Problem-solving and Decision making challenges are common cognitive impairments resulting from a stroke. Stroke-led brain Injury, particularly when it involves the frontal lobe, commonly results in difficulties with working through problems and making good decisions. Common symptoms include not being able to work out right from wrong, difficulty in recognizing a problem, difficulty working out why something has gone wrong and difficulty in anticipating potential problems. Making mistakes over and over, not being able to figure out what is causing the mistake, difficulty reasoning or being able to understand different point of views can also be observed in many stroke cases.
The problem-solving ability is affected in victims of right-brain strokes. Such survivors become impulsive and are often not aware of such stroke-led cognitive deficits. They may walk perfectly or drive to work independently, but they tend to be impulsive and fail to think before they act, developing an inability to think through a situation reasonably. Stroke-led memory loss might affect the stroke survivor’s problem-solving ability because of difficulty remembering how a similar problem has been resolved in the past.
Decision making, one of the most important elements of Executive Function, which involves long-term memory, working memory, and emotional intelligence, is affected in different ways due to memory-related impairments and problem-solving issues after stroke. While some victims may find making simple decisions (such as what toothpaste to buy) challenging, severe stroke survivors may find it hard to make a decision at all.
Even when the stroke is mild or the patient shows good recovery, difficulty in solving problems and decision making could be present. While motor deficits after stroke are characteristically more obvious, such cognitive problems are identified much later. In few cases, these deficits may remain persistent, lasting for years. Poor judgment in relationships or business can have devastating consequences.
Depending on the stroke severity, neuropsychologists can participate in the cognitive rehabilitation program. To address problem-solving and decision making challenges, Problem-Solving Therapy may be prescribed to improve coping skills after stroke. The therapy focuses on helping patients identify specific problems and goals, generate multiple solutions, choose the best option and then assess how well their choice turns out. Ongoing repetition, practice and consistency enable the problem solving and decision making to be learned.
Strategies like using a Memory Notebook (to record the previous problem-solving cases) and Thinking Games (such as word puzzles, watching Wheel of Fortune, and playing cards) are also emerging as compensatory methods for Executive Function rehabilitation after stroke.