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Tips for Dealing with Cognitive Dysfunction in Multiple Sclerosis
Beyond Sticky Notes

By Julie Stachowiak, Ph.D., About.com

Updated: January 13, 2009

About.com Health's Disease and Condition content is reviewed by the Medical Review Board

After years of suffering from short-term memory problems, word-finding difficulties and a non-existent attention span, I decided it was high time that I wrote this article on tips and ideas for dealing with cognitive dysfunction for people with multiple sclerosis (MS). However, when I started looking for the resource materials that I had been gathering on this topic, I couldn’t find them. Seriously.

After a bittersweet internal laugh at the irony of it all, I decided to let it go and offer up some things that have worked for me, as well as some things that seem like just plain good ideas. (Anyway, I seem to remember that most of those articles focused on sticky notes, PDAs and working a crossword puzzles daily, none of which has made my life work any more smoothly.)

Tame Your Environment

To me, this is the absolute most important thing that anyone (MS or not) can do to help their brain work a little better. We are so accustomed to noise, clutter, static, and chaos in our lives, that many of us just assume that is how the world is. Well, you have control over at least some parts of your immediate surroundings. I suggest you try the following and see what it is like to have a thought in a peaceful place:
  • Turn off the music and television. In fact, do a “sound inventory” in different rooms of your house: Is the ceiling fan squeaking? Is there a hum coming from your printer? Is your computer’s drive spinning? Does your child have his stereo on so loud that you can hear it in the kitchen? See what you can do to bring some quiet into your life.
  • Adjust the lighting. Make it soft and appealing when you can. Make it bright and focused when you need to see to do a task or to read. In general, I find that overhead lights can be very stressful and distracting.
  • Eliminate the clutter. Your eyes need a break from looking at stuff, especially if everything you look at chisels away at your attention – magazines that need to be read or recycled, knick-knacks that need to be dusted, other people’s belongings that need to be put away. Try a “clutter quarantine,” where you put it all in boxes for a while until you figure out what you really, really want or need in your space. You’ll probably be surprised at how little actually makes it out of the boxes.

Tame Your People

This one is a little trickier, but is also hugely important, in my opinion.
  • Only let one person talk at a time. I know that when more than one person is trying to get my attention at the same time, all of them might as well be speaking ancient Greek. I cannot process any part of what anyone is trying to say. Make it clear to those around you that if they want to be heard, they must wait their turn.
  • Embrace the conversation. What I mean by this is, when you have a conversation, only have a conversation. Everybody needs to put away their iPhones, newspapers, tacos, fingernail files – all of it – and just talk to each other. It might feel weird at first, so accustomed are we to “props” while we talk. I guarantee that this will help both parties have a much more fulfilling conversation, as well as help those of us with MS follow details, find the right words and not repeat ourselves unwittingly. By the way, this goes for phone conversations, too.
  • Check in with others. Ask people if they understand what you are saying. Ask them to repeat themselves if you aren’t following the conversation. Confirm important dates, directions, anything that needs to be exact. Try not to let this embarrass you – after all, people usually love hearing their words repeated back to them or being asked to repeat themselves, as long as it is done in an interested, sincere way.

Tame Your Brain

You have to work with your brain in partnership if you want to accomplish things. As frustrated as we may get at times by the forgotten appointments, lost words or wandering attention span, directing this frustration inward is a sure way to make things worse. Be nice to your brain and you will be rewarded.
  • Don’t multitask. I know this is like asking some people to stop breathing, but seriously – things have gotten way out of hand. Why can’t we just talk on the phone or just cook dinner or just have a cup of coffee? I think limiting what we do to just one thing at a time is now referred to by many as “mindfulness,” the experience of being in the moment that you are in. For those of you who say that multitasking is a timesaving measure, I am pretty convinced that if you do one thing at a time, and concentrate on just that thing, you will do it better and more efficiently.
  • Organize things your way. Look, if it makes sense to you to keep laundry detergent under the kitchen sink or extra pens in the pantry, by all means do what works for you. When I have tried to get organized by other people’s ideas of what things should look like, I end up losing things or leaving things strewn around, because I can’t remember where they “belong.” Decide on your system and stick to it. However, it is essential that you pare down (or box up) all the extra stuff that we all have eating up valuable space in our drawers, cupboards and closets.
  • Talk to your brain. You can talk out loud or to yourself, but think of your brain like a toddler that wants to run off and play with random objects on the way to a destination. You have to gently but firmly remind your brain of the task at hand. Be imaginative, like you would with a toddler – sing a little song about the three ingredients that you need to get out of the refrigerator or imagine someone repeating “car keys” with a funny accent while you look for them. Promise yourself treats of M&Ms if you accomplish your task. Whatever it takes.
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