Neuropsychological rehabilitation (NR) is concerned with the amelioration of deficits caused by insult to the brain. It adopts a goal-planning approach and addresses real-life difficulties. Neuropsychology studies how the brain affects behavior, emotion, and cognition. Rehabilitation is a process whereby people who are disabled work together with professional staff, relatives, and others to achieve optimum physical, psychological, and vocational well-being. Rehabilitation is not synonymous with recovery, nor is it treatment. It is a two-way interactive process with professional staff and others who aim to remediate or alleviate difficulties, adopting a holistic approach in which cognition, emotion, and psychosocial problems are treated together, aided by an increasing use of technological aids. NR enables people with disabilities to achieve their optimum level of well-being, reduce problems in everyday life, and help them return to the most appropriate environments. There may also be some partial or limited recovery of function and certainly some substitution of function. Accepting that return of normal functioning is highly unlikely, rehabilitation finds ways to help people learn more efficiently, compensate for their difficulties, and, when necessary, modify the environment. While theoretical models have proved helpful, indeed essential, in identifying cognitive strengths and weaknesses, in explaining phenomena, and in making predictions about behavior, they are insufficient, on their own, to seriously influence rehabilitation aimed at making lives more adaptable to problems encountered in everyday living. NR should focus on goals relevant to a person’s individual everyday life, it should be implemented in the environment where the person lives, and have personally meaningful themes, activities, settings, and interactions. We know from numerous studies that NR can be clinically effective. Although rehabilitation can be expensive in the short term, there is evidence that it is cost-effective in the long term.
Nicole D. Anderson
Healthy aging is accompanied by decrements in episodic memory and working memory. Significant efforts have therefore been made to augment episodic and working memory in healthy older adults. Two principal approaches toward memory rehabilitation adults are restorative approaches and compensatory approaches. Restorative approaches aim to repair the affected memory processes by repeated, adaptive practice (i.e., the trained task becomes more difficult as participants improve), and have focused on recollection training, associative memory training, object-location memory training, and working memory training. The majority of these restorative approaches have been proved to be efficacious, that is, participants improve on the trained task, and there is considerable evidence for maintenance of training effects weeks or months after the intervention is discontinued. Transfer of restorative training approaches has been more elusive and appears limited to other tasks relying on the same domains or processes. Compensatory approaches to memory strive to bypass the impairment by teaching people mnemonic and lifestyle strategies to bolster memory performance. Specific mnemonic strategy training approaches as well as multimodal compensatory approaches that combine strategy training with counseling about other factors that affect memory (e.g., memory self-efficacy, relaxation, exercise, and cognitive and social engagement) have demonstrated that older adults can learn new mnemonics and implement them to the benefit of memory performance, and can adjust their views and expectations about their memory to better cope with the changes that occur during healthy aging. Future work should focus on identifying the personal characteristics that predict who will benefit from training and on developing objective measures of the impact of memory rehabilitation on older adults’ everyday functioning.