Memory loss after stroke

Memory: It’s Complicated

By Jon Caswell

As with so many things involving the human brain, memory is complicated. There’s long-term memory and short-term; there’s skill memory, language-based memory and visuospatial memory. But the overarching issues of memory are storage and retrieval, and each can be affected by stroke.

It would be so convenient if there were a lobe in our brains for each of those, but there’s not — memory is diffuse. One brain component involved is the hippocampus, which is behind our ears in the region of the temporal lobe, deep within the center of the brain. “Think of that as a file drawer through which memories enter the memory system,” said clinical neuropsychologist Karen Postal, who teaches at Harvard Medical School and is president of the American Academy of Clinical Neuropsychology.

As anybody who has used a file cabinet knows, putting things in is easy, organizing them so they are easily retrievable is a different story. That job is accomplished by what is called the frontal executive network. “It’s not just the frontal lobe itself but how that lobe connects with other parts of the brain,” Postal said. For the purposes of understanding memory, think of this network as an executive secretary. A good executive secretary puts information into the file cabinet in an organized way.

If this executive network is affected by a stroke, memories may be getting in through the hippocampus but they are haphazardly organized. “Like kids just stuffing things in files,” Postal said. “The work of the executive system is so critical because if information is organized going into that file cabinet, then it’s going to be a lot easier to retrieve that information.”

“Memories are stored in multiple places in the brain,” said Alex Dromerick, a neurologist and rehabilitation physician at MedStar National Rehabilitation Network. “One of ways we think memories are stored is by strengthening and weakening the connections between neurons. The term for that is ‘long-term potentiation’ or LTP. LTP is a modulation of the connections in the brain, an upregulation or a downregulation.”

If that sounds complicated, it is, but that is only the start — “multiply that by tens of billions of neurons, each one of which has tens of thousands of connections with other cells,” Dromerick said. “Where do you begin to pull that apart and understand how it works?”

Short v Long

Dr. Karen Postal

Most of us know the labels short-term memory and long-term memory, and commonly think of short-term as from now to a week or two ago; long-term memory describes the past beyond that. Neuroscientists have a different concept of short-term, more like a half an hour. “Once something is in your brain for half an hour, it really has been encoded in a way that it’s likely to stay and be there days or weeks later,” Postal said.

“Short-term memory is something that’s over minutes to hours,” Dromerick said. “It’s remembering at 1 o’clock, what you had for lunch at noon. Long-term memory is things like remembering your birthday, what you did on the day you graduated from high school, your wedding day, those kinds of things. Both kinds of memory can be affected together or separately depending on the stroke. There is also prospective memory, where we have to remember something in the future, like remembering to go to a party later in the day at a particular time.”

“When neuropsychologists talk with patients about short-term memory, what we mean is ‘are you able to create new memories, or has that function gone away? Can you tell me what you had for breakfast this morning or dinner last night? That’s what clinicians mean with short-term memory — are you able to lay down new memories?” Postal said.

Dr. Alex Dromerick

It’s safe to say that all long-term memories were short-term memories first, but not all short-term memories turn into long-term memories. “You probably don’t remember what you had for lunch three months ago,” Dromerick said. “But if it’s a memory of an emotion, like anger or fear, that tends to go to an area of the brain called the amygdala. If it’s a memory of a motor skill — hitting a tennis ball, riding a bicycle — that tends to go into the basal ganglia.”

“In the clinical sense, what we mean by long-term memory, is the survivor able to access information from before the stroke?” Postal said. “In almost every case, a long-term memory problem is a problem with retrieval. It’s rare that long-term memories will genuinely be destroyed. For example, with Alzheimer’s disease, it’s very far into the dementia process where people start to lose those long-term memories. They are able to tell you about their work life and their family life and their childhood for years into the dementia process. When there’s devastation throughout the brain, eventually that goes away. But in stroke survivors that long-term memory problem is almost always a retrieval issue.”

Postal suggests that people often imagine our memory system as a video recorder where we just press record and then later press play, but that’s not how it works. Memories are not stored in discrete segments and neat paragraphs or even sequentially. “What happens when we need to retrieve a memory is that we reconstruct it, and we reconstruct it through association,” Postal said. “For example, you may not have thought about high school chemistry in decades, but if you see someone from that class at a reunion and start to talk about it, you will begin the process of reconstructing a more vivid memory. We know from courtroom research that these reconstructions can seem to be accurate but may not be. But we know that our memories are not stored as a single sequential video. We have to reconstruct memories.”

