Cognitive Deficits

Cognition is a fancy word for thinking. Cognitive deficits associated with RHD include: executive function (planning, problem solving, reasoning, and judgment), attention, awareness, and memory

 
 
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Executive Function

Executive function is the name for a group of thinking skills that include planning, organization, reasoning, problem-solving, and insight. Damage to the right side of the brain can affect these abilities. Some people with RHD report they can’t think as well as they used to, or they lose track of what they’re doing; some people appear to think more concretely than they did before; some may appear to have lost their ability to think logically. Others may not be able to see a problem from someone else’s point of view (see Theory of Mind, on the Communication Deficits page, for more details).

 
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Attention

Attention allows us to focus or concentrate on a task, to keep focused over a period of time , and even to seemingly do two things at once. Strokes and other kinds of brain injury can have a big effect on attention. It can be harder to focus attention, to ignore distractors, or to sustain attention long enough to complete a task. It can be much harder to do more than one thing at a time. Another complication is that many tasks that were automatic before the stroke now require thinking and concentration. It can help someone with attentional deficits to remove distractors, or break up tasks into steps into smaller steps, encouraging the person to complete one step at a time.

 
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Unilateral Neglect

This is a disorder in which people appear not to see things that are located towards their left side. Neglect is a problem with attention; in people with RHD their brain is not telling them to pay attention to things on the left side. It is not a problem with their vision or eyesight. For some people with RHD this affects the left side of their body, while for others it can be things on the left side in the room they are in. Some people with RHD can shift their attention when reminded to look to the left, but not all can do that easily. Unilateral neglect can appear to get better and worse throughout a day or week, depending on what the person is doing and how much is going on in their environment.

 
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Awareness

Reduced awareness of deficits, or anosognosia (an-o-sag-no-zha), is when the person with RHD is not aware of some or all of the problems caused by the stroke. They are not being stubborn or simply not accepting the problems – their brain is not recognizing the problems.

 
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Memory

Memory can be affected in many ways after a stroke. Some people with RHD have difficulty remembering events that happened in the recent past, others may not remember things they should do in the future. Some may not remember the precautions they were given (such as using canes or walkers). It may help to try to ensure that the people with RHD is paying attention to important information. Being consistent and placing reminders in a central location may also help.