Memory, thinking and perception
Difficulties with memory or thinking are common in dementia
You may have difficulty with things like making decisions, learning new tasks, remembering the right order to do tasks in or remembering appointments and arrangements. Thinking difficulties can make it harder for people with dementia to go about their everyday lives.
There are practical solutions, treatments and behaviour therapies which can help. Some therapies can delay your memory and thinking from getting worse, and help with problems which affect your day to day life. There may be medications which can help, and also things you can do such as training your brain or getting advice on managing everyday tasks.
Also for some people, dementia can affect the way the brain makes sense of what you see
Your eyesight might be fine, but your brain may not process this information correctly. For example, mistaking a reflection of someone in the mirror as a person. Find out more about changes in perception.
You might have trouble judging how far away something is, or how deep a step is
You might have trouble picking out an object from its surroundings, particularly if it’s the same colour, if there is poor lighting and there are lots of shadows, or the background is patterned. You may also have difficulty interpreting information when there is a mirror, or reflections from wet or shiny surfaces or glare.
You may be more sensitive to sounds, touch, and sights. This can sometimes make the world around you feel overwhelming and difficult to cope with. Other people may find smelling and tasting might be more difficult, which can lead to losing interest in food.
Agnes Houston has written about her own experiences of changes in perception in dementia and those of other people with dementia. She gives suggestions on how to manage these.
Strategies from others with dementia
We share practical strategies people with dementia use to help with their memory and thinking:
I forget to do things at the right time (such as appointments, medications, drinking water regularly, eating lunch)
- Use a reminder system that sounds an alarm at the right time – this might be a standard bedside alarm clock, or the alarm on your watch or phone. Sometimes people with dementia can’t remember what the alarm means and have to go to their calendar or diary to find what they need to do.
- Ask someone else to remind you, either in person or by phone.
- If you have a smartphone use Virtual Assistants such as Amazon’s Alexa, Google, or Apple’s Siri.
It is easy to set reminders which sound an alert which also tell you what you need to do. To set the alarm, just say to your phone or device “Alexa, set a reminder for me to take my medication at 4pm every day” or “Google, remind me to leave for the doctor at 8:30am on Tuesday 22nd May”.
When at home, you can also set and receive reminders through a home speaker/microphone device connected to those systems (e.g. Amazon Echo, Google Nest, or Apple Homepod). You can programme these yourself or ask a family member or friend to help you.
I have trouble keeping track of appointments
- Use a diary. Put it in your pocket or handbag and carry with you. When you make a new appointment, put it straight in your diary. If you’re making an appointment at a clinic, the receptionist will usually be happy to write the appointment into your diary for you.
- Use an electronic diary which you can see on your mobile phone and computer. If you use an electronic diary, ask professionals and friends to email you a calendar/diary invitation of your appointments.
- Use a large calendar or white board instead of, or in addition to your diary. This helps you to see what you have planned for each week or month. You might add weekly jobs to the calendar too, like doing the washing, or doing the shopping.
- Many people find it helpful to have a large display clock with day, date and month displayed. UK care guide has some examples. If you use a whiteboard, position the clock close by.
- If you don’t carry your diary or calendar with you when you’re out, ask for an appointment card from the clinic with the time and date written on it as a prompt to write it down when you get home.
- Ask someone keep track of your appointments for you, this might mean putting appointments in your diary or calendar and/or reminding you of the appointments you have coming up.
- Ask your friends to phone you the day before, or the day of the appointment, as a reminder. If you are using a mobile phone, you can sign up with some healthcare providers and other services to receive text message reminders the day before your appointment.
- Ask your doctor, optician or other healthcare provider to send you a letter and ring you on the morning of your appointment to remind you on the day.
I keep losing things like my glasses, phone, keys or walking stick
- Have a usual spot for these objects. A bowl or hook for keys and a spot for the walking stick near the door so you can drop them when you come in with your hands full. You might have several usual spots for your phone and keys, and glasses (the living room mantlepiece, bedside table).
- When you’re out, develop a routine of counting the things you need to have with you before leaving (such as glasses – check, phone – check, pocket diary – check).
- Develop a regular routine of putting important objects in their usual spot when you come home. Make it routine to return them to the usual place at home if you notice them in the wrong place.
- Use a bright phone cover, a bright key chain so these are easier to spot when you’re looking for them.
