Calendars, Timers, and Memory Books: External Memory Aid Tools for Mild Cognitive Impairment & Dementia

Do you ever experience the frustration of walking into a room and forgetting why you went in there? What about leaving the house unsure if you turned the oven off? Are you finding that your mom or dad is having trouble remembering which day they made that doctor’s appointment? These moments of forgetfulness happen to all of us at some point. However, for some, they happen constantly and begin to affect one’s ability to live, or manage daily tasks independently.

Understanding Mild Cognitive Impairment and Dementia

Many of us are familiar with or know someone who has been affected by dementia, a clinical syndrome marked by cognitive decline, most often caused by Alzheimer’s disease (Hopper et al., 2013). Although less widely known, there is a stage that can occur before dementia known as Mild Cognitive Impairment (MCI).

MCI refers to the stage when there is evidence of cognitive decline, yet, unlike dementia, it

has not impacted one’s ability to be independent (American Psychiatric Association, 2013). Within the realm of MCI, there are different trajectories that can occur. Many individuals with MCI will progress to developing dementia; however, other individuals with MCI have the potential to remain at their current cognitive level or even return back to their prior cognitive level (Smith & Bondi, 2013).

Insight Speech and Swallowing Therapy provided comprehensive evaluation for memory changes.

For this reason, early intervention can be critical. At this stage, individuals may notice struggles in completing tasks they have always done independently including managing finances, remembering doctors appointments, or taking their medications. In order to compensate for these changes, tools including external memory aids may be implemented. These are resources we use daily in our lives without realizing it including calendars, and planners. External memory aids allow us to reduce the cognitive load placed on our brains by identifying alternative ways to process and recall information.  

Role of Speech-Language Pathologists in Memory Treatment

Speech language pathologists are trained in assessing and treating individuals with cognitive-communication disorders including MCI and dementia. Non-pharmological approaches, including external memory aids, can be trained in speech therapy. At Insight Speech and Swallowing, we can work with individuals struggling with their memory to identify strategies and aids that would improve their ability to recall information, and increase participation in daily functions.  

What is an External Memory Aid?

An external memory aid is a broad term used to refer to tools that compensate for memory impairments. These include a variety of objects including calendars, planners, timers, alarms, medication management systems, memory books, and more. These approaches focus on compensation, rather than restoration, through strategies to overcome the impact of cognitive decline on daily life. Many of us have used external memory aids at some point in our lives, however, it is essential to learn how to use them consistently to successfully compensate for the challenges we experience. Individuals experiencing cognitive decline may have difficulty using these aids independently without proper training.

External Memory Aids Used In Speech Therapy

As a solution, speech language pathologists can provide specialized training in the creation and structured teaching of external memory aids for everyday challenges. A main priority of treatment is ensuring the selected strategies and tools are functional, person-centered, follow a structured training approach, and utilize multimodal communication to assist individuals in preserving independence, maximizing safety in their environment, staying engaged socially, and improving quality of life. External memory aids include:

Calendars & Planners can be used to help plan ahead for important events. This provides visual support to recall information. Additionally, you can incorporate spaced retrieval to remember information for increasingly longer intervals of time in between.

• Ex: “When I wake up in the morning, I check my ____ (calendar)”

  • “What do I check when I wake up in the morning?”

  • Ask the same question again in longer intervals of time (e.g. 30 sec, 1 min, 2 min)

Timers & Alarms provide visual and audio reminders. This can be a lower tech device like a watch or oven timer as well as higher tech options such as a phone or smart device. Timers and alarms can be set to remind you to turn off the oven, change the laundry, or pick up you prescriptions.

Using a medication management system helps keep track of if and when you take medications.

Medication Management Systems can provide easy accessibility and recall of daily prescriptions to ensure you don't miss any important medications. It is recommended to set up a medication management system at the start of the week. Incorporate this with use of an alarm to ensure medication is taken on time each day.

Memory Books is a tool for those progressing into dementia to recall important information such as family names, personal information, emergency contacts, and daily routine. When designing a memory book, we prioritize person centered and functional materials. Individuals and their families should be central members involved in the design, and creation of an external memory aid.

A memory book shares personal information and photos to support and maintain communication.

A central component is identifying one’s goals or priorities related to their memory. Another consideration is focusing on maximizing what they already use in their daily life. For instance, if they already use a calendar at home, it would be beneficial to grow off of that system and identify how to improve daily use. Another key consideration of training external memory aids is to train them in a structured way so they naturally become a part of an individual’s everyday routine.

Emphasis on Multimodal Communication 

Multimodal communication involves using a variety of modalities to get our message across. These can include speaking, writing, reading, gesturing, drawing, typing, and more. The goal is to utilize any resources we can to communicate successfully. Additionally, it is essential to identify what an individual’s communication strengths or challenges are. For instance, if reading is a strength, then an external memory aid such as a memory book or planner could be beneficial to prioritize relevant written information. 

Conclusion

External memory aids are successful tools used to compensate for memory impairments in individuals with mild cognitive impairment and dementia. Through use of person-centered materials, multimodal communication, and training using a structured approach, individuals can learn to compensate for everyday challenges through the use of an external memory aid. Speech language pathologists have the capacity to assess, and treat individuals with cognitive-communication impairments to increase participation in daily activities, maintain independence, maximize safety in environments, and improve quality of life. Whether it be forgetting doctors appointments, paying bills, birthdays, or medications, these aids can provide us with an alternative route to storing that important information. If you or a loved one has noticed a change in memory, consult us today for a consultation. 

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About The Author

Kelli Humphrey is experienced in the evaluation and treatment of cognitive disorders including mild cognitive impairment (MCI), dementia, and traumatic brain injury (TBI). 

As part of her master's program, Kelli completed a comprehensive literature review on External Memory Aid Tools for Mild Cognitive Impairment & Dementia. Kelli was invited to share her project at this year's American Speech-Language-Hearing Association conference in Washington, D.C.

Learn more about Kelli on our Blog!

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Speech Therapy Treatment for Memory Changes in Cherry Hill NJ

At Insight, we prioritize your individual needs and are committed to offering exceptional care to help you or your loved one overcome challenges with communication and memory changes. Speech therapy services are offered in our office in Cherry Hill, NJ or online for those in New Jersey or Pennsylvania

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References:

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596

Hopper, T., Bourgeois, M., Pimentel, J., Qualls, C. D., Hickey, E., Frymark, T., & Schooling, T. (2013). An Evidence-Based Systematic Review on Cognitive Interventions for Individuals with Dementia. American Journal of Speech-Language Pathology, 22(1), 126–145. https://doi.org/10.1044/1058-0360(2012/11-0137)

Lanzi, A., Burshnic, V., & Bourgeois, M. S. (2017). Person-Centered Memory and Communication Strategies for Adults with Dementia. Topics in Language Disorders, 37(4), 361–374. https://doi.org/10.1097/tld.0000000000000136

Smith, G. E., & Bondi, M. W. (2013). Mild cognitive impairment and dementia: Definitions, diagnosis, and treatment. Oxford University Press.