- Provide simple orientation information in both visual and verbal forms i.e. help the person understand where they are and why they are there, what happened to them. Repeat frequently. A programme of orientation carried out in structured and consistent manner is helpful for many people with significant memory impairments.
- Wear name badges and always introduce yourself on approach until you are absolutely sure they know who you are and your role in relation to them.
- Provide prominently displayed photographs and names of key staff members.
- It is helpful and reassuring to write on a notice board the plans for the day.
- Use timetables, diaries, mobile phones etc to trigger reminders.
- Provide regular reassurance that they are safe, being cared for and family is well.
- Be prepared to regularly repeat the same information. This may be about simple things such as actually having a brain injury, but also its consequences and impact on everyday functioning.
- When supporting the severely impaired person to re learn skills or compensatory strategies, therapeutic interventions may need to be very simple and repeated in the same way many times to support memory and learning. Advice on procedural and/or errorless learning techniques may be helpful. Support for this may be obtained from Clinical Neuropsychologist, Clinical Psychologist, Occupational Therapist and/or Speech and Language Therapist who specialise in Neurorehabilitation.
- Do not overload the person with information. Provide small, ‘bite sized’ amounts of information at a time.
- Do not expect the person with significant memory impairment to be able to manage to follow the plot of a long film, T.V. programmes. a book etc. Help the person choose activities that they can enjoy without such reliance on memory e.g. sketch shows, short programmes, magazines.
- Do not expect the person to be able to maintain a coherent, complex conversation/interaction for any length of time if they have severe memory impairment. Frequent, short, positive interactions may be more helpful.Conversations may be difficult to follow and interaction difficult to tolerate if the person with memory impairment cannot:
- Remember the identity of the individual they are talking to.
- Remember the nature of their relationship with other people involved in their care (e.g. are they friend, enemy, employer, carer, stranger, nurse, guard, fellow patient, a threat to them or a source of support).
- Recall how or why a conversational theme developed.
- Remember it is difficult for people to initiate communication in order to seek assistance, information, reassurance or just for a social chat if they do not understand where they are, cannot recall your name and cannot remember events to talk about with you.
- Remember it is difficult for people to initiate communication in order to seek assistance, information, reassurance or for just a social chat if they do not understand where they are, cannot recall your name.
- Never start a conversation with a person who has significant memory impairment with the word ‘remember’ e.g. ‘remember I told you….’, ‘remember when….’., ‘remember you did/said….’, They won’t remember!
- Providing a diary to record events and feelings or a tablet device to take photographs can support memory, awareness and also interaction.
- Maintain a safe environment, the person with memory impairment may lack awareness of safety issues, may wander/escape through doors, may disrupt other patients etc.
- For specialist advice and support refer to Clinical Neuropsychologist, Clinical Psychologist, Occupational Therapist and/or Speech and Language Therapist who specialise in Neurorehabilitation.
Please remember that even relatively mild memory impairment can be distressing and stressful. Significant changes to memory abilities can be highly anxiety provoking, cause significant levels of confusion and have a marked impact on rehabilitation. Severe impairment of memory can contribute to the development of challenging behaviours if the person is frightened, confused and cannot recall salient details regarding their situation.