- Ask people in your household to return items to their usual places if they notice them elsewhere.
There are also technologies which can help you to locate lost items such as key and wallet finders. Find out more at Alzproducts.
Start your own dementia toolkit
I have trouble managing my money
- Set up or ask someone help you set up automated bill payments.
- Ask someone you trust (a family member, friend, or accountant) to go through your bank statements with you each month.
- Think about setting up a joint account with someone you trust so that they can also access the account.
- Appoint someone you trust with financial Lasting power of attorney so they have legal permission to handle your financial matters. Read more about this in Planning ahead.
- If you have trouble adding up notes and coins, such as when checking your change, pay using a contactless credit card.
I keep forgetting to take my things like glasses, phone, keys or walking stick with me when I go out
- Pin up a list of things to take with you near the front door.
- Keep spares such as a spare key in your handbag, wallet or car and spare pairs of glasses in your handbag or car.
- Leave a key with your neighbours or someone local you trust.
- When you go out with someone, ask them to remind you to take your keys or other things when you leave the house.
- Install a key safe outside your home – set the combination to something you’ll remember. You can get these at DIY shops or ask your local council for help with this.
I keep forgetting important information
- Keep a note of important things in a notebook or on your smartphone. Read your notes when you have time to help the information sink in.
- Take photos with your smartphone camera. Look at these when you have time to help the information sink in.
- Check your notebook or smartphone if you need to tell someone the information.
- Don’t be too hard on yourself if you don’t remember.
It takes a lot of time and effort to make decisions, even about small things
For everyday decisions, think how you can make choices easier:
- If you have trouble choosing what to wear, wear the same thing every day (such as jeans, white t-shirt, and jumper) and buy multiples of the same thing. Or have a set outfit for each day of the week that you wear every week. You may need to change these to suit the weather.
- If you have trouble choosing your accessories, shoes or makeup, again just wear the same thing every day.
- If you have trouble deciding what to eat, eat the same thing every day (hopefully it’s healthy), or have the same dinners every week. You could also make a plan for each week so that you have some variety.
- When food shopping, write on the list the exact number of items and the brand (such as 2 packets of spaghetti).
It takes me much longer to do things, or I get confused or distracted half-way through a task
- Do one thing at a time. Try to finish one task before moving on to the next one.
- Take regular breaks.
- Many people find they think best in the morning. If possible, plan activities where you need to concentrate in the morning. Do more routine or physical jobs in the afternoon and evening.
- Accept that some things will take longer and allow yourself more time if you need it.
I don’t notice things that are right in front of me
- Make it easier to see things by reducing visual clutter. For example, leave one cup, kettle and jar of tea or coffee on the kitchen bench, rather than having many items out.
- Keep important areas of your house tidy.
- Buy important items in bright colours so they stand out visually (such as bright red glasses, or a yellow phone cover, or blue wallet)
- Add a contrasting background colour in important places where you can’t find things (For example, put a white mat on your wooden table so that you can see your keys and wallet more easily).
For more suggestions on managing challenges in everyday life visit the By Us for Us guides. These are written by people with dementia and carers and can be downloaded free online.
Using Technology to manage memory and thinking
There are many different ways you can use technology to help with your memory and thinking and everyday tasks. The examples above explain how you can use different strategies and devices to help you stay independent, in control and safe. Find out more about using everyday technology to help with your dementia.
Assistive technologies may not be expensive. If you (or someone close to you) already has a smartphone, tablet or computer, you can use these as suggested to organise your appointments and help you to remember important information.
Here are more everyday examples of how you can use assistive technology to support independence, safety and wellbeing include:
- Using Virtual assistants such as Alexa to set prompts or ask simple questions to support orientation
- Dementia clocks which clearly display the day, date, time, and period of the day (such as morning, afternoon, evening)
- Using shared online calendars
- Apps such as pill reminders, brain training, mindfulness, and relaxation
- Electronic medication boxes.
You can also find out if your local authority provides assistive technology to help you with everyday activities. Click on the link for your local area.
Medication and non-drug therapies to help with dementia-Therapies for managing memory and thinking difficulties can help by:
- Improving your memory and thinking. Medications and brain training can help, or
- Helping reduce the impact of problems with memory and thinking on your everyday life. Non-drug treatments such as cognitive stimulation therapy can help.
