Thinking and
perception
after stroke
Summary
•Stroke can affect your thinking and
perception.
•Perception is how your brain
understands what it sees, feels,
smells, tastes and hears.
•Problems with thinking or
perception can affect how you do
everyday activities. It can affect
how you feel about yourself.
•There are many things you and
your family/friends can do to help.
What is cognition?
Cognition is a word used to describe your
thinking and memory skills. After a stroke you
may have trouble with different types of thinking
skills. For example:
• Paying attention. You may find it hard to
concentrate on things going on around you.
For example, conversations or television
programs.
• Orientation. This is knowing what the day and
date is. It also includes knowing where you
are and who the people around you are. Not
knowing some of these things can make you
feel confused.
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• Short-term memory. This is remembering
things that have happened a short time ago.
For example, what happened earlier in the day
or a week ago. It could also be remembering
someone new that you have met or why you
are in hospital. You may be able to remember
what happened to you before your stroke
(long-term memory).
• Learning new tasks. This can be because you
have trouble paying attention or find it difficult
to remember something new.
• Solving problems. Solving problems may be
difficult. Making decisions can also be hard.
You may find it tricky understanding numbers
or managing money.
• Planning what you are going to do. You
may forget steps in an everyday activity. For
example, forgetting to put your socks on
before your shoes or forgetting to take your
toiletries to the bathroom.
A lot of things can affect your ability to think
clearly. Being tired, emotional, stressed or in a
busy or noisy environment can all make it harder
to think clearly.
What is perception?
Perception is the way our brain receives and
understands messages from our five senses
(smell, touch, taste, sight and hearing). It is how
the brain makes sense of these messages. After
a stroke you may have difficulty with perception.
Fact Sheet | Thinking and perception after stroke
Thinking and perception after stroke
For example:
• You may not feel contact, pain, heat or cold
on the side of your body affected by the stroke
(your arm, leg or one side of your face).
• You may not recognise shapes, objects or
even parts of your body .
• You may find half of your vision in each eye
is lost. This is called a hemianopia. This may
cause difficulty reading, watching TV, moving
around or seeing things around you.
• You have trouble seeing or feeling things on
your affected side. This is called neglect. If
you have neglect you may not see people or
things in the room on your affected side. You
may bump into things or knock things over.
You may also have difficulty watching TV or
reading.
• You may also have trouble reaching for objects,
judging distance or telling left from right.
• You may have trouble doing a certain
movement or action, even though there are no
physical reasons for not being able to do the
action. This is called apraxia.
How can this affect me?
Having difficulty with thinking or perception after a
stroke can affect many different areas of your life
such as:
• Everyday activities. For example, difficulty
getting dressed, having a shower, cooking or
going shopping. This could be because you
forget some steps, need help getting organised
or get tired easily.
• Social activities or hobbies. You may have
difficulty remembering what has been said,
or concentrating on conversations (especially
with more than one person). Or you may have
trouble remembering names. This might stop
you going out with friends or doing the things
you once enjoyed.
• Your feelings. You may have problems doing
the things you used to do because of difficulties
with your thinking or perceptual skills. This can
lead to feeling hopeless, frustrated, angry or sad
and perhaps depressed. See the Depression
after stroke fact sheet for more information.
• You may not be able to drive safely with these
difficulties. You should not return to driving
without medical approval. See the Driving after
stroke fact sheet for more information.
Difficulties with your thinking or perception can be
dangerous at times. For example, you may forget
to turn the stove off or take food out of the oven.
This can result in a fire. You may forget to take
your medications or take too many. You may get
lost or disoriented when walking around. Or you
may walk into things on one side or have difficulty
crossing roads.
It is important that you and your family and friends
know about the difficulties you may have. This
way, you can all be aware of potential dangers.
What can I do?
• Your occupational therapist or
neuropsychologist may do some tests with
you. These tests will help to work out any
problems as well as your strengths. Talk to
them about the test results. They will be able to
suggest things that can help you. • Talk about the problems you are having with
your family and friends. Together you may be
able to work out ways to help you.
• Make time to rest and relax. Plan your day so
you have rest breaks. An afternoon nap may
help.
• Pace yourself. You don’t need to finish a big
job in one go. Break one task into several
smaller parts. Or you can get someone to help
you.
• Tell people when you are having trouble with
something. Let them help.
• Use a diary, day planner, calendar or note
pad to help remember things. Writing down
appointments or jobs to do can help you to
remember them. Photos or pictures can also
help ‘trigger’ your memory.
• Use other memory aids such as tape
recorders, pagers, mobile phone alarms, lists
or even notes placed around the house. These
can prompt you to remember things.
• Check your calendar, newspaper or diary. This
can help you to remember the day and date.
• Limit the amount of things you have to think
about at any one time. For example, when
someone is speaking to you turn off the TV
or radio. This lets you focus on what they
are saying. Being in a quiet room can help
you concentrate when reading or learning
something new.
• Ask your family or friends to remind you about
things. For example, if you have a neglect your
family can remind you to look towards your
affected side.
• If you have problems with eyesight have your
eyesight and glasses checked. You may need
to wear special glasses.
Thinking and perception are like any other
difficulty after a stroke - they can improve with
practice. So try to ‘exercise your brain’ as often
as you can. Talk to your occupational therapist
or doctor if you are having difficulties with your
thinking or perception.
What can my family and friends do to help?
There are a number of simple things that your
family and friends can do to help you with your
thinking and perception. For example:
• Keep instructions clear and short. No more
than five or six words to a sentence. Only one
or two instructions at a time.
• Write or draw instructions on paper. For
example, draw a map.
• Keep activities simple.
• Encourage the use of memory aids. For
example, a diary, note pad, tape recorder or
calendar.
• Know that problems can be made worse by
stress or being tired. Being in a busy or noisy
environment can also make it difficult.
• Keep the area around you as clutter-free as
possible.
• Encourage regular breaks. Suggest plenty of
time to rest and relax.
• Slow the activity down. Work through one step
at a time.
Fact Sheet | Thinking and perception after stroke
For more information
Speak to your doctor, occupational therapist
or neuropsychologist if you are having
difficulties with your thinking or perception or
want more information.
National Stroke Foundation
National Office
Level 7, 461 Bourke Street
Melbourne VIC 3000
Phone: +61 3 9670 1000
Email: [email protected]
www.strokefoundation.com.au
We have offices in Brisbane, Sydney, Hobart and Perth.
Occupational Therapy Australia Ltd.
Toll free: 1300 682 878
Email: [email protected]
www.ausot.com.au
Call StrokeLine 1800 STROKE (787 653)
Proudly supported by Allergan Australia P/L.
For a complete list of fact sheets, visit our online
library at www.strokefoundation.com.au
© National Stroke Foundation 2012. This fact sheet was developed by the
National Stroke Foundation together with OT Australia. FS06_May2012
Printed on 100% post-consumer recycled paper.
Fact Sheet | Thinking and perception after stroke