Powerful Tools for Family Caregivers

Attention is the ability to focus on a task or element of the environment. We need a number of attending skills in our daily lives for the functions described below:

• Focus attention on what we see, hear, smell, taste and feel
• Sustained attention or concentration for long periods of time
• Divided attention among two or more elements of the environment at a time (e.g., driving and listening to what someone is saying)
• Selective attention to “tune out” irrelevant aspects of the environment or distractions
• Alternating attention on one thing and then another (e.g., multi-tasking)

One or more of these functions may be affected in different disabilities.

Difficulties in attention and concentration are common after head injury or stroke. In MS, you may notice difficulty screening out distractions, problems with divided attention (e.g., listening to a family member when doing something else), fatigue when reading, poor recall due to lack of focus and decreased ability to organize information in a way that will allow it to be retrieved later. Alternating attention can be impaired in MS due to slow information processing and difficulties with concentration; for example, a person with MS may have difficulty resuming a task or conversation after an interruption.

You may also notice that your loved one:

• Makes statements such as “my mind goes blank”
• May not hear you talking if he/she is focused on another task (e.g., dressing, reading).
• Is easily distracted by small things.
• Loses track during conversations.
• Loses interest in a conversation due to inability to pay attention.
• Has difficulties shifting from one topic to another in conversation.
• Displays significant confusion in a crowded and noisy environment.

Note: If you notice that your loved one is unable to focus on a task for any length of time and lacks enjoyment of previous hobbies, consider other factors that may be involved. What appears to be lack of attention may be due to difficulties with perception or memory.

• Remove unnecessary objects from the environment to reduce distractions.
• Designate a consistent workplace for the loved one to engage in certain activities.
• Modify enjoyable activities to shorten the time required for completion.
• Simplify tasks.
• Remove time pressures from tasks and don’t rush the person.
• Make sure the person is well rested when attempting activities that require concentration.
• Do not expect the person to attend to more than one thing at a time; focus on one topic or task, and then move on after a break.
• Promote the habit of taking frequent rest breaks during tasks.
• Don’t give too much information at one time, and be prepared to repeat information.
• Secure the person’s attention prior to engaging in conversation (e.g., “I need you to pay attention to what I am saying...”).
• Alert the person to a change in topic (e.g., “OK I have finished with that. Now what I want to talk about is…”).
• Keep a to-do list.