What you need to know

• Stroke can affect how you think, remember and perceive things.
• Your treating team will work with you to develop a rehabilitation program.
• Difficulties with your thinking, memory or perception can put you in danger.
• Thinking, memory and perception can improve with practice.

Thinking and memory

The word cognition is often used to describe thinking, memory and judgement. After a stroke, you might have difficulty with:

Orientation. Not knowing what the day or date is. Not knowing where you are or who people around you are.

Short term memory. Not remembering things that happened a short time ago. Not remembering people you met recently.

Attention. Finding it hard to concentrate. Being easily distracted.

Planning and sequencing. Not knowing how to begin something. Doing things in the wrong order.

Problem solving. It’s difficult to understand and fix a problem.

Judgement. Making choices that don’t make sense. Doing things that make you unsafe or uncomfortable.

Insight. Finding it hard to understand your difficulties and how they impact your life.

Perception

Your brain processes messages from your senses – smell, touch, taste, sight and hearing.

You might have difficulty with:

Sensation. Not feeling touch, pain, heat or cold on the side of your body affected by your stroke.

Recognition. Not recognising shapes, objects or even parts of your body.

Vision. Half of your vision in each eye is lost. This is called hemianopia.

Neglect. Not seeing or feeling things on your affected side.

Treatment and recovery

These difficulties affect everyone differently. If you notice changes, speak to your doctor or therapist. Assessment and testing is needed. Your treating team can then work with you to develop a rehabilitation program to meet your needs and goals.

Your treatment might include practicing solving problems and everyday tasks. You might use notebooks, diaries, electronic calendars and alarms to help you remember things.

If your vision has been affected, prism lenses may be recommended. If you have neglect, you may be taught visual scanning. This will help when you are doing things like walking and reading.

A home assessment can identify any hazards as well as ways to make you more independent.

Thinking, memory and perception are like any other difficulty after stroke – they can improve with practice. Regular activities and exercises that challenge you in the areas you find difficult will help you improve.

Things you can do

Rest and relax. Your difficulties may get worse when you are stressed or tired. Plan your day so you have rest breaks. A quick nap may help.

Pace yourself. Limit the amount of things you do at once. Slow activities down. You don’t need to finish a big job in one go. Do one step at a time and rest in between.

Keep it simple. If someone is helping you, ask them to keep instructions short. No more than six words to a sentence. Only one or two instructions at a time.

Support concentration. When someone is speaking to you, turn off the television or radio. Focus only on what they are saying. Being in a quiet room helps reading or learning something new.

Memory aids. Use notebooks, diaries, alarms and even notes around the house. Write appointments down. Use photos or pictures to trigger your memory.

Talk about it. Let people know about what’s changed since your stroke. Tell them when you are having trouble. Let them help. Ask your family or friends to remind you about things.

Staying safe

These difficulties can put you in danger. You might have difficulty with things like taking medicine or using the stove. You might get lost or disoriented when going places. If you have problems with your vision or with neglect, you might have difficulty crossing roads.

Difficulties with thinking, memory and perception mean you may not be able to drive safely, even after the normal waiting period for driving after a stroke has passed. You must follow the laws about driving after a stroke.

More help

The health professionals at StrokeLine provide information, advice, support and referral. StrokeLine’s practical and confidential advice will help you manage your health better and live well.
Call 1800 STROKE (1800 787 653)
Email strokeline@strokefoundation.org.au

Join Australia’s online stroke community with videos, fact sheets, resources and support for stroke survivors, their family and friends.
enableme.org.au

Find an occupational therapist:
Occupational Therapy Australia
1300 682 878 www.otaus.com.au

Download Thinking and perception after stroke fact sheet (PDF)

For more information visit the EnableMe resource topic on Thinking and perception