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Years ago, the medical community didn’t recognize cognitive impairment as a symptom of multiple sclerosis. It’s now estimated that anywhere from 40 to 60 percent of people with MS develop some type of cognitive problem. Dealing with changes in memory and thought processing isn’t always easy, but minimizing the effects when possible can go a long way in improving quality of life. What follows are nine strategies to help manage various cognitive problems, three from each author who specializes in MS. And don’t forget to talk with the physician treating your MS so they can advise you of their recommendations, too.

Julie Stachowiak

1) Tame Your Environment: Turn off the music and television. In fact, do a “sound inventory” in different rooms of your house. See what you can do to bring some quiet into your life. Adjust the lighting. Make it soft and appealing when you can. Eliminate the clutter. Your eyes need a break from looking at stuff, especially if everything you look at chisels away at your attention.

2) Tame Your People: Only let one person talk at a time. Embrace the conversation. Put away iPhones, newspapers, tacos, fingernail files, and just talk to each other. Check in with others. Ask people if they understand what you are saying. Ask them to repeat themselves if you aren’t following the conversation. Confirm important dates, directions, anything that needs to be exact.

3) Tame Your Brain: Don’t multitask. Organize things your way. If it makes sense to you to keep laundry detergent under the kitchen sink or extra pens in the pantry, do what works for you. Talk to your brain. You can talk out loud or to yourself, but think of your brain like a toddler that wants to run off and play with random objects on the way to a destination. Gently but firmly remind your brain of the task at hand.

Shelley Peterman Schwarz

4) Use sticky notes: Keep a pack in the car and write notes on them to help you remember errands, appointments, and schedules. Put assorted notes on the back of the door before you leave town so you remember to adjust the thermostat, take out the garbage, and check to see that all the appliances are turned off. If you make a dentist or doctor's appointment for one of your children, put a note on the mirror in their bedroom to let them know.

5) Wrist reminder: For tasks that have no definite ending time, put an old bracelet around your wrist when you begin the task to remind you it needs to be finished. For example, put the bracelet on when you begin watering the yard. If you lose track of time, the bracelet will remind you to return to the task. When you’re finished, take the bracelet off and put it around the faucet so that it’s ready to use for next time.

6) Get creative: Compose rhymes and tunes. Use rhyming words or create new words for familiar tunes to help you remember tasks, sequences, dates and facts. Make up stories. Link items together in your mind by putting them in story forms. (Remember how story problems helped you learn math?) Develop acronyms. Using the first letter of each item you want to remember, create an acronym or funny phrase such as KISS (Keep It Simple Stupid).

Patricia Farrell

7) Computerize with pop-up reminders: There are programs that can display your calendar and also put a daily “to do” list for you on your screen as you boot up your computer each day. Pop-up reminders can be scheduled to flag important dates, times, or anything you have scheduled. Not everything has to be expensive, because there are freeware programs on safe Internet sites.

8) Trail of breadcrumbs: Finding your way home, or to any other place for that matter, doesn’t need to be anxiety-evoking because we now have global positioning system devices that go in our cars. You can program it for several destinations (your home is one of them, maybe the post office, your office, and the market) and it will give you voice commands for every turn and tell you, in advance, when you are coming to an exit or turn.

9) Keep it simple: Simplify and break everything down into smaller tasks so they don’t become overwhelming. The turtle, not the hare, wins the race, remember? And take a break if you suddenly feel something is just too much to handle. Just use a bit of relaxation breathing or imagery to help get things sorted out again. Asking for help is always allowed. In fact, it’s highly recommended. You don’t have to know all the answers, so give yourself a break and ask someone else to help you anywhere you need help.