Expert view: How is memory affected by brain injury?

Although people tend to talk about memory as if it were one skill or function or ability, there are in fact many kinds of memory and many ways it can be classified.

We can consider memory in terms of the length of time for which memories are stored; the type of information to be remembered; the  modality the information is in; the stages in the process of remembering; explicit or implicit memory; whether recall or recognition is required; whether the memory is retrospective (for things that have already occurred) or prospective (remembering what has to be done) and whether the memory dates from before or after an injury or illness.

The typical situation for most memory impaired people is for their immediate memory to be normal or nearly normal, to have problems after a delay or distraction, to have difficulty learning most kinds of new information, and to remember things learned a long time before the accident or illness better than things which happened a short time before.

The three main approaches to current memory rehabilitation are improving learning, compensating for memory difficulties through the employment of external memory aids, and adjusting or modifying the environment so people can survive without a functioning memory system.

New learning includes spaced retrieval, vanishing cues and errorless learning. External memory aids such as diaries, notebooks, tape recorders and mobile phones, widely used by the general population, are often problematic for memory impaired people simply because their successful use involves memory.

For those with severe and widespread problems, the best method may involve restructuring or organising the environment.

The emotional consequences of memory impairment such as anxiety, depression and loneliness should also be dealt with in rehabilitation through counselling, anxiety-management techniques and treatment in memory or psychotherapy groups.