Short term memory loss is almost always the result of injury to the frontal lobes. This can also effect emotional stability and appropriate and proportional emotional response. There can also be alterations in other "executive functions."
"The executive functions of the frontal lobes involve the ability to recognize future consequences resulting from current actions, to choose between good and bad actions (or better and best), override and suppress unacceptable social responses, and determine similarities and differences between things or events. Therefore, it is involved in higher mental functions.
The frontal lobes also play an important part in retaining longer term memories which are not task-based. These are often memories associated with emotions derived from input from the brain's limbic system. The frontal lobe modifies those emotions to generally fit socially acceptable norms. - Wikipedia - Frontal Lobe."
Talk with the Neurologist. There are some recent medications that can mitigate some of these issues.
I have lesions in my frontal lobe. It affected my short term memory, my recognition of faces, my problem-solving abilities, and my language skills.
What I would do is (if you can afford it) to get a neuro-psych exam. This will help you pinpoint problem areas.
After my neuro-psych exam, my psychiatrist recommended Aricept, which is usually given to Alzheimer's patients. There's some debate about how effective it is for MS patients. I found that it helped me think around the areas in my brain that weren't working all that well.
However, it's not a fix - just a way to get through a very rough spot cognitively speaking. I would not make any serious decisions at this time, just try to take care of the basics and postpone any major events if possible.
I was reading something the other day that stated MSers leave the work force due to cognitive issue long before they do for the physical issues of MS. I'm not saying he should leave the work force but that its not an uncommon issue and something to take on board for future reference.
I think it would probably be a good idea to reduce some of the more problematic issues that he acknowledges as being a problem for him now, if thats for example, keeping track of all the legal paper work, get someone to take over the accounts side of the business.
One thing I find helpful is breaking down problem areas into the steps needed, i create check lists, i use to be able to do this in my head but now i have to have a physical list that i have to cross off or i forget. Well its more that i think of it but then because i've thought of it, my brain files it off somewhere never to be retrieved until i'm reminded, the lists help me not forget the physical side of what i'd thought.
I also use post it notes, and note pads all the time, if its not written down in plain sight then it just may never get done. I want to make a point here though, my brain is not working as it use to but it is working, and though i am no longer able to function as my old self, I still function at a new base line, it is when i'm physically fatigued, and not being sufficiantly rested through out the day that makes an enormous difference to my cognitive function and speach.
I find supporting what doesn't come easily more helpful than anything, so where does he feel he needs support? Personally i know when my cognitive function is off, and when its more off than usual but its a sensitive subject because it happens to be one of my biggest concerns, to loose my mind is not somehting i'm ever going to be happy about, to be reminded of it is like poking a raw wound. I would tread very carefully on how you go about being helpful and make sure he is fully in control with what he wants and needs.
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