“Honey, have you seen my car keys?” This unfortunately has happened to me more frequently than I would like to admit.
Since my chemotherapy treatment, I have noticed my memory skills are not up to par. This mental fog is not my imagination. It is referred to as "chemo brain." According to the American Cancer Society, between 15 and 70 percent of patients who receive chemotherapy may experience chemo brain. It has been described as memory lapses, difficulty remembering details, and inability to multitask as one once did before treatment.
From a personal perspective, difficulty with recent memory, especially numbers and misplacing objects, has become a problem. Other patients have described the inability to think as fast as they once did, difficulty remembering steps of a task once easily performed, confusing dates and appointments, or fumbling for the right word or phrase.
The above symptoms can be frustrating and embarrassing, and patients may not readily admit to their presence. As nurses, we need to be open and sensitive to subtle clues or comments made by the patient. We can suggest the following strategies as part of our patient education:
- Exercise. Even five minutes of mild activity can improve mental function.
- Rely on memory aides. Use a notebook; take advantage of a computer-based calendar. Learn the features of your smartphone such as built-in alerts that can help you stay on track.
- Set up your work environment to boost concentration. Clear everything off your desk except what you are working on. Set up a to-do list as a priority list of tasks to be accomplished.
- Rehearse to remember. If you read something out loud, such as names or facts, you are less likely to forget.
- Get into a routine. Advise the patient to place keys, files, and other items in the same place day after day. It will reduce the “where is it?” stress. At home, designate a “launching pad” where the patient puts everything he or she may need to take to work the next day. I have discovered a corner in my kitchen for this purpose. It reduces my early morning stress and allows me to focus and concentrate.
- Take frequent breaks. Divide tasks into manageable portions and take a break each time one part is completed.
- Be aware of your stress level and work to lower it. Excess stress by itself can impair performance and thinking skills. Learn quick rescue techniques to control stress, such as deep breathing.
- Maintain a regular schedule, as fatigue can affect performance.
- My favorite strategy is the use of humor when possible. Try not to take yourself so seriously. Laughter releases tension and will allow you time to refocus on the task.
While memory problems can happen to anyone, nurses have a unique opportunity to help our patients "clear the fog." Have any of you employed these patient education suggestions in your own clinical practice?