We’re trying something new….AGAIN!
Corey has severe memory loss, especially for short-term memory. Day to day activities are lost 5 mins after they are experienced. She started taking Aricept (an Alzheimer’s Rx – used to prevent further memory loss) since January. We’ve noticed there are flashes of memory recall within a week or two of the experience for a certain person she’s met and recall of certain words or a phrase of a recent conversation. Corey doesn’t remember the experience but she tries to describe one image from the experience. Unfortunately, these flashes are not consistent. I mentioned we went to the eye doctor last Friday for a 3 hour appointment. Last night Corey repeatedly asked me when we can go to the doctor to get her eyes checked. Yesterday we went to the dentist. Last night she couldn’t understand why her teeth hurt and asked what she ate that might have made them sore?
We use reminder cards; large 5×7 index cards with key words or one sentence to place infront of her. Cards include, “Exercise – Candy Store – Giant” for Tuesday’s schedule. Instead of asking “what are we doing today?” she can look at her card and answer her question. Another important card is, “Mom is getting (whatever I forgot to bring downstairs that morning)”, so she doesn’t look around the kitchen 2 minutes after I’m gone and panic why she’s alone.
A common cognitive tool is a memory journal. Bryn Mawr tried introducing this strategy in early 2013 but it was much too early for Corey. At the time Corey could write but could not read any written word. When she began reading, she had no memory of what she read once she hit the period at the end of a sentence. As she progressed, she could write and read and tell you one word she might recall. When the therapist explained she could use a journal to remember daily activities, calendar events etc. and she could look up key facts to help her answer her common questions, Corey went into a rage as to why she had to do this at all!
I knew it was time to switch it up. How can we help Corey feel comfortable with this concept?
-We moved to “Retail Therapy”; reading magazines and circling what items she liked.
-Next step, re-introduction of the notebook concept. Once Corey found the items she liked, she would transfer the information to a notebook to “save” it.
-Next step, reading recipes and transfering the ingredients to a single page. Her focus was on gaining control of writing in a straight line and managing the size of the letters/words.
-Next step, I would stand at the refrigerator and dictate the items we needed to buy for the week as Corey wrote our shopping list. I would deliberately ask her to go back and “check me”…”did I tell you milk and eggs”? This was to break her concentration, redirect her thinking, re-read the list and respond to a directed question.
-Next step, we watch a TON of cooking shows. Caitlin and Corey began “jotting down” their favorite recipes. Corey was taking notes as the recipe was dictated live on the show.
-Next step – trying to increase ‘processing speed’.
We have been working with Dr. A, neuro-behavioral psychologist, since January. We have been trying multiple APP’s on the IPad, old-fashioned flashcards for words and math facts and verbal ques for guessing games to retrieve facts quickly. The computer apps are similar to the childhood game Concentration or Guess Who. The flashcards are basic math facts for addition, subtraction and multiplication, along with basic sight words not for re-teaching but for Beat The Clock…using easy, early-childhood memorized facts, timing how fast and how many you can call out in one minute. This has been more fun for Caitlin and Corey because of my responses. I get so excited being the announcer I call out 6+9…when the card actually says 6+3….Yup, I give the answer in the question. Needless to say, the girls laughter follows with Corey asking me “who has the brain injury mom”?
To highliight why people need a daily organizer (aka ME), we re-introduced the “day-timer journal” for Corey. It is a standard lined composition book. Corey picked out purple with white polka dots. We also bought a purple, blue and pink pen along with purple paper clips. On the top of the page, I write in capital letters the Day, Month, Date and Year. I will be writing what she ate for each meal, our schedule, along with anything she might want to ‘remember’ for later.
This morning, Corey woke up and asked me to “write down” something she wanted to remember for later. This is a HUGE request. She remembered to ask and she remembered there was a book to write in. I opened the book and wrote;
When I asked her what that was for, she told me she needed to look up recipes to add to her cookbook for the people that have allergies to those kinds of foods. She couldn’t name specific people, but she remembered friends of our family have those allergies.
Matter of Time…healing and recovering from a Traumatic Brain Injury has been compared to watching paint dry or watching the grass grow. Today’s request does not mean Corey will suddently and consistently recall her daily activities, and it doesn’t mean she will remember she asked to write something down nor remember there is a book holding the answers for her repeated questions. But it is progress! It’s a small step forward. It’s todays reason to NEVER GIVE UP AND NEVER GIVE IN, xoxo