Memory and Attention

Many people experience short-term memory problems after their concussion. They may be easily distracted, have problems paying attention or concentrating and have anxiety. This is because the brains system for remembering and paying attention has been affected by the brain injury. The brain pathways may be broken or less efficient.

Attention

The way the brain pays attention can be broken into levels known as the hierarchy of attention.

hierarchy of attention

Divided attention (multi-tasking) is when you are trying to do more than one task at a time, such as driving and talking. Did you know research shows people can’t multi-task? We can only quickly change our attention from one thing to another.

Alternating attention is when you have to switch your attention from one task to another. Think of grocery shopping. You look at your list, scan the shelves and look back to the list.

Selective attention is the brain’s ability to ignore distractions and pay attention to one thing. An example of this is being able to remain focused on a conversation at a party.

Sustained attention is when the brain can concentrate on something for a long period of time, like watching a movie.

Focused attention is being aware of your surroundings and responding. An example of this is hearing a loud noise and looking in the direction of the noise.

After a concussion, you may have problems with one, or more of these forms of paying attention. You may notice you can no longer:

  • concentrate for any length of time
  • ignore distractions
  • keep track of conversations
  • recall information or respond to a question
  • return to an activity or conversation if you are distracted
  • You may also be easily irritated by noise and appear restless, disinterested or tired

Strategies to help you pay attention:

  • make sure you have had lots of rest before doing an activity that requires you to pay attention
  • give yourself extra time to do the activity
  • take breaks and alternate between physical and mental activities
  • avoid multi-tasking and focus on one thing at a time
  • write down a plan to accomplish your activity or task
  • complete one activity before moving to another
  • break down the task into manageable steps
  • reduce distractions around you – like making sure to turn off the TV or radio
  • maintain eye contact during conversations

Try these sites for helpful activities: Cambridgebrainsciences.com, happy-neuron.com

How can family members help you pay attention?

Memory

Each type of memory system will be affected differently by a brain injury. Most people with a brain injury do not have problems with their long-term memory but do have problems with short-term memory. It is common to have issues remembering things like; future appointments, to take medications, losing things like cell phones and keys. Decide what’s important to remember and what’s not important. Don’t expect to remember six to seven things at once. Be easy on yourself. People of all ages forget things. When you do forget something, ask for help (e.g., I know we’ve met several times, but I can’t remember your name. Please tell me once again.) or ask someone to help you remember an important task or event.

How can you help your memory after a concussion?

Focus on your strengths. Is it easier for you to remember written information than information you hear? Visual memory or what people read is usually easier for people to remember after a brain injury than what they hear. What you read can be re-read and can act as a reminder. Try:

  • asking for a written summary of important conversations (like doctor’s appointments)
  • saying things out loud - repeating information can help you remember
  • repeating back a conversation to see if you heard it correctly or ask for information to be repeated
  • removing distractions
  • to pay attention to one thing at a time

Organizing your life to help your memory

  • keep a routine of your daily activities (schedule activities for same time, same day every week
  • have a system - either on paper or using technology such as smart phones to write important notes and track appointments
  • pair regular tasks with other routine activities (i.e. taking medication with brushing teeth)
  • put things together to make sure they’re not forgotten(i.e. keep your work keys in your lunch box)
  • have a place for everything in the house; try to keep items in their correct locations. If you want to move locations of certain items, write a note in the old spot directing you to the new spot.

Other strategies:

Repetition:

Try repeating something over and over in your head. Repitition includes repeating phone number over and over long enough for you to dial it. Long-term repetition would include reviewing something everyday, you will eventually remember it.

Visualisation:

Try to see things in your mind. Visualization is photographic memory. Most of us can’t visualize as perfect as a picture, but we can sometimes recall details like colours and shapes. You can visualize by turning information into stories in your head, like a videotape. Then later you can replay the “video”.

Association:

Tie what you want to remember to something you already remember. Mnemonics (having letters of a sentence match letters in something you are trying to remember) is an excellent association task. For example, if you want to remember the planets in the solar system in order a good mnemonic would be,“Many Very Eagar Men Jump Stars Up Near Pluto.”