Memories are encoded in the brain and perhaps also the brainstem and spinal cord. The term ‘muscle memory’ is inaccurate as muscles don’t have the neurons that encode memories. “Skills that we learn through repetition, highly learned motor skills, once they become automatic, much of that seems to be in the basal ganglia,” Dromerick said.

The memory-loss masquerade

Although what appear to be memory deficits are not uncommon after stroke, other stroke deficits can masquerade as memory problems. “For people with stroke, what looks like memory loss can actually be something else,” Dromerick said. “Absolutely, you can have loss in short-term memory after a stroke, but you’ll also get that with aging. You also get it with side effects of blood pressure medicine, sleeping pills and other medicines. People who are hard of hearing or have trouble with vision may appear to have forgotten something when they never heard or saw it to begin with. People with stroke may have problems paying attention, especially early after stroke. It may be their medicines making them drowsy. Sleep apnea may leave them sleep deprived, which causes problems with attention and concentration. If you can’t pay attention, it’s very hard to encode any memories. All those things can look like memory loss, especially to family members, but actually, the underlying process is quite different. The good news is that these causes of apparent memory loss can be treated.”

Family members may mistake a survivor’s inability to recall the names of things as memory loss. “This is called anomic aphasia or anomia, but it isn’t memory loss,” Dromerick said. “It’s a matter of summoning the memory. It’s a problem with language. Forgetting is losing memory, but in the case of anomia, the name is still stored in there. It’s a matter of bringing up that word, but it’s not a memory loss.”

In relation to skill memory, other conditions affecting other systems may be imitating a loss of memory. “Let’s say somebody had a stroke and they can’t play the piano anymore or they have trouble playing,” Dromerick said. “It could be that they have lost the motor control to move their fingers in the right way. Or that they’ve lost the sensation to know where their fingers are and which key it is that their finger is on. It’s possible they have apraxia and can’t organize the movement of their fingers up and down. Maybe they can’t generate the right pattern to play the keys in the right order. Or it could be that they’ve just forgotten the melody. In which case, finally, we’ve gotten to something that relates to memory. Actually, it turns out to be more complicated because there are all these different things going on. As you begin to pull them apart, it may be that memory doesn’t play a role at all. It may have to do with some other cognitive, sensory or motor function or a combination.”

What helps

Let’s get the bad news out of the way first — if the problem really is memory loss, there is currently neither drug nor therapy that will fix that. There are memory meds for Alzheimer’s patients, but they do not appear to be very effective for stroke survivors. Some computer games promote themselves as memory improvers, but so far, studies show that all they seem to do is improve a player’s ability in that game. The improvement does not generalize to other areas of life. Though there is no treatment for memory loss, there are ways to compensate (see “Short-term memory tools”).

There is good news as well. “Aerobic exercise does wonders for the memory system,” Postal said. “When we exercise three things happen that help memory. First, exercise triggers new brain cell growth. Brain cells are born every time we engage in aerobic exercise. They may be born in various parts of the brain, but we know for sure that they’re born in the hippocampus, the very part of the brain that allows new memories to be formed.”

Second, aerobic exercise stimulates our executive secretary. “That frontal lobe and its connections with other parts of the brain starts working faster, better, stronger,” Postal said. “After we exercise we are better able to organize information to store new memories. Plus, the executive system is responsible for focus and concentration and resisting distractions.”

Third, aerobic exercise releases brain-derived neurotrophic factor (BDNF). “BDNF helps repair cells that are damaged and helps strengthen connections between the synapses of the nerve cells,” Postal said. “When you release BDNF, you’re helping with cell repair but you’re also helping to consolidate memories.”

Of course, after you’ve had a stroke, there is a huge emphasis on preventing another one, and that means taking care of your cardiovascular system — eat a heart-healthy diet, get regular aerobic exercise, reduce stress and stop smoking. “For the benefit of your heart, your brain and your memory, the last thing you want is to be sedentary,” Postal said. “I always recommend that my patients work with their physical therapist to figure out a way to get aerobic exercise.”

Dromerick agrees that exercise benefits memory and points to another practice that aids memory — adequate sleep. “There’s something called ‘consolidation,’ where as time passes, or particularly as you sleep, your memories become refined and more long-term,” he said. “Actually, researchers are looking at using sleep to increase the effectiveness of stroke rehabilitation, because sleep and rest periods may be important for people trying to learn new skills.”

In the past decade, there has been growing interest in transcranial direct current stimulation (TDCS) and transcranial magnetic stimulation (TMS), but both experts agree that the jury is still out on their effectiveness for helping memory.

