Environmental adaptations

One of the simplest ways to help people with memory impairment is to arrange the environment so that they rely less on memory. Examples include using written labels or drawings for cupboards in the kitchen or bedroom as reminders of where things are kept; positioning objects so that they cannot be missed or forgotten (for instance tying a front-door key to a belt); or painting the toilet door a distinctive colour so that it is easier to find. Sometimes changing the wording of our questions or comments can reduce problems. For example, CW, a former musician, became very densely amnesic following encephalitis. He frequently thinks he has just woken up and says, 'This is the first time I've been awake. I don't remember you coming into this room but now I'm awake' (or words to that effect). Sympathizing with him, or offering explanations, seems to increase his agitation and causes escalation of the number of repetitions he makes about awakening. One partial solution is to distract him by introducing another topic of conversation or asking him a question about music. Such a ploy can also be viewed as an environmental adaptation, although in this case it is the verbal rather than the physical environment that is being modified.

For people with severe intellectual deficits, or progressive deterioration, or extremely dense amnesia, environmental adaptations may be the best we can offer to enable them and their families or carers to cope, and to reduce some of the frustration and confusion associated with their conditions.

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