There are three aspects of memory that may be affected: (1) recent memory, or recollection of events that have occurred in the recent past; (2) immediate recall, or events immediately following their occurrence; and (3) remote memory, or recollection of events in the distant past. Of these three, the first two are the most affected.

Loss of recent memory and immediate recall is often seen in the continual repetition of questions or inability to remember directions. This affects the person's ability to learn new material or acquire new skills. The following are examples of environmental problems that can result from memory loss:

Possible Underlying Causes:

Lack of recent recall; lack of ability to discern difference between rooms; disorientation; confusion; dark hallway; poor vision; distance from bedroom.

Possible Modifications:

• Put picture of toilet and identifying word "toilet" on door.
• Attach strips of reflector tape on the wall from bedroom to bathroom.
• Put night light in hallway between bedroom and bathroom.

Possible Underlying Causes:

Confusion with complexity of task; physical problem (e.g., arthritis/vision).

Possible Modifications:

• Attach a direct dialing system to telephone with most needed telephone numbers.
• Put phone numbers next to telephone.
• Provide written instructions next to telephone.
• Put large-numbered template on telephone.
• Use an answering machine when you are not at home to receive messages.

Possible Underlying Causes:

Lack of recent recall; cues are not adequate; too much stimuladon; disorientation.

Possible Modifications:

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• Provide adequate cues and reminders in person's room such as a bold-faced calendar and clock. Mark off the days as they pass.
• Pin up simple schedules of the days activities and when they will occur.
• Leave familiar objects such as pictures and magazines in their usual places. Keep environment consistent.
• Provide written reminders of chores or when caregiver will return.
• Display photographs of family and friends.
• Have friends wear name tags when they come into the room, if that is comfortable for you.

Possible Underlying Causes:

Lack of recent recall; confusion; suspicion; hallucination; mild form of paranoia.

Possible Modifications:

• Take away items (e.g., wallet, keys) that can be lost and replace with non-valuable duplicates.
• Reduce clutter in home. Keep simplified.
• Provide person with special security "box" that he/she can keep their items in.
• Go through wastebaskets and garbage cans at the end of the day to see if anything valuable has been accidentally thrown away.

Possible Underlying Causes:

Boredom; insecurity; difficulty in making sense out of environment; lack of recent recall.

Possible Modifications:

• Introduce an activity or simple task.
• Try to be patient and when answering questions, hold person's hand.
• Display a reality board (e.g., with date,time, place, weather conditions) to help person orient him/herself.

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