Finally, Dromerick’s insight that not all of what looks like memory loss is memory loss means there is more good news for survivors. “The hardest thing to treat is memory loss, but these other conditions that imitate memory loss, that can be treated,” he said. “So, problems with sleep, medications, depression or with hearing or vision — those things can be treated and improve.”

See our profile on survivor Kelli Smith, who experiences rare challenges with both long- and short-term memory>

The Stroke Connection team knows that it can sometimes be hard to understand how profoundly post-stroke memory issues may be impacting a survivor. Sometimes, apparent memory problems may be due to something else. We’ve created a quick-reference sheet that you can use to talk with your healthcare provider and others.

This information is provided as a resource to our readers. The tips, products or resources listed or linked to have not been reviewed or endorsed by the American Stroke Association.

Thinking & Memory After Stroke

Henry Hoffman
Tuesday, September 5th, 2017

CognitionLife After StrokeMotivation

Whether you’re awake or asleep, your brain is continuously active. Vast amounts of information—thoughts, moments, feelings, etc.—are sent to your brain, where they are filtered and stored, and it’s important for your brain to be working properly in order to place them in the right spots.

After surviving a stroke, there is a possibility that some of the brain’s vital functions could be damaged, which makes its processes more difficult to carry out, potentially causing harmful issues for the patient. In many stroke cases, issues with thinking and memory are likely to occur, but there are ways to rebuild brain power and regain a healthy lifestyle over time.

Common Problems After a Stroke

Due to physical trauma to the brain, it’s common to experience a variety of issues. Daily actions, like executing a simple task or reacting to external situations, can become difficult to navigate. These kinds of challenges may include watching a television show, reading a book, following through with a task from start to finish, remembering what others have just told you, troubles with directions, executing simple instructions, and even cooking for yourself. If these don’t sound cumbersome enough, along with a slew of physical hurdles lies a deeper obstacle of impaired cognition.
Continue reading our previous post Most Common Questions Answered for more common stroke recovery questions & answers.

Cognitive Problems After a Stroke

Impairments dealing with cognition refer to mental actions and operations that the brain cannot fully sort out. Basically, there is a lack of communication when it comes to gaining information and understanding through vital pathways—thoughts, experiences, and the senses. Because of this, a stroke survivor can possibly mimic symptoms of someone who has dementia or memory loss.

Depending on which side of the brain is most affected by a stroke, different symptoms can occur. For example, someone with a right-brain stroke can exhibit complications with problem solving. In addition, they may confuse information or muddle up the order of details of an event. For those who are left-brain impacted, there may be a significant change to their short-term memory. In this case, a survivor may have a hard time learning new things and will most likely have to be reminded of something many times. That being said, there are ways to help improve cognitive abilities with patience and repetition, and it all starts with rebuilding memory.

Memory Loss After a Stroke

Not only is it common for stroke survivors, but memory loss can be an issue for anyone. Factors like old age and physical accidents can contribute to its deterioration, so understanding its processes can provide a better scope of what to expect.

Types of memory loss may include:

  • Difficulty speaking and understanding language
  • Visual confusion with faces, objects, and directions
  • Trouble with new information and tasks
  • Inability to think clearly

Although these issues may seem challenging, keep in mind that one’s memory has the capability to heal itself over time with the help of mental exercises. Daily routines of mental stimulation may aid in rebuilding awareness and focus, and the best part is that these activities can be enjoyable. There are ways to incorporate a variety of exercises into your life that can make a big difference towards a healthy recovery. Remember, memory symptoms have the potential to last for years, so it’s unlikely that progress will be made overnight, but consistency can set the pace for improvement.

Something else to keep in mind is that techniques for improving after memory loss are considered experimental. In most stroke cases, treatments are designed to help prevent further damage, so if you or a loved one feel like treatments aren’t working, consult with your doctor about taking medications that may assist in rehabilitation.

Ways to Stimulate the Brain

The good news is that there are many options to increase your brain power, and they are all useful in more ways than one! For instance, taking up a new hobby that involves both the mind and body is a great way to work your brain muscles. In addition, performing various physical movements shows a huge correlation with growth in mental and physical strength. Along with these methods, great improvements of mental health can be made by following a routine. Simple tasks like writing things down, designating certain spots for items, and overall repetition provide stability and reassurance.

Apps

Rather than focusing all your attention on classic methods of brain stimulation, try technology; it can be an immediate and fun way to see results. On a smartphone or tablet you’ll find countless apps available that can help improve memory and speech, set reminders for medications and appointments, and help manage other illnesses or issues that you may have. With today’s growing technology, apps are both widely accessible and easy to use, giving you freedom to develop your own regiment of “app rehab.”

