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Memory Inventory
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Major
Problems |
Moderate
Problems |
Minor
Problems |
None |
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1. |
Rate your memory in terms
of the kinds of problems you have? |
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2. |
How is your memory compared
to the way it was... |
Much
Worse |
Same
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Much
Better |
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a.
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one year ago? |
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b.
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five years ago? |
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c.
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ten years ago? |
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d.
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before brain injury? |
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e.
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after brain injury? |
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3. |
How often do the following
present a problem for you? |
Always
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Some
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Never
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a.
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names |
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b.
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faces |
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c.
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appointments |
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d.
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where you put things (e.g. keys) |
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e.
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performing household chores |
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f.
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directions to places |
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g.
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phone numbers you've just checked |
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h.
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phone numbers you used frequently |
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i.
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keeping up correspondence |
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j.
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personal dates (e.g. birthdays) |
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k.
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words |
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l.
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going to the store and forgetting what you wanted to buy |
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m.
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going into a room and forgetting what you wanted |
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n.
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pay bills |
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o.
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social cues - (resulting in inappropriate responce) |
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p.
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thank those that have helped you |
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q.
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show empathy for others |
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r.
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beginning to do something and forgetting what you were doing |
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s.
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losing the thread of thought in conversation |
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t.
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knowing whether you've already told someone something |
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Always
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Some
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Never
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4. |
As you are reading a
novel, how often do you have trouble remembering what you have read... |
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a.
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the opening chapters, once you have finished the book. |
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b.
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three or four chapters before the one you are currently reading. |
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c.
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the chapter before the one you are currently reading. |
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d.
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the paragraph just before the one you are currently reading. |
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e.
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the sentence before the one you are currently reading |
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Always |
Some
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Never
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5. |
When you are reading
a newspaper or magazine, how often do you have trouble remembering what
you have read... |
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a.
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in the opening paragraphs, once you have finished the article |
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b.
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three or four paragraphs before the one you are currently reading |
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c.
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the paragraph before the one you are currently reading |
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d.
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three or four sentences before the one you are currently reading |
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e.
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the sentence before the one you are currently reading |
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6. |
How well do you remember
things that occurred in the past if the event was: |
Very
Bad
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Only
Fair
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Very
Good
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a.
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ten minutes ago? |
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b.
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an hour ago? |
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c.
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yesterday? |
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d.
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last week? |
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e.
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last month? |
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f.
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before brain injury? |
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g.
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after brain injury? |
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7. |
When you actually forget
events listed below, how serious a problem do you consider this to be? |
Very
Serious |
Somewhat
Serious |
Not
Serious |
Does Not
Occur |
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a.
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names |
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b.
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faces |
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c.
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appointments - business, medical |
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d.
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appointments to hang out with friends |
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e.
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where you put things (e.g. keys) |
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f.
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performing household chores |
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g.
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performing routine work assignments |
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h.
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performing routine school assignments |
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i.
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maintaining personal safety routines |
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j.
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directions to places |
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k.
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phone numbers you've just checked |
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l.
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phone numbers you used frequently |
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m.
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keeping up correspondence |
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n.
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pay bills |
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o.
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personal dates (e.g. birthdays) |
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|
|
|
|
p.
|
thank those that have helped you |
|
|
|
|
|
q.
|
show empathy for others |
|
|
|
|
|
r.
|
social cues - (resulting in inappropriate responce) |
|
|
|
|
|
s.
|
words |
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t.
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things people tell you |
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u.
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going to the store and forgetting what you wanted to buy |
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v.
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beginning to do something and forgetting what you were doing |
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w.
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losing the thread of thought |
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x.
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knowing whether you've already told someone something |
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Always |
Some
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Never
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8. |
How often do you use
the following techniques to remind yourself about things? |
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a.
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keep an appointment book |
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b.
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write yourself reminder notes |
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c.
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make lists of things to do |
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d.
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have people call you |
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e.
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make grocery lists |
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f.
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plan your daily schedule in advance |
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g.
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mental repetition |
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h.
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associations with other things |
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i.
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keep things you need to do in a prominent place where you
will notice them |
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j.
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self talk |
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k.
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reminder service - friends or professional service |
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l.
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alarm clock |
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m.
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kitchen timer |
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Use our Memory
Strategies to enhance your memory |
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