You can read the NHS dementia guide to find out about treatments and therapies.
Although there is currently no cure for dementia, you may be able to take medication to help slow down your symptoms. This will depend on which type of dementia you have. You can find out more about drug treatments here.
Ask your doctor if you are not sure about dementia medication.
If you have Alzheimer’s disease or mixed Alzheimer’s disease and vascular dementia Acetylcholinesterase (AChE) inhibitors are usually the main treatment. Donepezil (Aricept), galantamine (Reminyl) and rivastigmine (Exelon) may be recommended if you have mild to moderate Alzheimer’s disease.
Memantine (Nameda) may be offered if you are unable to take AChE inhibitors or you already take an AChE inhibitor and your dementia is more advanced.
If you have Dementia with Lewy Bodies AChE inhibitors donepezil or rivastigmine may be offered if you have mild to moderate dementia or advanced dementia. Galantamine may be offered if you cannot take. ACheE inhibitors. Memantine may be offered if you are unable to take AChE inhibitors.
If you have Vascular Dementia AChE inhibitors or memantine may be offered if you have mixed dementia with Alzheimer’s disease, Parkinson’s disease dementia or dementia with Lewy bodies.
If you have Frontotemporal dementia AChE inhibitors or memantine are not recommended.
New guidance on the use of dementia drugs also now recommend a trial of dual therapy such as an AChE inhibitor together with memantine if either of these drugs alone no longer seem to be working.
Common side affects
Side effects of AChE inhibitors can include nausea (feeling sick) and loss of appetite which usually get better after 2 weeks. Side effects of Memantine are usually temporary and include headaches, dizziness and constipation. If you have side affects, ask your doctor if patches are available instead of tablets.
Group cognitive stimulation therapy (CST)
If you are in the earlier stages of dementia you may be offered cognitive stimulation therapy (CST). You can join group activities and do exercises to help with your memory, problem-solving skills and language. CST is one of the few non-drug therapies to have shown positive effects in research studies on thinking and quality of life for a person with dementia.
CST is available through the NHS in some areas. Memory clinics may run courses. Ask your doctor if CST is available in your area. If it is available, your doctor can refer you. You can watch a short video about CST here.
Group reminiscence therapy
If you are in the earlier stages of dementia you may be offered reminiscence therapy. At reminiscence groups you can talk about stories, memories and life experiences. You may find it easier to remember things about your past and enjoy talking about it with other people. Organisations such as the Alzheimer’s society and Dementia UK may offer local reminiscence services.
They also offer a range of ideas to try yourself:
Your local library may also have reminiscence collections. Some museums offer local and online reminiscence resources. For example:
National mining museum
Cognitive rehabilitation or occupational therapy
Cognitive rehabilitation can help you use the parts of your brain which work better to take over for the parts of your brain which work less well. This can help you cope better with everyday tasks.
You may be offered cognitive or occupational therapy if you are in the earlier stages of dementia.
A trained professional such as an occupational therapist can help you to set and achieve goals to help you with everyday tasks you may find difficult. Ask your doctor about occupational therapy and cognitive rehabilitation. Your doctor may be able to refer you. Your family and friends can also help you with this. Find out more about the benefits of cognitive rehabilitation here.
Doing mental exercises can help different parts of your brain which affect your memory and thinking. This might be doing puzzles or playing special computer games. Read more about brain training. The science is not clear if brain training helps people with dementia. Some studies found it improves memory and thinking, others did not.
Doing intensive brain training (more frequently each week) may work better. You might only improve on the tasks you train on. For example if you practice remembering shopping lists, your memory might improve, but finding the right words may not.
Some people with dementia feel brain training helps them. If you are interested in computerised brain training, some companies offer tailored brain training programmes online. There is no evidence these programmes improve memory and thinking for people with dementia, and we do not specifically endorse these. You can try some for free, but for ongoing access there is a monthly fee or you can buy a lifetime package. Click on the links below to find some apps you might find helpful.
Try strategies to help with life
Reread the article and write down one or two areas you find challenging. Using our examples you could think of some strategies that you think might be helpful. When you have a plan, try out one of your ideas and see if it helps.
Ask your doctor
Ask your doctor about medication, cognitive stimulation therapy, occupational therapy or cognitive rehabilitation