Here are some of our favorite apps to try out:

What’s the Difference?

In this game, two pictures will appear on the screen, and it’s your job to use your finger and circle any differences you spot on the image below compared to the image above. As you move from one level to the next, the differences will be harder to find! This game will improve your awareness and perception skills with every round.

Thinking Time Pro

Designed by Harvard and UC Berkeley neuroscientists, this app uses four different scientific games to enhance your memory, attention, reasoning, and overall cognitive skills. The best part about this app is that you can set the difficulty level to move at your own pace.

Fit Brains Trainer

Ranked as one of the best educational apps in the world, Fit Brains Trainer stimulates your cognitive and emotional intelligence through a variety of brain games, workout sessions, and personalized status reports based on your performance.

Eidetic

For the ultimate boost in memorization, Eidetic utilizes a technique known as “spaced repetition” to aid you in memorizing loads of information. Whether you want to remember someone’s phone number or a recipe you just found online, this app will do the trick.

Support Leads to Progress

If you or a loved one is suffering from issues pertaining to thinking and memory, know that there are treatments out there to make improvements. With patience and understanding, a stroke survivor can eventually reach a level of fulfillment in life, but it’s difficult to get there alone. More than anything, a survivor will need encouragement in order to believe that progress can be made. With the support of friends and family, and help from various exercises and technologies, development is certainly possible.

All content provided on this blog is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. If you think you may have a medical emergency, call your doctor or 911 immediately. Reliance on any information provided by the Saebo website is solely at your own risk.

Symptoms of memory loss due to a transient ischemic attack are often temporary and vary depending on the area of the brain affected.

Short-term memory loss is the most common form of memory loss due to a TIA. Patients experiencing short-term memory loss will have vivid memories from long ago, but will have difficulty remembering the events of the present day.

Symptoms of memory loss include:

  • Confusion
  • Difficulty paying attention and concentrating
  • Difficulty organizing thoughts or actions
  • Difficulty deciding what to do next
  • Depression
  • Difficulty speaking
  • Difficulty understanding speech

Causes and Risk Factors

Patients at risk of experiencing a transient ischemic attack are at a higher risk of developing memory loss due to a TIA. Risk factors for experiencing a TIA include:

  • Narrowing of the arteries, usually caused by atherosclerosis. This is when fatty material builds up and hardens on an artery wall. This material can break off and get lodged in smaller blood vessels in the brain.
  • Cerebral artery stenosis
  • Spasms in the walls of the arteries
  • High blood pressure
  • A lack of oxygen in the blood flowing to the brain, which can occur when a person is severely anemic, has carbon monoxide poisoning or has leukemia or polycythemia, a condition that produces abnormal blood cells and clotting

9 Best Cognitive Exercises for Stroke Patients

These cognitive exercises for stroke patients can help improve memory and problem-solving skills.

While extra emphasis is often placed on physical recovery after stroke, cognitive recovery is also important.

Today we’ll share 9 amazing cognitive exercises for stroke patients that will help sharpen your mind.

Let’s start with a quick explanation of why these exercises are so important.

How to Improve Memory and Thinking with Cognitive Exercises for Stroke Patients

Cognitive exercises help sharpen your memory and thinking by activating neuroplasticity.

After stroke, the brain is capable of rewiring itself so that healthy parts of the brain “pick up the slack” from the damage.

This happens through mental rewiring, where the brain forms new neural pathways to strengthen skills that you practice frequently.

The more you practice these cognitive exercises, the more your memory and thinking will improve.

You get better through practice!

Now, let’s dig into the best cognitive exercises for stroke patients.

Bonus: . (Link will open a pop-up that will not interrupt your reading.)

Cognitive Training Apps and Software

1. Lumosity

Lumosity is a cognitive training app that contains over 60+ cognitive exercises.

The app helps strengthen your brain’s cognitive skills through entertaining games that won’t let you get bored.

2. CT Speech and Cognitive Therapy App

The CT App is specifically designed for stroke survivors. It contains 100,000+ language and cognitive exercises to help you rewire your brain after stroke!

3. Tactus Therapy

Tacuts Therapy is also designed for stroke survivors, which extra emphasis on aphasia.

Although it’s mostly used for improving speech after stroke, the exercises also help improve cognitive function.

Try Tactus Therapy here.

4. Aura

Aura is a meditation app that we recommend because meditation is seriously good for stroke recovery!

Meditation has been shown to help improve attention, mental flexibility, and information processing, which are all important cognitive skills.

