by Cynthia Perkins, M.Ed. © 2004
Impaired cognitive functioning is a frequent symptom of many chronic illnesses and can be one of the most difficult aspects to manage. It can impact your relationships, self-image, ability to work, work performance and daily life functioning.
Cognitive symptoms may include any of the following: speed of information processing, thinking, attention and concentration, forgetfulness, word finding, problem solving, a decline in language skill, learning, organizing, comprehending, cognitive or mental fatigue and judgment.
There are three important steps for managing cognitive symptoms:
1. Self-awareness and Acceptance
The first and most important step in managing cognitive symptoms is self- awareness and acceptance. Individuals experiencing cognitive dysfunction sometimes further complicate their situation or the impact the symptom has on their life by trying to hide them or deny they exist.
Do not be ashamed of your cognitive impairment; it is something out of your control and an integral characteristic of many chronic illnesses. It is not a reflection of your character or a deficit in your personality.
Be open and honest. Do not try to shove them or the impact they have on your life and others under the carpet. Address them head on and they will lose some of the power they have on your life.
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2. Develop Strategies to Help You Cope More Effectively
Once you identify your problem areas it probably won’t be possible to eliminate the impairment, but it is possible to work around them and compensate for the loss they may impose.
Try some of these techniques:
Allow your brain to catch up when it’s processing slowly. Slow down your actions and relax. Don’t put too much pressure on yourself at one time. Reduce the amount of information you need to process at one time.
Write notes to remind yourself of things. Use calendars, planners or post it notes.
Make to do lists and mark items off with a checkmark when completed.
Pace yourself and allow as many rest periods as are necessary. Divide tasks up over a period of time. Plan so that you do your most demanding tasks during good periods. Reserve a couple days of rest to recuperate after an event, chore or task that takes a lot out of you.
Do deep breathing exercises, relaxation techniques, meditation or exercise to combat cognitive fatigue. Rest your mind.
Get adequate sleep and proper nutrition.
Counseling may be helpful to assist you in processing, acceptance and dealing with the impact it has on your daily life, relationships and self-esteem.
Allow your brain the time it needs to retrieve information when trying to remember. Sometimes putting your focus somewhere else temporarily will bring forgotten words or material to the surface. If you can’t find the right words, then describe the word you’re trying to find.
Keep things in specific places. For example, always keep scissors in a particular drawer and the keys on a particular stand. Routine and consistency make it easier for you to remember.
Use timers, alarms or beebers to remind you of tasks or appointments throughout the day.
Reduce background noise and distractions.Work on one task at a time.
Don’t put yourself in positions where you have to think on your feet. Plan ahead and think things through.
Use electronic organizers, address books, or notebooks to keep phone numbers, addresses or other important facts and numbers nearby. If you have trouble remembering your own phone number or address, which is not that uncommon, then keep it written down and handy as well.
Honest and direct communication with loved ones, co-workers, friends, etc is essential to prevent misunderstandings and to preserve the relationship. If those around you are not aware of what you’re experiencing they can perceive your actions as laziness, a lack of interest or concern, or that they aren’t important to you. They need to be educated that this isn’t the case. All parties, including yourself, need to understand that your symptoms aren’t something you can control and are not a result of an emotional disorder.
Ask for encouragement, patience, support and understanding from family and friends. Talk openly about how it impacts you, them and your relationships. Work together to find solutions.
If you still work, you may need to pursue some accommodations under the ADA to continue working. Talk honestly with your employer about your symptoms and the problems it creates. Don’t wait until the problem is so severe that it creates crises in the work environment. Educate your employer and go to them with suggestions for possible solutions already in hand. They will be more willing to accommodate if you have solutions prepared.
Cognitive symptoms may fluctuate up and down. There may be periods of improvement and periods of exacerbation. Fatigue, stress, food, relationships, hormones, etc can trigger your symptoms. Know yourself and your triggers and try to plan accordingly.
Be patient, loving, forgiving and understanding with yourself.
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