Please answer the following questions, and send your answers in the appropriate format to melissa.luebbe@ctca-hope.com. (As explained in previous blog, "Here We Go")
- What is Chemo Brain, and does it affect everyone who receives chemotherapy?
- Are there any ways to prevent Chemotherapy Induced Cognitive Impairment?
- Are there other explanations for diminishing word skills and memory loss?
Discussion question - Suggest coping skills for a patient who feels that they are experiencing Chemo Brain.
Darby Hilgendorf
ReplyDeleteI always try and help the patient and their families accept the problem and learn to laugh about it. Laughter is a great way to cope with a problem, and yes I know it is not for everyone but it doesn't hurt to suggest the idea. I also try to reinforce to the patient that they notice their problems much more than others do. Making a to-do list everyday is always a great check list to make sure you do everything you wanted to that day also.
Suggest coping skills for a patient who feels that they are experiencing Chemo Brain: Write a list of tasks that need to be completed and check them off as they're done. Also, keep a journal of things that occurred throughout the day. Write down questions for the doctor, etc. Take one day at a time! Realize that this side-effect isn't going to last forever!
ReplyDeleteTheresa Rodriguez, Infusion, X6200, Theresa.Rodriguez@ctca-hope.com
ReplyDeleteHi everyone, In the Infusion Center, I find that patients tend to laugh at "chemo brain" more than be distressed by it. This is helpful, honestly--because they are smiling! :) Coping skills include word and number puzzles...perhaps this is why our volunteers pass out "Word Searches" and "Soduku?"
I agree, many patients are able to laugh it off, but it does become frustrating and even debilitating in some cases. I encourage patients to talk to their caregivers so they are aware of their struggles. Also, writing things down is so helpful, especially medication schedules, questions for the physician, and other important information.
ReplyDeleteFirst, I would start with explaining chemo brain to the patient and make sure they know they are not alone. Doing one activity at a time, making lists and mind challenging games are examples of ways to cope and live with chemo brain. Making sure family members/caregivers understand what chemo brain is and explain ways they can help make the patient's life easier when going home is also a good idea. :)
ReplyDeleteOur patients usually tell US that they have "chemo brain"....and yes, they do have a wonderful sense of humor about this. We certainly try to provide simple, clear teaching. For example, when providing pre-procedure instructions we give verbal + written instructions that are specific-detailed (i.e., medication sheet will have drugs highlighted that should be taken pre-procedure such as blood pressure pills/or held such as aspirin). We also call patients for follow-up after procedures to make sure they understood discharge information. Contact information is always provided with encouragement to call for questions. We reinforce information over and over r/t sedation/anesthesetic effects. It is ideal if patients have a caregiver accompanying them, but we do seem to be seeing more and more solo patients.
ReplyDeleteI would begin by validating their concerns and explain that while this phenomenon is not fully understood, it's real! Some of the coping skills I often suggest to patients are to maintain an open commination with family, friends, and caregivers and make use of calendars and/or journals. For example, I highly encourage patients explain their symptoms to family, friends/caregivers, and suggest ways they may help. Often times caregivers pull me aside to express frustration as they don't know what to do or how they can help. Perhaps, ask a friend to remind you of plans via text, e-mail, or phonecall. Another helpful pointer is to utilize or designate a binder, such as the one all of our new patients receive to jot down questions or concerns for the medical providers and only use it for that purpose.
ReplyDeleteI totally agree with you. When pts comment that they are forgetful, I tell them, "So am I and I don't have an excuse!" I think making "light" of it helps pts cope. I also encourage them to be OPEN and honest with their family members; it helps lessen their frustration. I think doing puzzles, crossword puzzles, sudoku, etc. can also help "sharpen" memory skills.
DeleteI find that instructing patients to use lists really help patients to cope with 'chemo brain'. Encouraging patients to share their concerns and fears not only with the nurse and doctor but with their family they are greatful to be included and helps them to understand then to help the patient too.
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ReplyDeleteNancy said... Patients respond when they are unable to answer questions or remember "Oh, it is my chemobrain". I think they can cope by making lists, and using support of their significant others. I also, think they can use things to keep their brain stimulated such as word puzzles in local papers. I try not to make them feel insecure.