We love Aura because it gives you a different guided meditation every day, which can help prevent the habit from getting stale.

Cognitive Training Activities

5. Board Games

If you have any simple board games lying around the house, like checkers or Connect Four, they could serve as excellent cognitive training.

Although these games are simple, they help stimulate the brain’s problem-solving skills.

Games for the Brain has an abundance of online games for you to try.

6. Puzzles

“Brain teaser” games like Sudoku, word searches, and crossword puzzles are excellent cognitive training games for stroke survivors.

They can be quite challenging – sometimes even frustrating – but know that you will get better at them with practice.

So even if you can only finish a little bit each time, just keep practicing. You will get better with practice.

Cognitive Boosts for Stroke Patients

7. Speech Therapy with an SLP

Speech therapy often incorporates cognitive training to help strengthen communication.

A speech-language pathologist (SLP) can help you improve language difficulties after stroke.

Although their primary focus is communication, they will also help with cognitive training because it’s closely tied with speech.

8. Music Therapy

Did you know that music therapy helps improve cognitive function and attention span after stroke?

This is because music engages different areas of the brain, which gives your brain a little workout.

And best of all, you can just press play, sit back, and relax to experience these benefits.

9. Painting and Creative Therapy

Did you know that the right side of your brain is associated with creativity, while the left side of your brain is more analytical?

When you participate in creative activities, you engage the creative part of your brain. And when those activities involve your fine motor skills, like painting and pottery, it engages many different parts of your brain.

That’s why some stroke survivors experience major cognitive improvement from “mindless” creative tasks like painting.

Because it’s actually not mindless at all!

Get Your Cognitive Training Going!

Those are the best cognitive exercises for stroke patients.

Choose the activity that appeals to you the most because staying engaged is key to long-term success.

The more you practice your cognitive exercises, the more your memory and thinking will improve.

What other cognitive training games do you like? Share your ideas with our community in the comments below!

The 10 best apps for stroke survivors

Following a stroke, the body needs time to heal, and recovery time depends on the symptoms and severity of the stroke. We have identified the best apps to help stroke survivors with their recovery and rehabilitation.

Share on PinterestSmartphone apps can assist with stroke recovery and rehabilitation.

More than 795,000 individuals in the United States have a stroke each year, and around 140,000 of these people die from stroke.

Ischemic strokes — wherein “blood flow to the brain is blocked” — account for roughly 87 percent of all strokes.

Stroke can cause significant injury to the brain that may result in many long-term problems.

For example, communication, concentration, memory, and executive function, as well as spatial awareness, are all cognitive functions that may be impacted by stroke.

Stroke can also trigger mental health issues such as anxiety and depression, as well as movement and coordination problems, paralysis, difficulties swallowing, visual impairment, and urinary incontinence and loss of bowel control.

The faster a person is treated after stroke, the more likely they are to recover from it. Surveys have shown that people who “arrived at the emergency room within 3 hours” of their first symptoms of stroke had “less disability” 3 months later than those who were treated later.

While some people recover quickly from stroke, others may need long-term support. Apps are available to help aid the stroke recovery process. They can help you or your loved one to track appointments and medications, provide language therapy, train the brain, and even lower some risk factors for future strokes.

Medical News Today have selected the top 10 apps to assist with stroke recovery.

Cozi

Android: Free

iPhone: Free

Cozi is a family organizer designed to keep track of multiple schedules. The app can help caregivers to manage their schedules and is ideal if the person recovering from a stroke has several caregivers.

Keep track of schedules with a shared color-coded calendar and set reminders for yourself or other family members so that medical appointments and medications are not missed.

Shopping and to-do lists can also be shared with everyone in the family to ensure that you have everything you need from the grocery store. All items added to lists are viewable instantly in real-time.

Medisafe

Android: Free

iPhone: Free

Medisafe is the must-have pill reminder that makes sure that you never miss a dose of your medication or mistakenly double up due to not tracking your medications ever again.

According to the app, mistakes with medicine use and dosage tracking result in 50 percent of individuals not taking medication as prescribed, 700,000 hospital visits, 125,000 deaths each year, and 44 in every 100 prescriptions not being collected from the pharmacy.

Whether you are taking one drug dose or multiple doses each day, it can be challenging to remember to take the right pill at the right time. Medisafe takes the stress out of having to remember if you or your loved one took their medications correctly.

Stop, Breathe & Think

Android: Free

iPhone: Free

Research has shown that increased activity in a brain region called the amygdala, which is involved in stress, is tied to a greater risk of stroke. Therefore, reducing stress while in recovery from stroke could reduce the risk of future strokes.

