Memory

Tips and Tricks

Memory problems are very commonly reported by people with MS. They say things like “I get so frustrated that I can’t remember”. However, most people with MS do not experience severe memory problems and there are many strategies that seem to help. In particular, prompts and reminders can work very well.

Everyone forgets things now and again. The strategies that everyone uses to help remember things are very good for people with MS.
Paper diaries and electronic organisers are unobtrusive and very useful. You may find that you need to use them more often and more scrupulously than previously, but they work.
For important appointments (e.g. at hospital) and dates (e.g. birthdays), you may need to note necessary preparation in advance. For example, a reminder to book leave from work or transport a week before a scheduled hospital appointment. Or reminding yourself to buy a card, wrapping paper and the present a week before the birthday.
Most people with MS are able to remember pretty complete information from a small prompt or cue. For example, a post-it note saying “dry cleaning” on your car dashboard will probably be enough to remind you to stop to pick up the cleaning.
If you feel that your memory problems are becoming apparent in your relationships, it might be worth checking with your family and friends if there are things that they have noticed you forget. If you are forgetting to do chores or help out your partner, the important things can be identified and a prompt, schedule or reminder set up to help you complete your tasks, which your partner will appreciate. If you are missing out on social occasions or meetings because you forget the invitations or information, you can set up prompts or reminders so that you don’t miss out. Friends may be prepared to e-mail you meeting details, so you have a written prompt.

Gadgets and Gizmos

These details are supplied for information only, not by way of endorsement. Items are usually available from several retailers and items are often made by several manufacturers. The MS Trust cannot guarantee that these items are available or suitable for any individual and accepts no responsibility or liability with regard to their usage.

Pill organiser

Organise your tablets a week ahead. Small enough to put in a handbag or pocket.

Pillbox reminder

Pocket size pill box that can be worn round neck. Audible alarm and flashing light when medication due. Time display, with count-up and count-down timers.

Weekly dosage system

7 removable daily boxes have 4 compartments (morning, noon, evening, night) so you can arrange exactly what to take and when to take it. Small enough to slip inside handbag or pocket.

Ball point pen with post-it notes inside

For when you have to jot something down, but there’s no paper around. This pen contains a supply of post-it notes. It looks like an ordinary pen, but twist the barrel and it dispenses a post-it note.

Leather Essentials Purse

A compact leather purse with coin section, credit card slots, keyring, mirror, lipstick holder, pocket for mobile phone. Has detachable wrist strap.

Magic Bag - Mini bag that expands into regular shopper

Palm-sized bag holds all regular handbag items (phone, money, specs, and credit cards). Bag unfolds into shopping tote with handles, handbag pockets now accessible on side of tote.

Leather Specs - Leather case for two pairs of specs

2 side-by-side zip-up compartments.

Classic VIP Handbag Liner

Handbag insert to transfer essential items between bags

Pocket holdall which organises and keeps safe all everyday essentials and allows easy, complete transfer of all items from bag to bag.

Contact flydragonfly@gmail.com.

Touchman

Electronic diary with appointment alarm

Designed for youngsters, which keeps the cost down. Personal digital assistant with backlight touch screen that has appointment alarm, diary, calendar, phone book and FM radio.

Digital organiser

Designed for youngsters, which keeps the cost down. Includes a “to do” mode, telephone directory, daily alarm, diary and calculator.

Child’s MP3 player with voice recording function

Designed for youngsters, but looks adult, is compact and is good value.

For a range of voice recording devices go to www.olympus.co.uk/voice/

Ta-Da List

Ta-Da List is a simple, free, web-based application that allows you to creates quick lists of to-dos to check off. Make a topic, enter a list of tasks to be done and when the task is completed, the entry moved below to the bottom of the list and marked with a tick.

Other Important Influences

There are a number of outside factors that might make your mental skills less efficient:

Having an infection, or being otherwise unwell. If this is the case, seek medical advice
Some drugs given for MS symptom management, including drugs for continence management and spasticity. If you think this may be the case for you, discuss with your doctor
Fatigue has been shown to affect mental skills in MS. Cognitive fatigue has more impact than physical fatigue on mental efficiency. Repeating the same mental task over and over again is especially vulnerable to fatigue in MS. You may find varying your mental tasks, taking breaks, being rested and choosing your best time of day all help. You are also less likely to employ your preparation and strategies when you are feeling fatigued, which reduces how well you can manage your cognitive difficulties.
Download 'MS Trust Publication living with Fatigue'
Anxiety may affect your mental performance, especially if you are “on the spot” and feeling tense. Try to stay relaxed and work round the immediate block.
Depression in MS reduces performance on cognitive tasks that need a lot of concentration. It seems to take up capacity (“thinking space in your brain”) with worries and recurrent bleak thoughts. Like fatigue, depression can also reduce your motivation to employ strategies to manage your cognitive difficulties. Because depression gives people a negative view of the world, you are also likely to view your cognitive difficulties as worse than they are and underestimate the effectiveness of your management strategies. If you think that you may be suffering from low mood or depression, seek medical advice.

Professional Help

Because memory is a very wide-ranging skill and information is remembered in different ways, assessing exactly where one person’s weakness lies can take time. For example, it may be that visual information (pictures, drawings, photos) is easier to register and remember than verbal information (spoken words, read words). If so, then the therapy strategies can concentrate on pictures, either on paper or in your mind. It may be that a memory aid will be helpful to you, and the health professional can help with identifying which aid is appropriate and how much help (if any) you will need to use it.

