Management techniques used in hospitals will vary according to the type of hospital ward and the clinical diagnoses of the patients. Different programs are used on acute general medical wards, rehabilitation wards, and long-stay wards. Different approaches are taken according to whether an impairment is one that is likely, to some extent, to show improvement (stroke or early head injury), to remain static (longer-term head injury), or to deteriorate (multiple sclerosis and dementia). Most of the previous literature has reported studies based on rehabilitation or geriatric wards. These will be considered in this chapter, but most emphasis will be placed on approaches that might be used on general medical wards, as there have been few published reports on the training of memory in this setting.
The studies considered are those that were designed for real-life memory problems, as opposed to investigations of the ability to learn experimental material. The former studies fall into two main categories. On geriatric or long-stay wards, the main approaches used are reality orientation, environmental modification, and reminiscence therapy. In a rehabilitation setting, training in specific memory strategies, such as visual imagery (Glasgow, Zeiss, Barrera, & Lewinsohn, 1977; Wilson 1981, 1982), PQRST (Glasgow et al., 1977), and first-letter cuing (Wilson, 1982), is more often used. These strategies may be carried out with individuals or in groups (Wilson & Moffat, 1984a).