Many = M = Mercury
Very = V = Venus
Eager = E = Earth
Men = M = Mars
Jump = J = Jupiter
Stars = S = Saturn
Up = U = Uranus
Near = N = Neptune
Pluto = P (although not a planet any more).

Grouping:

Place like items together. For example, it’s challenging to remember 21 grocery items, but it’s not difficult to remember seven meats, seven vegetables and seven fruits.

Write it down

This is the best method, because if your memory fails you can look back at what you wrote. The physical act of writing itself is a memory aid.

Memory Tips

Remembering names: When you meet someone repeat the person’s name as soon as it’s said. Ask the person to spell his or her last name, even if it’s easy to spell. Or try to associate things with the person such as Mr. Bush has bushy eyebrows. Form a picture in your mind, like Mr. Finn swimming around in your fish tank with a big fin on his back. It may seem silly, but it often helps us remember. If you are leaving and have just met someone, end the conversation by saying the person’s name (“It was great meeting you, Lisa”). As soon as they leave write their name down and when and where you met. Make up a sentence that includes names and places to remember and say it out loud. For example, I am going to meet with Henry Biggs, who is a music teacher at Masonville Public School.

Remembering items

Make up silly sentences that includes items to remember and say them out loud. For example, “Pour detergent on the bananas in the envelopes” to remember to buy detergent, bananas and envelopes at the store."

Establish a spot or box near the door to place objects you need to take with you, such as your keys, cell phone, purse or wallet.

Keep things in the same place at all times, such as keys hanging by the door, scissors in the sewing drawer, address book by the phone or computer.

To remember where your car is parked: Once it is parked look around and describe aloud certain visual cues that could help remind you where your car is parked such as I am parked in the third row directly across from the grocery carts.

Remembering events and to dos

  • use symbols to help you remember an important event. Try turning your watch over, switching your watch or ring to the opposite wrist or hand, or setting the alarm on your cell phone.
  • do activities on the same day each week or month.
  • use direct deposit and direct bill paying services available through your bank to ensure that your checks are deposited and that important bills are paid on time.
  • make a checklist of steps to perform an activity or a daily “to do” list. Check your list throughout the day and monitor your progress.
  • use verbal rehearsal to help you remember things as you do them. For example, I’m putting the scissors in the top drawer so the baby can’t reach them or I’m checking the burners on the stove before I go upstairs.  I’m locking the front door before I leave to go out the back door.
  • write your name and address and directions to your house on an index card and tape it to each of your phones. If you need to remember this information in an emergency, you can just read it off the card.
  • if you have difficulty remembering your license plate number, get a vanity plate with an easy-to-remember word or name on it.
  • keep a memory diary in which you record all the important information you need to remember, such as names, birthdates, important dates, addresses and phone numbers, repair companies, location of important papers, directions to places you visit often, dates when warranties expire, etc. Refer to this diary everyday. Keep a copy of the diary somewhere in case you misplace your original diary.

Using the telephone

    when you take a phone message, focus on the most important information in the message. First, write down the caller’s name and phone number. Then, write the content of the message. Note the date and time of the call.
    keep a notebook by your phone and keep a log of who called, what time, and what each person wanted. This log will help you when questions come up about payments, appointments, etc.

Remembering directions

  • when you drive, pay special attention to landmarks to help you remember directions. Comment on these landmarks out loud as you pass them. For example, turn at the “big red house” then turn left at the third street past the "pizza place.”
  • keep directions to places you visit on separate index cards in the glove compartment of your car.

Remembering conversations

  • during conversations, comment on what the other people are saying.  Restate their comments in your own words. Actively participating in the discussion will help you remember the main points of the conversation later.

Remembering what you have read

  • to help remember what you have read, stop at the end of each paragraph or page and think about what you’ve read.  Summarize it aloud.
  • use highlighters to mark key information as you read. Keep a tablet or paper handy to jot down questions and comments as you read instead of waiting until you are done and perhaps have forgotten them. Memory activity – remembering 20 objects

Instructions:

  • using everyday household items, lay 20 items out on a table
  • look at the objects for one minute
  • try to recall all of the objects seen

Strategies:

  • say the items out loud, and point to them
  • try to group similar objects together (i.e. wooden objects, office supplies, etc)
  • close your eyes and try to visualize the items on the table