I forget to take my tablets

Memory problems are very commonly reported by people with MS, and can cause frustration and dismay. Everyone forgets things sometimes, and most people with MS do not experience severe memory problems. There are a number of strategies that can help, whether you have MS or not.

A primary memory problem is difficulty in registering and/or remembering information. Having a problem with primary memory can have a knock-on effect on other thinking skills. 

We use our memory for verbal information very extensively every day. For example, when we meet someone we will usually refer to the last conversation we had with them. When we switch on a TV drama, we remember what happened to the characters in the previous episode to follow the plot in the new episode we are watching. After a visit to the doctor, we rely on our verbal memory to have stored what was said and make the information available to us when we need it in the future.

Tips and tricks

  • Paper diaries and mobile apps 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.
  • Set up prompts or cues around your home to jog your memory. 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 text or  email you meeting details, so you have a written prompt.
  • Get into the habit of taking notes during a meeting or an appointment, so you have a record later.
In this 4 minute video, clinical psychologist, Dr Eleanor Ansell gives her tips for managing memory problems in everyday life.

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. A cognitive psychologist can work with you to discover whether you find visual information (pictures, drawings, photos) 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 you will need to use it.

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.

Other resources

Software

Test and improve your memory
Encyclopaedia Britannica London;Focus Multimedia Ltd;2004 ASIN: B0006398AE

References
Adler G, Lembach Y.
Memory and selective attention in multiple sclerosis: cross-sectional computer-based assessment in a large outpatient sample.
Eur Arch Psychiatry Clin Neurosci. 2015 Aug;265(5):439-43.
Deluca J, Leavitt VM, Chiaravalloti N, Wylie G.
Memory impairment in multiple sclerosis is due to a core deficit in initial learning.
J Neurol. 2013 Oct;260(10):2491-6.
Sumowski JF, Leavitt VM, Cohen A, Paxton J, Chiaravalloti ND, DeLuca J.
Retrieval practice is a robust memory aid for memory-impaired patients with MS.
Mult Scler. 2013 Dec;19(14):1943-6.
Goverover Y, Chiaravalloti N, DeLuca J
Self-generation to improve learning and memory of functional activities in persons with multiple sclerosis: meal preparation and managing finances
Arch Phys Med Rehabil 2008;89:1514-21.
Ernst A, Blanc F, De Seze J, Manning L.
Using mental visual imagery to improve autobiographical memory and episodic future thinking in relapsing-remitting multiple sclerosis patients: A randomised-controlled trial study.
Restor Neurol Neurosci. 2015;33(5):621-38.
Chiaravalloti ND, Moore NB, Nikelshpur OM, DeLuca J.
An RCT to treat learning impairment in multiple sclerosis: The MEMREHAB trial.
Neurology. 2013 Dec 10;81(24):2066-72.
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