not always get to the proper place or it takes longer for them to get there.

For example: picture a busy highway with road construction. Cars are backed up for miles and it takes longer for you to get where you are trying to go. Or you may turn around, leave the highway, and never get to your destination. This is what is goes on in the brain for many stroke patients.

Understanding How Memory Works

Questions or commands take longer to reach their destination, so the response is slower. In the case of memory, the information never reaches its destination. Memory is like a large filing cabinet with millions of files. Everything we experience is placed in a file, labeled and can be pulled out when needed. If something happens and the information is placed in the wrong file or mislabeled, the information may not be pulled out when needed. After a stroke, the information may be misfiled or never reach the file cabinet. If the file is not available, it cannot be pulled out and used. This is what makes stroke caregiving so frustrating —not knowing exactly what the problem is.

Be Realistic and Ask for Help

The problems of memory and thought-processing only get worse as the person ages. Caregivers are too often not prepared for what will occur later in the life of the stroke patient. This is especially true of African-Americans. Our inability or unwillingness to ask for information — or a doctor’s lack of knowledge about the culture — creates real barriers to much-needed information. There are ways to create a sense of independence and competency for the family member whose thought processes are slowing down.

Here are some suggestions for dealing with declining memory:

  • Ask questions as slowly as possible
  • Purchase a medicine holder with day and night sections along with the days of the week printed on the lids
  • Place notes with simple directions in areas where the family member will find them
  • Keep verbal directions simple and slow
  • Allow plenty of time for the person to answer or respond to verbal directions
  • Do not ask too many things at once
  • Use a large calendar for appointments and important dates that the patient can easily view
  • Maintain a consistent routine for morning and bedtime
  • Create a list of to-do’s for each day and post in a viewable place