Developing Safe Technique in Patients with Memory Deficits - Kristin B., Physical Therapist

As a therapist working in a rehabilitation setting, much of my job is helping improve the safety of my patients to decrease their risk of falling. In patients who are completely cognitively intact, this is not difficult. These patients will remember to use safe techniques and understand how deal with dangerous situations. There are, however many patients with slightly decreased memory or problem solving who require additional training.

With these patients, often we must rely on procedural memory. Procedural memory is that innate sense of being able to do things you’ve done many times before. Procedural memory is often referred to as muscle memory or habit. These techniques are not something that a patients thinks about, then executes, they are actions that happen naturally because the patient has done them so many times before.

When creating procedural memory in a patient there are a few keys. The most important part of procedural memory is repetition. By having the patient do something over and over you are helping to create the procedural memory for the proper way to complete a task. Another important factor in creating procedural memory is decreasing the amount and frequency of cues given over time. Initially a patient will need many cues to ensure that they are using appropriate technique, but over time, these cues should be tapered off to allow the patient’s procedural memory to kick in.

            Finally, patients must be trained to use their new skills in different situations and settings. A good example of training patient to use their safe technique universally is having a patient sit down and stand up from several different types of seating surfaces in succession. They will learn to apply their safety techniques despite the changing environments they will encounter.

As a final note to therapists, ensure that you are documenting your efforts to enhance procedural memory in patients.  This will help ensure that whoever may be reading or auditing your documentation understands the need for further training and repetition of functional skills for your patient.