Where are my keys? Effective Memory Strategies for Persons with Memory Concerns

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1 Where are my keys? Effective Memory Strategies for Persons with Memory Concerns What are you forgetting? I d like you to meet.the new teacher.she s from Pittsburgh.her name is?? Michelle Bourgeois, Ph.D., CCC-SLP The Ohio State University bourgeois.14@osu.edu Erskine Fellow, University of Canterbury, 2013 Where s my car??? I must be getting Old Timer s What is normal aging? O Inevitable physiological changes due to aging: O Our bodies wear out O Vision changes, Hearing changes O Arthritis, aches and pains O The Brain shrinks O less blood flow to the brain O less oxygen to the brain O Slower processing of information O But we can control O Stress, anxiety, depression, loss/grief, inactivity, disorganization, fatigue, physical illness, medications, alcohol, nutrition, smoking O As we age we have O more experience, practical knowledge & wisdom to share Differentiating the effects of normal aging from dementia O Reversible and/or Treatable Conditions Rule out and treat metabolic and nutritional disorders, depression, other disease processes and medical conditions O Age-Associated Memory Impairment Rule out depression and dementia < 1 standard deviation below mean of young adult scores on cognitive tests; Slower psychomotor speed; benign forgetfulness; Preserved occupational and social functioning O Mild Cognitive Impairment Increased frequency of memory complaints; Preserved occupational and social functioning; < 1.5 standard deviations below mean of age and education matched healthy controls on cognitive tests Check out the Symptoms O Community Health Fairs O Memory Screenings O Medical Assessment O Blood Chemistry O Neurological Exam O Pharmacological Assessment O Radiological Assessment O Neuropsychological Testing O In-depth Cognitive testing 1

2 Types of Dementia O Alzheimer s disease O Vascular dementia O Dementia with Lewy Bodies O Fronto-temporal dementia O Jacob Creutzfeld disease O Parkinson s dementia O.more than 100 types.. Many causes of dementia symptoms: Vascular; high blood pressure, high cholesterol Psychiatric: Depression Metabolic disorders (thyroid, liver, diabetes) Nutritional deficiencies (folate, thiamine, vitamin B Drug overdoses or side-effects Infections (encephalitis, meningitis, syphilis, HIV) Toxic poisoning (alcohol,mercury, lead, arsenic) Autoimmune disorders (multiple sclerosis, lupus) Many of these causes are reversible!! What is Dementia? O Abnormal Aging O Acquired, progressive impairment of intellectual function and judgment O Difficulties with memory, cognition, language, and visual-spatial information O Changes in personality, emotion O Interferes with daily functioning O Alzheimer s Disease is the most common type of dementia If I have memory lapses, do I have dementia? O Occasional memory loss does NOT on its own mean dementia. O The Alzheimer s Association has recognized 10 specific signs of dementia to discuss with your doctor. 1. Memory changes that disrupt daily life O Forgetting something recently learned O Asking for the same information over and over O Relying on memory aids or family members for things you used to handle alone 2. Challenges in planning and solving problems O Problems developing or following a plan O Problems working with numbers O Problems following a familiar recipe O Difficulty keeping track of bills O Challenges concentrating O Taking longer than before to do common tasks 3. Difficulty in completing familiar tasks O Trouble with daily living activities O Difficulty driving to once familiar places O Problems managing a budget at work O Difficulty remembering the rules of a favorite game 2

3 4. Confusion with time or place O Losing track of dates, seasons, and the passage of time O Forgetting where one is or how one got there 5. Trouble understanding visual images and spatial relationships O Diminished ability to track visual surroundings O Difficulty reading O Trouble judging distance O Problems determining color or contrast 6. New problems with words in speaking or writing O Problems following or joining a conversation O Difficulty tracking conversations O Repeating what has already been said O Difficulty finding the right word O Calling things by the wrong name 7. Misplacing things and losing the ability to retrace steps O Putting things in unusual places, such as leaving keys in a fruit bowl. O Difficulty retracing steps to locate a missing item O Accusing others of stealing 8. Decreased or poor judgment O Spending money impulsively O Wearing clothes inappropriate to the weather O Changes in decision making 9. Withdrawal from work or social activities O Withdrawal from hobbies, family gatherings, team projects O Losing track of a favorite sports team O Forgetting how to engage in a favorite activity O Avoiding social situations 3