Establish a routine: specific places to keep keys, wallet, cell phone, and other important items. Keeping things in familiar places helps most people remember where things are. Do things at the same time daily, plan out the day’s activities. Make lists. Use a note book, cell phone, note pad and sticky notes. Write down everything, medications, schedules and day today activities, names and where car is parked. Use a calendar or organizer. Keep track of appointments, tasks, things to do, social commitments, and special days such as birthdays and anniversaries. Use of the answering machine or voicemail to remind of appointments, events, and other information helps with recall. Prioritize task. Do not multitask. Do one task at a time. Let people know about memory issues. They can help with reminders and will be more understanding when something is forgotten. Get plenty of exercise and sleep.
ReplyDeleteI reinforce to patients that this is a real phenomenon, that these symptoms are not "all in their head," as the patient often verbalizes. Validating their concerns and giving a name to their symptoms alleviates some of their fears. I discuss organizational skills such as making lists, using pocket calendars, using sticky note reminders, cell phone alarm reminders, and placing notes in strategic areas at home and work. These seem like simple suggestions, but sometimes patients need simple reminders and a focus on simple interventions.
ReplyDeleteI remember one day a friend of mine told me "Oh I have a chemo brain syndrome." She actually was laughing as she was telling me this. She has breast cancer and received chemo/radiation. I was in silence at first thinking how should I react to it. Then she started sharing her funny stories as to how her memory lapses brought laughter to her family and she gets everybody’s attention. I was very impressed with her disposition, We both shared ideas, thoughts about ways she could do to be able to keep track of her appointments, activities, and obligations. Keeping a daily diary and a planning calendar to log all important events and activities is an important part of daily routine in order to be on top of their schedule is Helping them verbalize their concerns with friends, family, and care takers can reduce their anxiety and stress level. I would advocate that they keep an open communication with their providers and caregivers in order to gain support and understanding.
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If I had a patient who was finding it difficult to remember things, I would simple suggest tools of how to help cope. Keeping to do lists, important phone numbers by the phone and also putting things back in the place they were found originally. I would also encourage them not to get frustrated when they are having difficulty with "the right word" or finishing a thought, just take a deep breath and refocus. Sometimes the frustration can add to the forgetfulness.
ReplyDeleteI would reassure my patient that many of the symptoms are related to cancer therapies and that nothing more dire is occurring(of course making sure of this first). Without minimizing a patient's concerns over overwhelming, I would offer appropriate suggestions to help a patient cope.
ReplyDeleteA lot of patients do find the humor in chemo brain. Suggestions to help cope might include "to do lists", informing family and friends in order to have their support and understanding, being gentle with yourself, and utilizing puzzles, word and number games, etc. if you enjoy that type of activity.
ReplyDelete“Chemo brain” has to be a scary term and even scarier for cancer who are living with it. Although chemo brain has been described as temporary there are those who after five years are still concerned with its effects. We should continue to promote mind stimulating activities such as word games. Furthermore, acupuncture with Chinese medicine, Herbal tea with citrus, peppermint and rosemary have been shown to stimulate brain activity.
ReplyDeleteA few suggestions for patients who experience chemo brain include doing one task at a time, carrying a planner or diary at all times to write down important events, doing puzzles etc. Also, having good support system can be very helpful in dealing with "chemo brain".
ReplyDeleteBrain exercise like learning a new language. word puzzle, take a class are some coping mechanism to rehabilitate the brain. Also discussing your mental problem to your care giver, physician and or family will help to recognize that there might be some side effects of chemo affecting your memory or skills.
ReplyDeletept. should be encouraged to talk about there problem and not to try to hide it. therfore we as health care workers can get them some help. Discuss with pt. to keep a diary, make reminders of appointment, daily activies and also do one task at a time.
ReplyDeleteSome coping mechanisms for Chemo brain I came up with are rest and relaxation, memory games, to continue to be involved in a hobby, and to continue to be active in exercise.
ReplyDeleteThe first thing I would do if a patient feels like they are experiencing chemo brain is to explain to them that this is a real side affect and then offer ways to help the patient cope. The patients first reaction is to laughter followed by some comment like 'I am not crazy afterall!'. Day to day coping methods would include keeping daily journal, putting reminders in cell phones and exercising their brain by doing crossword puzzles or word searches.
ReplyDeleteI would start by letting the patient know they are not alone. This is a very common problem. Gettng enough rest, a healthy diet, exercise as able. Make lists to help remember things. Follow a routine and ask for help from family and friends.
