multitasking and stroke rehab

 This was from petitep from DailyStrength.
It was so good it needed  to be passed on.
http://www.dailystrength.org/c/Stroke/forum/680277-improving-shortterm-memory
I started typing this as a reply to someone in another topic area and later thought it would be good to have it's own topic...
It was in reference to someone having short-term memory issues and being denied speech therapy..
Here are a few things I learned in speech therapy and now I'm good to go unless it's in a conference or (too much information too fast - needing more time to process) situation where I don't have one on one interaction with someone.
The reason he forgets quickly is because he's trying to multi-task. Us frontal lobe stroke people have short term memory issues and we cannot multi-task in it's simpliest forms...
Speech will teach him NOT to multi-task in it's simpliest forms. Such as "thinking of other things while hearing something else. Prior to my speech therapy, I couldn't hear and watch the therapist type at the same time she wanted me talk, ( I couldn't complete a sentence thought process or could retain the information she was asking long enough for a complete sentence to be said) because in it's simplist form it's multi-tasking. The distractions of doing more than one thing at once is too hard. (seeing thinking, hearing background sound or whatever it may be is all one more task at hand and short term memory people can't multi-task) Bring it down to the simplist forms..
When there is background sound or other things happening we go into "overload status" really fast, or multi-tasking when getting ready to walk out the door for instance, or coming in with groceries etc...)
When ALL is quiet, no surrounding sounds in the house or distractions. Have him stare you in the face when you are giving him instructions an instructions as long as it's not a long sentence (start with repeating simple words... and say three words, (apple, juice, flower) then four and five words- find out where his ceiling is = at the moment) or something you want him to remember in 1 minute. But get his UNDIVIDED attention, you cannot do this otherwise, we stroke people are like ADD people, we will forget if you don't have our undivided attention)
Then start saying... (I put the keys in the dish = let him put the keys there = he will remember it better then, always putting it in one spot) Start off with having him remember something in 15 second increments, 20 second, 1 minute, and so on... If he can retain it keep increasing the time, and going back to the same group of words until he's mastered it... then introduce one more thing (see below) or do something else and keep going back to the same words... (apple juice and flower work up to as far as he can get... 30 minutes or an hour is ideal. THEN he has learned to put it into his LONG TERM memory, by repeating it or knowing he has to remember it that far down the road... 30 minutes is a long time.
IF he does NOT retain it, the first time you ask him, at the 15 second mark, ask him "what other thoughts were in his mind when you said... a,b,c He will probably not even know because he's not aware, but you have to be aware of it... EVEN if it's a simple glance away (and not looking at you in the eyes) and he glanced past your shoulder to see something on the wall... He will NOT retain the information you are asking him at that exact moment. That little "glance was considered MULTI-TASKING when he was suppose to be paying attention to you.
For that half second (during this time he will not retain anything - then with the last half of a sentence if you're talking to him he is trying to figure out what he lost and he'll just go into "overload status" and will get lost and not have a clue of whats said.. trying to play "catch up"
You have to clue and zone in on him... even if his eyes move the slightest and not starting to pay attention... even if he's internally thinking of something else that was happening prior to you asking him and he thought of that while you're talking. (Such as if the baby needed something or if he came in from kitchen and he tried to hear if the faucet is running... Again, all of this is considered multi-tasking".
You're trying to increase his attention span and reteach him how to listen. He needs to learn to "clear his head" completely of ALL thoughts, stare at you and concentrate at what you are saying, no glancing away or looking out a window. My speech therapist pounded on me everytime I did something without me even realizing I was doing it. You have to make him aware that he's even doing it, once he has that, he'll start doing it on his own.
It may take many many times of practicing this... IF he can accomplish that, and remember.... He is then on his way of getting a better short term memory.
You have to "re-train his brain" how to receive incoming information. If someone is talking, he has to learn how to STOP everything and listen iwth NO outside influnces. Same goes for putting his keys down. nothing else counts, when he places his keys he has to clear his head.
After the 3 words or three numbers, you can progress into sentences or "where did you just put the keys? after he just placed them there.
He has to LOOK, STARE and CONCENTRATE and REPEAT in his mind "I'm PLACING THESE KEYS HERE" or I'm keeping them in my hand until I place them here" Putting his keys in the SAME PLACE each time. It is only then he will start remembering. Do this exercise with him in 1, 5, 10 and 30 minute increments... He probably has the memory to do it in 30 second increments, (if he doesn't do the same as above, what were you thinking, because he wasn't concentrating on this solely if he doesn't remember 15 seconds after he placed them) you will need to practice this consistently and see if they work. Do it for him, remind him he's doing it then reinforce it by you asking him, then he has to reinforce it by him telling you.
I was also having issues when it went past 2 minutes, when she asked, "tell me what time it is in 1 minute, we stroke (right side) don't have a perception of time and distance... we don't know if 2 minutes or 10 minutes has passed or 30 and 45 minutes... or... (miss by a half or quarter inch when pushing a shopping car and we'll push it right into the door jam)
If he can progress and tell you when 30 seonds has passed, that means he has remembered in 1 or 3 or 5 minute increments or... IF he does not remember you need to bring that to his attention so he can start remembering on his own...
I hope this has helped... Let me know how it works out or if anybody has anything to add or to make additional comments.