Feature article: HOBSCOTCH (HOme-Based Self-management and COgnitive Training CHanges lives): a program for people with epilepsy and concerns about their memory
HOBSCOTCH (HOme-Based Self-management and COgnitive Training CHanges lives): a program for people with epilepsy and memory deficits. If you are concerned about your memory, this article will interest you.
There are many factors that may contribute to a worsening of memory problems in those who have epilepsy and seizures. First and foremost, if seizures are not well-controlled and a patient is having episodes frequently, the probability of memory problems increases. Second, during a seizure, memory may be affected because a loss or alteration of consciousness can interfere with normal brain processes and disrupt the learning and storage of new information. The confusion that can occur following a seizure can also prevent memory from working properly. 3) Some people with epilepsy can experience abnormal electrical activity within the brain between seizures and this can also affect attention and memory functioning. 4) Specifically, patients with temporal lobe epilepsy may have memory difficulties even if seizures are well controlled because the temporal lobe is responsible for creating memories. 5) Memory problems can sometimes happen due to the side effects of anti-epileptic drugs. For instance, side effects such as drowsiness or attention problems can affect short-term memory and may make it more difficult to learn and store new information. 6) Other factors that may contribute to a worsening of memory problems include mood (e.g., anxiety or depression), sleep disturbances (insomnia), and age.
What is HOBSCOTCH?
HOBSCOTCH stands for "HOme-Based Self-management and COgnitive Training CHanges lives." This is a program for adults that was developed in Dartmouth College and is specifically designed to help persons living with epilepsy and seizures. It is a behavioral program that targets memory and attention problems in people who have epilepsy using certain strategies (self-management and problem-solving). The program is simple, cost-effective and time-limited. The program spans 3 months and includes 6 sessions in total that are led by a memory coach. In between sessions, the patient practices the newly learned problem-solving strategies and skills in real-life and then returns to the following session with feedback. It is important to note that this is not a one-size-fits-all type of program but can actually be remarkably personalized to the unique issues each patient is encountering. Once all sessions are completed, the patient continues with a self-maintenance plan.
The components of HOBSCOTCH include:
*Education: learning the basics of how memory works and understanding the difference between typical memory problems and seizure-related memory problems
*Self-awareness training
*Compensatory strategies or skills training
*Problem solving therapy
*To learn more about HOBSCOTCH, go to this page: https://www.dartmouth-hitchcock.org/epilepsy/hobscotch
HOBSCOTCH has already been examined through research. There are also ongoing research projects in a number of epilepsy programs in the US. https://www.dartmouth-hitchcock.org/epilepsy/hobscotch-research
But sometimes reading an actual testimonial from someone who completed the HOBSCOTCH program can be more powerful than all the research combined.
"I just wanted to again thank you for referring me to HOBSCOTCH. I just completed it this week and we developed a monthly self maintenance program. My memory coach said that I was a perfect referral and since I put in the work had a wonderful result. The very best part is the personalization of it to your needs and abilities. It's not a one size fits all. It's been a bright spot in a very difficult time right now. So again, thank you so very much."
If you are concerned about memory changes or other problems with thinking, your physician may refer you for a neuropsychological evaluation. A neuropsychological evaluation consists of several parts. First, there is a clinical interview, where the neuropsychologist gathers information regarding your medical, social, and educational history. It is sometimes helpful to have family members present during the interview to help provide additional information. The next part of the evaluation involves the administration of standardized measures that tap into functions such as memory, attention, visuospatial functions, executive functions, and language. Tests might involve learning stories or lists of words or putting together designs with blocks. Just as you may have had EEGs or MRIs to look at your brain, neuropsychological testing allows the neuropsychologist to "look" at your brain by making you use it. The final part of the evaluation typically involves completing questionnaires in which you self-report on your mood and behavior (e.g. quality of life, stress coping).
Following the evaluation, the neuropsychologist writes a report which includes the test findings, areas of cognitive strength and/or weakness, as well as any recommendations which may help manage symptoms or compensate for memory problems in day-to-day life. Your neuropsychologist might recommend numerous strategies to better manage cognitive issues and may also recommend you attend a program such as HOBSCOTCH.
