Compensatory Strategies to Improve Functional Cognition Post-Stroke: A Review for Caregiver Empowerment and Burden Reduction

Abstract

Background/Objectives: Acquired brain injuries (ABIs), such as stroke, are a major cause of disability globally and frequently affect functional cognition. Functional cognition is the ability to use cognitive processes including memory, attention, and executive functioning to perform daily tasks. When these processes are disrupted, it affects the individual in their participation, independence, and quality of life; it also places a significant burden on family members who often become primary caregivers. The aim of this review is to summarize evidence-based strategies to enhance functional cognition following strokes in an attempt to decrease the caregiver burden and improve both patients and their caregivers’ quality of life. Methods: This review summarizes and interprets findings using an annotated bibliography review and systematic search strategy to gather the most effective and relevant evidence-based interventions for those with ABIs and strokes experiencing memory, attention, and executive dysfunction. Studies outlining adaptive and compensatory interventions were included. Results: Evidence suggests compensatory strategies including environmental and external memory aids, structured routine, technological interventions, metacognitive strategies, as well as attention processing, strategy, and visual imagery training. These tactics demonstrate improvement in functional cognition domains of memory, (particularly prospective memory, i.e., remembering to perform future tasks), attention, and executive functioning after stroke and other ABIs. Conclusions: Effective intervention strategies can help individuals’ post-stroke become more independent in their participation and activities of daily living, leading to decreased caregiver burden and improvements in functional independence and quality of life in both patients and their caregivers. It is suggested that caregivers use these evidence-based approaches in their residential environments.