ReplyDeleteIf the patients feels that they are expiriencing chemo brain , I suggest they should be well rested and dont do any multitasking. they can also start doing brain exercises like puzzles, reading books. It also helps to have positive attitude , to smile and be optimistic., being with your family and do not be afraid to asked question and get clarification if you are experiencing any problem
ReplyDeleteChemo brain is a real phenomenon that patients experience as they continue chemotherapy. There is no medication or therapy to treat chemo brain. It is very frustrating for patients who experience it as well as their family and friends. Sometimes it will improve once the patient has stopped chemo. It is good for families, friends, and patients to understand that this is a normal part of chemotherapy and that for some it will never resolve. Understanding it helps to deal with it.
ReplyDeletePatients and families should be told about chemo brain before they begin their therapy. When symptoms start to occur they will realize what is happening and it will prevent frustration and fear in the patient and their loved ones.
ReplyDeleteFollowing a well balanced diet to provide nutrients and vitamins is important for your brain.
I usually encourage patients to make lists. This way they don't have to try to remember everything. They have the list to help them. I have heard many patients laugh about chemo brain, but sometimes I feel the laughter is a front to try to not show the frustration they have. When speaking with patients on the phone I can hear that they are frustrated at times when they cannot remember what it is they were calling for. I try to help them through it by encouraging them to discuss their issues with their phsycian and family members.
ReplyDeleteJennifer T. Castro SCTU
ReplyDeleteFirst of all, i'll acknowledge that the patient is experiencing chemo brain. Then, i'll ask myself, if i'm in his/her shoes, what will i do to help myself cope with chemo brain? Right now, there is no known ways to prevent it. It's real and felt by most patients. Very frustrating and frightening at the same time. Some patients may laugh it off.
Some ways/skills suggested to cope with chemo brain are the following: (1) use a detailed planner to keep appointments and schedules in one place, to do lists, phone numbers and addresses; (2) exercise your brain like taking a class, do word puzzles, jigsaw and sudoku or maybe learn new language; (3) exercise your body- regular physical activity will improve mood, keep you more alert and decrease fatigue; (4) get enough rest and sleep;(5) ask for help to do daily tasks when you need it from friends, loved ones and caregivers; (6) eat vegetables/nutritious foods-some foods are linked to keeping brain powe
Many patients joke about their "chemo brain" while others are very frustrated. I had a patient that told me that he things that he really needed to remember, he repeated in his head 3 times, and that it would actually help. I always encourage them to carry a note book and actually use it! Place appointments on a calendar or in cell phone. Involve family in the situation so they can help. At MRMC we have a speech/ language pathologist that can be consulted for cognitive impairment.
ReplyDeleteI always tell me patients that at least they have an excuse for their memory lapses. I have no real excuse except for business and stress. I tell them when I relax, just take a minute to focus, it usually comes back to me. I think the reiki therapy that is provided is a great way to focus the mind. Any point of quietness and focus usually helps to get the brain in tune no matter what the cause is.
ReplyDeleteWhen working with a patient with "chemo brain," I always try to reassure them that there are things they can do to improve their condition. I suggest mind games such as crossword puzzles, board games, sudoku, word searches, etc. If the patient is able I will also suggest physical activity. Depending on how the patients deals with the issue, whether it be jokingly or frustration, all depends on how I work with the patient. I feel that it is important to let the patient know that chemo brain is a common side effect of chemotherapy and that there are many other people "out there" just like them.
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ReplyDeleteMy pts do not laugh about chemo brain. They get very upset and frustrated. I am sure there is chemo-brain however there is only a few that cross the brain/blood barrier. The chemo could contribute some, but what about: nutritional state of pt, financial issue, stress, multiptasking, taking care of the family, just the word CANCER, medications taken for side effects. Pts need to but themselves first, delegate responsibilities,stop muli-tasking, write things down, do one thing a day. It is good to let patients know that they are not the only person with this problem.
ReplyDeleteOne of the most important things a person with chemo brain can do is to realize that this is a side effect which can be temporary or longer term. Either way, realizing this, a person can make adjustments in how they manage their day and things to remember. Setting up routines of what they do each day, where they put the bills, where they keep lists and having a daily planner can be very useful to keep focused on the important and priorities that one wants to get accomplished.
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