4 10. Changes in mood and personality O Increasingly displaying signs of O Confusion O Suspicion O Fear O Anxiety O Agitation Remember there can be many causes of dementia symptoms: O Vascular; high blood pressure, high cholesterol O Psychiatric: Depression O Metabolic disorders (thyroid, liver, diabetes) O Nutritional deficiencies (folate, thiamine, vitamin B) O Drug overdoses or side-effects O Infections (encephalitis, meningitis, syphilis, HIV) O Toxic poisoning (alcohol, mercury, lead, arsenic) O Autoimmune disorders (multiple sclerosis, lupus) O Many of these causes are reversible If you have concerns, see your doctor O Doctor can evaluate your condition and refer you to services if needed O Behavioral and pharmacological treatments are available O Community support can benefit both those with memory challenges and their loved ones Treatment of Alzheimer s Disease O Pharmacological O Cognex (tacrine) O Aricept (donepezil) O Exelon O Reminyl (galantamine) O Memantine O Behavioral O Treatment of Patient Problem Behaviors O Caregiver Training Early Intervention for MCI? O Increased risk for conversion to AD O Increased awareness of deficits & fear of AD O Evidence of successful cognitive/memory training for healthy adults O Verhaeghen et al. (1992); meta analysis O Troyer (2001) O Willis et al. (2006); ACTIVE Study; positive effects 5-year follow-up Encouraging Evidence for MCI O Troyer et al. (2008) O Impact of impairment can be moderated by training compensatory strategies O Participants with amci increased knowledge and use of memory strategies O Kinsella et al. (2009) O RCT; Memory rehabilitation group vs. waitlist group; N=52; 5 90-min sessions; discussed strategies; written materials and home assignments O Participants with amci improved everyday memory performance, knowledge and strategy use O Successfully used memory strategies! 4

5 Memory Strategies: Which ones do you use? O Fads and Quick Fixes? O Exercising your brain What is Memory? 1. Sensory memory Information from our senses Vision, Hearing, Touch, Taste, Smell Automatic, over-learned Examples: Driving a car Reading Aroma of baking bread 2. Short term memory (working, temporary) O Information is processed & understood O Action is taken O Information is stored for later use O Need to pay attention to important information O Most problems with this type of memory 3. Long term memory O Memories from long ago (childhood, school) O Memory for How-to-do things (walk, play piano) Memory Strategies Common memory strategies Association Mnemonics O My new neighbor, Marsha. 5

6 O Internal Strategies require: O Effortful, conscious processing processing O Active memory search to recall practice O Mental representation products inside the Brain External Strategies require: Automatic, unconscious Recognition based on experience & Physical, permanent in the Environment Strategies for Sensory memory Written Cues: Notes, Labels, Lists, Signs Organizational Cues: Planners, Medication boxes Environmental Cues: Objects, color-coding, special places Strategies for Short term Memory Strategies for Long Term Memory Ways to process and encode information. Recommended Memory Strategies O Pay attention to what is important O Active Observation O Do something active to store the information O Elaboration O Written cues (calendars, notes, planners) O Routine, Organization, Special Places O Practice remembering the information O Spaced Rehearsal Pay attention to what is important O Where is my car? O Active Observation O Notice O How many rows to door of the store? O Is there a sign for the row? O Count the cars from your car to the store. 6

7 Do something active to store the information Elaboration Written cues (calendars, notes, planners) Routine, Organization, Special Places O My car is in row G O There are 6 cars to the store. O My car is to the left of the store O Write down your row and the # of cars O Always park in the same row or area Practice remembering the information Spaced Rehearsal Say to yourself: My car is in row G. Walk 5 paces and repeat: My car is in row G. Walk 15 paces and repeat. My car. Walk to your destination and repeat. My car Ten minutes later, repeat.. My car O Thirty minutes later, repeat.. My car. O When you go back to find your car, say My car And there it is.success!!!! O It is NOT Dementia Things to do if. O Learn about helpful Memory Strategies O Stay healthy, exercise, follow doctor s advice O Reduce stress, enjoy life O It IS Dementia O Do all the above AND. O Learn about the disease O Join a Support Group O Find out about other helpful resources O Participate in research studies References 7

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