MS Trust Publications

Cognition Factsheet

This factsheet describes the range of cognitive problems that can occur with MS difficulties with short-term memory, concentration, verbal fluency - and discusses ways to approach managing the various problems.

Cognition problems chatroom Transcript

Transcript of an open forum chatroom where issues raised about cognitive problems are answered by health professionals. The views expressed by participants are not necessarily those of the MS Trust.

More general information about MS

MS explained

MS Explained is a book for anyone who wants to understand the mechanisms of MS and what is causes symptoms to occur.

It describes the immune system and the central nervous system and then explains how MS is thought to cause them to malfunction and the symptoms that result.

MS: what does it mean for me?

If you have recently been diagnosed with MS, you will almost certainly have a number of questions about how it will affect your life.

In our experience, one of the best ways of learning to adjust to your new circumstances is to have access to clear and accurate information. This booklet provides a practical introduction to MS to help you to maintain a positive attitude to managing your MS.

At work with MS

The book considers some of the ways in which MS might affect work, the protection afforded under the Disability Discrimination Act and what adjustments can be made for a successful working life with MS.

Tips for living With MS

A compilation of nearly 150 useful ideas sent in by people with MS. The book contains practical suggestions on saving time and energy, getting around, making the most of benefits and getting equipped and more. There is also an extensive section of contact details for useful organisations.

Living with fatigue

Fatigue is one of the commonest symptoms of MS and can have a major impact on daily life. Living With Fatigue was written in conjunction with an MS specialist occupational therapist and illustrated with comments by people with MS who know what it is like to live with the symptom.

Open Door

Quarterly newsletter that contains articles news and research relevant to people living with MS and their families.

Practical management of cognitive impairments associated with MS

Patrick Carroll, Clinical Specialist Occupational Therapist, Gosport War Memorial Hospital, Gosport Way Ahead 2004;8(2):4-5.

Other Resources

Your memory: a users guide. 2nd ed.

Baddeley A Camberwell: Carlton Books; 2004 ISBN 9781844427802

Describes how the memory works and how individuals can make it work for them, written in clear accessible language.

Master your memory: more inspiring ways to increase the power of your memory, focus and creativity.

Buzan T. London: Pearson Education Limited BBC Active; 2006 ISBN 1406610224

Use your memory: understand your mind to improve your memory and metal power

Buzan T. London; Pearson Education Limited BBC Active; 2006 ISBN 1406610186

Classic memory systems are explained along with Tony Buzan's own Mind Mapping technique.

Your memory: how it works and how to improve it. 2nd ed

Higbee KL Avalon Group; 2001 ISBN 1569246297 7

Managing your memory: a self help guide for improving everyday memory skills

Kapur, N Southampton: Wessex Neurological Centre;1991 ISBN 0951793004

Memory problems: a self-help guide for patients, carers, health professionals and students in training 2nd ed.

Thompson SBN Oxford: Oxford Press:2001 ISBN 0953709817

The memory doctor: fun, simple techniques to improve memory and boost your brain power

Xavier Smith S, Mason DJ Oakland: New Harbinger Publications inc;2005 ISBN 1572243708

101 ways to improve your memory: games, tricks, strategies.

Readers Digest (ed) London: Readers digest; 2005 ISBN 0276440498

DVD

Test and improve your memory

Encyclopaedia Britannica London;Focus Multimedia Ltd;2004 ASIN: B0006398AE

Websites

Mind Tools

features tips for memory improvement particularly in the work environment.

Helpguide

American not for profit organisation aims to empower people to understand, prevent, and resolve health challenges.

Listverse

The Psychologist - How to improve your memory

Morris PE, Fritz CO The Psychologist. 2006;19: 608-611.

Article from The Psychologist journal in which authors detail powerful and robust techniques using the scientific evidence available todate.

Involving Family and Friends

If you are experiencing lapses of memory, the people around you may not have noticed. In that case, your problems must be mild. You may still want to share your experiences with them. You can let them know what strategies you are using. You may not need any direct help from them, but you may want their understanding.

If the people around you have noticed your memory lapses, your memory problems may be more significant. However, it is unlikely that your family and friends will have linked these memory problems to your MS. Once you let them know that you want to discuss your memory problems with them, they are likely to be interested and want to help. This may mean that of something important is coming up, they can either remind you themselves, or leave written prompts.

Research

Memory difficulties are the most commonly reported cognitive difficulties by people with MS. Laboratory studies have shown that groups of people with MS tend to be less efficient at memory tasks than people without MS. This includes remembering lists and remembering words that were paired with another word. Sometimes recognising words that have been seen before is not as hard as remembering words without any cue. There is evidence that memory problems in MS are secondary to a primary slowing of processing speed.

There is quite a lot of evidence that how information is presented to people with MS can make a big difference to how ell they are able to remember it. If people with MS organise and “think” about the information as it is presented (“processing” and “encoding”), they do better at remembering. Reducing the information presented to essentials and removing non-essential items also helps. Cues and prompts are most helpful when the person with MS has thought of them themselves, rather than someone else thinking them up on their behalf.

Cognitive difficulties

Rehabilitation

Some studies which have investigated how computerised packages can improve memory in MS have produced no evidence that they do. However, one programme which adapted to each person’s starting memory level, gave feedback and adapted to each person’s rate of progress did produce improvement in memory function. Teaching people with MS to incorporate information to be remembered into a story (and thus use context and imagery) did improve the memory of those with more marked memory difficulties.