14: Memory Rehabilitation Flashcards
What type of memory strategies should be used with pts with mild impairments?
1) internalized strategies (e.g. visual imagery)
2) external memory compensations (e.g. google calendar with notifications)
What type of memory strategies should be used for pts with severe impairments?
1) errorless learning
2) external memory compensations
What are 4 facets of approaches for memory treatment?
1) direct training (drill)
2) focus only on certain memory functions
3) focus on intact memory functions to support impaired ones
4) compensatory strategy use
What are 6 variables for manipulating difficulty of memory activites?
1) amount of to-be-remembered info
2) type of to-be-remembered info
3) similarity of encoding and retrieval conditions
4) encoding strategy
5) length of time until recall
6) type of recall task
What are 4 different types of to-be-remembered information considerations?
1) syntactic complexity
2) emotional content
3) self vs. clinician generated
4) modality
What are 2 different encoding strategies?
1) shallow-rote rehearsal
2) semantic elaboration
What are 2 different types of recall tasks?
1) free recall
2) recognition/cued recall
What can be helpful for encoding memory? (2)
1) making associations - linking new info to existing info
2) organizing information
Which is better? Working on learning something for a few minutes several times a day or 1 hour once a day?
a few minutes several types a day
What are 3 treatment methods for memory?
1) drill based memory tasks
2) mnemonic strategy training
3) metamemory training
What is drill based memory tasks and waht is their goal?
repetition used to “restore” memory capabilities
goal = teach specific info to allow individual to funcion more independently
What is the key factor in drill based memory tasks and what is the theory?
key: errorless learning
theory: memory can be exercised like a muscle and using it for one task will increase performance on other tasks
What pt types is drill based memory tasks used with?
CVA, TBI, anoxia, MCI
What are 4 strengths of drill based memory tasks?
1) good to pair with other strategies
2) works best for information that does not change
3) efficient way to teach specific protocols and routines
4) can assist in increasing attention
What are weaknesses of drill based memory tasks?
1) little empiraical evidence to support increased memory funciton
2) limited generalization to untrained stimuli
What is the clinical bottom line of drill based memory techniques?
does not increase memory capacity or abilities, doesn’t cure memory deficit, it is not a msucle
It should be used in conjuction with other techniques/strategies
What are internal memory strategies?
techniques used to cue interal recall of information
What are 3 strategies for internal memory?
1) visual imagery
2) semantic elaboration
3) verbal organization strategies
What is the theorhetical foundation of internal memory strategies?
encourages deeper level of processing, improving recall
integrates isolated information
provides built-in retrieval cues
What are 2 weaknesses of internal memory strategies?
1) requires metacognition
2) unnatural and difficult to generalize in every day life
What is the clinical bottom line with internal memory strategies?
only use with mild-moderate memory impairments
consider value of many tools in the toolbox
What are 2 association techqinies?
1) visual-verbal imagery
2) visual schematis
What is visual-verbal imagery?
recall names, ID a promitnent feature on a face with a name
What is an example of a visual schematic?
For: goal-plan-do-review, draw a picture of that map
G->P->D->R->
What is metamemory training?
training regarding the nature and extent of their memory problems, educational or experiential approach, prediction exercises
What is the goal of domain specific treatment?
address specific problems associated with memory and be able to access infromation independently
What are components of domain specific training?
1) takes time, weeks, months
2) partner with caregivers, staff, need to also be on board
3) use requires reinforcement
4) awareness - lack of makes more complicated
What are external memory aids designed to do?
reduce load on memory and exec function to allow a person to successfully carry-out tasks
What are common pt types for external memory aids?
Dementia, TBI, CVA
Older individuals are more likely to purchase/use an external memory aid device if what? (5)
1) aware of mem deficits
2) has specific need for reminders
3) can afford it
4) familiar with electronics
5) has support in learning to us it
What is the procedure for external memory aids? (4)
1) assess (attitudes, budget, goals, environment)
2) plan treatment
3) implement treatment
4) evaluate outcomes
What is an orientation book
external memory aid for sever impairments
errorless learning, spaced retrieval
has autobiographical orientation page and additional orientation info (who are they, life story, basic info, and then info/pics of family, staff, etc)
What are different options of external memory aids?
1) orientation book
2) memory notebook
3) autobiographical memory aids
Spaced retrieval training is used with what pt types?
1) dementia (MCI may respond faster, late stages = more difficulty)
2) TBI
3) stroke
What type of pt is a memory notebook used with?
mild to mod recall deficits
What is a memory notebook?
What are the 3 core sections visible on 1-2 pages?
includes day to day activities, can vary based on pts unique needs
1) daily schedule
2) memory log
3) things to do
What should happen in acquisition stage of using a memory notebook?
learn and remember names, locations, purpose, and use
What should happen in the application stage of using a memory notebook?
start using in real life or role playing
pt encouraged to fill out notebook
What should happen in the adaption stage of using a memory notebook?
start use in real world activities
What are autobiographical memory aids?
approach used to remedy memory deficits and provide compenstory mechanism in form of memory aid or cues
What are additional uses of autobiographical memory aids?
1) facilitate conversation/comm
2) orientation
3) increase engagement
4) modify difficult behavior
5) gain access to memories they have trouble retrieving
What are factors to consider in developing and autobiographical memory aid?
1) format
2) font size
3) information included
4) information content
5) photographs/illustrations
What training needs to be done with caregivers for autobiographical memory aids?
prompts, cues, reassurance, redirection, and expansion ideas
What patient training needs to be done for autobiographical memory aids?
1) presentation of aid
2) rewards for reading book and elaborating on content
3) prompt for it if they don’t elaborate
4) training complete when pt has read everything and elaborated on at least 30% in 1 session
What are 5 strengths of autobiographical memory aids?
1) personally relevant
2) customizable
3) easily accessible
4) facilitate communication between pts and partners
5) can be used to observe non-verbal expression of pleasure
What are 3 challenges of autobiographical memory aids?
1) family/staff must be active in development and use
2) development can be time consuming and costly
3) must begin training and implementation early
Research shows that autobiographical memory books have…
1) increased number of on topic utterance
2) decreased ambiguous statements with dementia pts
3) improved QOL
4) improved autobiographical memory
What are 2 strengths of external memory aids?21
1) can provide both visual and auditory reminders
2) can reduce anxiety and improve confidence
What are 4 weaknesses of external memory aids?
1) cost
2) vision requirements
3) fine motor requirements
4) may be challenging to learn-new memory
What is FOCUSED?
family/caregiver training
Functional and face to face
Orient to topic
Continuity of topic and concrete
Unstick communication blocks
Structure with y/n or multiple choice questions
Exchange conversation and encourage interaction
Direct, short, simple sentences