Stop, Breathe & Think is a meditation and mindfulness app that helps to decrease stress and anxiety. The app provides guided meditations, breathing exercises, and yoga and acupressure videos to help you check in with your emotions.

Stop, Breathe & Think says that taking a few minutes every day to feel calm is just as important as getting frequent exercise and will reduce stress and promote peace of mind.

7 Minute Workout Challenge

Android: $2.99

iPhone: $2.99

Working out three to five times per week reduces the likelihood of recurrent stroke by fivefold, according to a study published in the journal Neurology.

If you are unsure of how to start an exercise routine after stroke, the 7 Minute Workout Challenge app could be the perfect app for you. The 7-minute workout is a research-backed exercise program that has become a hit internationally.

Scientists have put together 12 exercises to perform for 30 seconds each with a rest period of 10 seconds in-between. The exercise sequences are easy to do, require no equipment, and can be done anywhere.

Language Therapy 4-in-1

Android: $59.99

iPhone: $59.99

After stroke, it is common to experience a condition called aphasia, which affects your ability to understand what people are saying, find the right words, and read and write. Aphasia is often a symptom of the brain damage caused by stroke.

Language Therapy 4-in-1 is a scientifically proven speech therapy app that aims to improve speaking, listening, reading, and writing in those with aphasia. Get started by giving their free version, Language Therapy Lite, a try today.

Research led by the University of Cambridge in the United Kingdom found that using the app for 20 minutes each day for 4 weeks showed improvements in all study participants with chronic aphasia.

Constant Therapy

Android: Free trial

iPhone: Free trial

Constant Therapy is a cognitive and speech therapy app designed for individuals who are recovering from stroke, brain injury, and aphasia. The app is free for 15 days and then offers users the chance to continue with a monthly or annual subscription.

With more than 65 task categories, 100,000 exercises, and 10 levels of difficulty, Constant Therapy can help to improve cognition, memory, speech, language, reading, and comprehension skills.

Constant Therapy was developed by scientists at Boston University in Massachusetts and is recommended by neurologists, speech language pathologists, and occupational therapists. Research published in the journal Frontiers in Human Neuroscience showed a significant improvement in standardized tests for stroke survivors after using Constant Therapy.

VocalEyes AI

iPhone: Free

Stroke can sometimes cause damage to brain areas that receive, process, and interpret information sent from the eyes. This damage may result in losing part of your field of vision or causing double vision.

VocalEyes is computer vision for the visually impaired. The app uses machine learning to help people with vision problems identify objects in their everyday lives. Take a photo, and the app will tell you what the camera sees.

VocalEyes’s audio response describes scenes and environments, identifies objects, label logos, and brands, reads text, detects faces, classifies emotions, recognizes ages, and distinguishes currency denominations.

Glasses

iPhone: Free

Glasses is a digital magnifier and mirror that can help you to view fine print and objects with up to 12x magnification.

If your vision is impaired after stroke or you have simply forgotten your glasses, the app can zoom in on labels and nutritional information in a grocery store and menus in dark restaurants as well as help you see how much to pay on the bill after eating out.

Glasses is simple to use. Double tapping quickly zooms in or out by 6x, while swiping uses a slow and continuous zoom method. If you have shaky hands, you can tap and hold to freeze the image on screen.

Elevate

Android: Free

iPhone: Free

If you are experiencing cognitive function problems after stroke, brain-training apps provide a platform to exercise and improve the areas of the brain involved in concentration, memory, planning, reason, and problem-solving.

Elevate is a brain-training app that is designed to enhance speaking abilities, processing speed, focus, and memory. Elevate provides a personalized training program that adapts in difficulty over time to ensure you are always challenged.

Elevate features more than 40 games aimed at improving your skills, plus a workout calendar that tracks your streaks to keep you motivated. Users who train with Elevate at least three times each week have reported considerable gains in abilities and increased confidence.

Peak

Android: Free

iPhone: Free

The Peak app includes 40 unique brain-training games developed by neuroscientists to challenge and build your cognitive skills.

Peak features a personal brain trainer, known as Coach, who selects the perfect workouts for you at the correct time. Choose your training exercises from Coach’s recommendations to challenge yourself and stay motivated by tracking your progress with in-depth insights.

Free games challenge your attention, memory, problem-solving skills, mental agility, coordination, emotional control, language, and creativity. Upgrade to Pro for additional features.

