Remembering When You Start to Forget

Many people struggle with their memory. It’s certainly not uncommon to experience a decline in memory as people age, but how do you know if your memory difficulties are part of the normal aging process or a sign of something more serious?

Alexis Caletka and Sara Beth Kirkweg, Speech-Language Pathologists with Boone Therapy, help physicians answer this question for their patients through a formal cognitive assessment. Whether a patient’s doctor diagnoses a mild impairment or a more severe neurological issue, cognitive therapy may help.

Processes that allow the brain to learn, make judgments, problem-solve, and recall information relate to cognition. With normal aging, mild changes can occur in memory and word finding, such as when what you want to say is right on the tip of your tongue, but you have trouble getting it out. But when memory problems start to interfere with your ability to function independently, a formal assessment of cognitive skills can distinguish normal aging from underlying neurological processes such as dementia or other neurological disorders. The first step to take if you or someone you know is concerned about memory loss is to contact a physician.

Alexis Caletka and Sara Beth Kirkweg, speech-language pathologists at Boone Health.
Alexis Caletka and Sara Beth Kirkweg, speech-language pathologists at Boone Health.

“We get referrals from different providers,” says Sara Beth. “They may be from general practitioners whose patient says, ‘I’m having some difficulty with my memory.’ Their first step may be to send them to us to have a cognitive evaluation to determine if there are any cognitive concerns that might need further referrals. Or we might get a referral from a neurologist for a patient with known cognitive concerns to get a baseline measure for how the patient’s performing or to determine if the patient is performing worse than they had been previously.”

Alexis and Sara Beth begin with standardized cognitive assessments, where patients answer questions and perform tasks to assess cognitive abilities. Depending on the results, they may recommend therapy to the patient’s doctor. The strategies they teach patients in therapy focus on what individual patients need to help them in their daily lives. Every case is unique because each patient’s deficits and requirements to live as independently as possible are different.

“If it’s something they still have to do in daily life, like manage their medications, and they can’t remember what to take and when that’s where we come in,” says Alexis.

Cognitive therapy is used to treat more than memory. Sara Beth and Alexis treat patients who experience difficulty with problem-solving, reasoning, judgment, maintaining attention, and executive functions, including the ability to plan, organize, and execute tasks. They also treat patients who have language problems, like being unable to find the words to express themselves. Regardless of the deficit, seeking treatment early can help patients with cognitive impairment live more independently for longer.

To help with memory, there are internal strategies like using mnemonic devices such as rhymes, songs, or acronyms. Boone Therapy also teaches external strategies, like using a calendar to remember appointments or using a pill sorter and setting alarms to remember to take their medication.

Cognitive therapy tends to be more effective when family members are involved.

“We always encourage families to be involved in therapy,” says Alexis. “The more people you have who can help carry over the strategies that you are trying to implement within your therapy session – which is only maybe one hour a week – the better. The family is with them all the time. So, if they can be here for the therapy to help carry over whatever we’re working on, it’s more likely to be effective.”

Alexis works with a patient on a cognitive task.
Alexis works with a patient on a cognitive task.

Alexis adds, “If someone has a bad enough memory impairment, they aren’t going to remember what we’re saying outside of the sessions. Having someone else to help remember information is necessary as well.”

Motivation is an equally important factor in therapy success. If patients are not willing or not interested in participating fully, therapy will be less effective.

Toward the end of the therapy process, Sara Beth and Alexis readminister the cognitive assessment to check for measurable improvements in the targeted deficits. Patients may be discharged from therapy or referred for more if they need more time and support.

By identifying memory decline and providing strategies for patients and their loved ones, Sara Beth and Alexis help people safely and effectively perform the activities of daily living with confidence and lead better, more independent lives.

For more information on cognitive assessments and Therapy Services, visit or call 573-815-3868.

By Michelle Terhune