8 Ways to Get Your Memory Back After Stroke

Bob Mandell, now 71, who had a hemorrhagic stroke in 1996, credits various types of therapy, including speech therapy, with getting his memory back. Right after his stroke, Mandell of Naples, Florida, couldn’t get three words out and his memory loss was frustrating. But his determination to recover worked in his favor, and he believes others can do the same. “I worked really hard at therapy,” he says. He wrote about his recovery in the book Stroke Victor. “I did what psychologists called engaged therapy. I went all in, and that jarred my memory and my mind.”

3. Post reminders for yourself. Leave notes in key areas, such as a sign in the bathroom reminding you to brush your teeth, says Stephen Page, OTR/L, PhD, an occupational therapist and associate professor at the School of Health and Rehabilitation Sciences at The Ohio State University College of Medicine in Columbus. Use the alarm on your smartphone or even an old-school clock to remind yourself of appointments and when to take your medications, Page adds. Once you form a routine, it will help you re-establish your memory. Meyers agrees that in her work with patients as a therapist, “creating a routine that is repetitive and consistent can help.”

4. Make up mnemonics. Mnemonics are creative ways to remember things. They often take the form of an acronym, like the popular RICE: rest, ice, compression, and elevation — a shortcut to remember how to treat a sprain. You might make up your own mnemonic for the steps to cook a familiar meal, Page suggests. Rhymes also work, that associate a name with an object, like: “Shirley is the woman with curly hair.”

5. Get organized. Making it easy to see items you need for daily activities will help you remember what you need to do and when to do it, Meyers says. For example, lay out your clothes for the morning before you go to bed at night. Put your toothbrush on the sink where you’re sure to see it.

6. Repeat and rehearse. When you’re given new information, repeat it to yourself several times, the American Stroke Association recommends. Go over the material as many times as you need for it to sink in. Don’t be afraid to repeat back, in your own words, what you’re told to be sure you understand it correctly. If you have to make a presentation or give a speech, break up the material into smaller segments. These will be easier to remember.

7. Stay active. Get out of bed and move as much as possible, Kaisler-Meza says. A six-month exercise training program for patients promoted not only memory but also attention and conflict resolution in a small study of stroke survivors. And aerobic exercise promotes the recovery of brain function after a stroke, according to a study done on animals and published in the International Neurourology Journal.

Mandell, who was paralyzed on his right side after his stroke, believes exercise helped him regain his memory. “I always feel better after exercising,” he says. Exercise helps relieve stress and stress relief is important to brain health, he adds, noting that he tries to exercise almost every day.

RELATED: The Best Diet to Prevent Stroke

8. Feed your brain. A brain-healthy diet includes lots of fresh fruits and vegetables and fish rich in omega-3 fatty acids, according to the American Stroke Association. Eating this way will help your brain recover optimally, Kaisler-Meza says.

A healthy diet and smaller portions helped Mandell lose the 30 pounds of excess weight he was carrying when he had his stroke. He believes that helped his mental recovery. He felt better, and feeling better improved his mental outlook.

For the majority of stroke patients, the road to recovery is a long one that includes many hours of therapy aimed at restoring both physical strength and language capacity. People who suffer a serious stroke may lose the ability to coordinate muscles and execute complex movements.

They can have trouble performing routine tasks including bathing, dressing and feeding themselves. Some will experience numbness or lose feeling in their limbs. Many will have difficulty understanding and producing language. While it is not always possible to recover completely from a stroke, with the right treatment plan quality of life can be improved.

According to the National Stroke Association, strokes are one of the top causes of long-term disability in adults. Damage can be irreversible and recovery may be affected by depression. This makes choosing the right treatment activities essential.

Keep in mind that every case is unique and no two stroke victims will need exactly the same type of therapy. Family and friends can provide emotional support and help reinforce coping strategies while specialized therapists will be able to suggest a recovery programme, including tools and resources to try.

It’s important to remember that a stroke patient may be struggling with impairments but also grieving the loss of their former life, including their job, routine and independence. That’s why starting a recovery plan is key, even if progress isn’t immediately apparent.

Sticking to the programme over an extended period of time can bring about a change in attitude. It’s particularly useful to participate in activities that are both therapeutic and fun, to help stroke victims rebuild confidence and improve self-esteem.

What is a stroke?

Strokes are caused when blood supply to an area of the brain is cut off because of a clot or blood vessel that bursts. This results in the affected part of the brain not getting the oxygen it needs to function.

Depending on the severity and location of the blockage, as well as how long it lasts, a stroke can result in damage that impacts on physical and mental abilities – including language use and processing which may have short or long term consequences.

Common symptoms include: difficulty speaking and understanding language that was previously familiar and fluent, a left or right side weakness or paralysis including of facial muscles, numbness, muscle coordination and shaking and balance issues that make it hard to hold a pen or pencil or to move around, blurred vision which interrupts reading and causes seeing double (making it virtually impossible to look at certain kinds of screens), and slurred words and missing vocabulary that needs to be retrieved.

Note that while words become hard to reach, meaning is often still accessible which can result in a degree of frustration for stroke patients who know what they want to say but are unable to express themselves. It’s been described as a filing cabinet that has fallen over. The words are still there, but it can be difficult to find them and pull them out of the jumble.

Learn more in this article on communication and language ability after a stroke.

Recovery activities for stroke patients

In addition to direct therapy at medical and rehabilitation centres, patients should beware of becoming isolated and try to engage in a handful of home-based and social activities throughout the week.

  1. Get some exercise. Exercise in any form is important for rehabilitation. The coordination of movements brings about positive emotions thanks to endorphins. Even swaying side-to-side or rocking mobile parts of the body helps increase blood flow and is likely to make patients feel better.

  2. Make art. The brain is a muscle and when its language centres are down you can stimulate it through colour, texture and movement. If the fine motor skills required to hold a paintbrush are lacking, rethink your approach to art. Just arranging objects into collages and patterns or drawing in the sand with fingertips can be helpful.

  3. Learn something new. You don’t have to go back to school, it might be you pick up a hobby like gardening or bird watching. You may also want to acquire a new skill—particularly one that helps with language recovery, such as practicing sign language or typing. Stimulating new areas of the brain gets things moving.

  4. Satisfy your senses. Learning is enhanced through multi-sensory approaches in which you hear, see and feel material at the same time. Go to a greenhouse and smell the flowers, visit a museum or get a neck and shoulder massage. All of these activities stimulate your sensory systems.

  5. Turn up the music. Hearing a rhythm can improve the attitude and outlook of stroke patients. It’s also a great way to maximise the potential for re-learning coordinated movements and to work on balance. Express yourself in whatever way is possible, whether it be through syncopated tapping and conducting to the radio, or even just deep breathing in time to the music. Language and music are stored in different areas of the brain and someone who struggles with the spoken word may have no difficulty with singing a song. Singing is good exercise.

  6. Try touch-typing. When writing by hand is too hard and speaking ability is inhibited, it can sometimes be easier to type messages on a computer or tablet. That’s because keyboarding trains muscle memory in the fingers to remember the spelling and help with word recovery. Repetitive drills reinforce learning and it is particularly helpful when the approach taken is multi-sensory – such as with Touch-type Read and Spell.

    Learn more

  7. Engage your brain. Do some mental heavy lifting and try puzzles, audio books or even routine activities, such as making to-do lists. The idea is to work your reasoning, comprehension and problem solving skills. Meditation and clearing your mind afterwards can be a great way to wrap this type of activity up.

More tips

If you are putting together a plan for someone else, be creative as you consider the patient’s former hobbies and interests. As one illustrative example, a keen gardener may well appreciate a raised bed or bench that can be tended from a wheelchair. You may have to replace terra cotta pots with plastic ones so they are easier to lift and help with writing plant labels. Small tools with bigger handles are also a good idea.

Activities will vary greatly depending on the impact of the stroke and the patient’s recovery needs. Be aware that interacting with people is stressful and exhausting due to the communication required. Sometimes the stroke survivor just can’t keep up, and friendships may drift away.

People who have had a stroke and their carers can find great support in the company of others who’ve been there too. You may consider joining a local stroke support group. Being with others in the same boat can be both comforting and stimulating. In a context like this, group speech therapy sessions often prove popular and effective. Additionally, you can always suggest solo walks or encourage the person to sit outside to observe nature as part of a recovery plan that focuses on mindfulness.

TTRS as a resource

If you’re a therapist who works with stroke victims you’re probably aware of different solutions and online programmes that can be used for language recovery.

Touch-type Read and Spell is a multi-sensory keyboarding programme in which individuals hear letters and words, see them on the screen and then practice typing the correct keys. It focuses on repetition, sound-letter mapping and short spurts of multi-sensory activity and is ideal for those who may tire easily and need to take frequent breaks.

Individual modules can be repeated as often as necessary and the course provides plenty of feedback at each step, to enhance motivation and gradually build confidence and self-esteem for users. If you are a therapist you can help a person who’s had a stroke by working through the course with him or her at weekly sessions. Patients can then continue daily use of the course on their own, to reinforce learning.

Learn more

Do you have any activities to add? Join the discussion in the comments!

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