Stroke can affect executive function which can impact daily life, but there are ways you can help. 

What is executive function? 

Many other thinking processes happen without us being aware of them. These are known as automatic processes. Together, many of these automatic processes are known as executive function.  

Executive function is about planning and problem-solving. It includes all the things that allow us to organise, make decisions and know when we need to do something. It also involves the way we monitor what’s going on around us, and adjust what we think and do in response. 

Signs of problems with executive function 

If a stroke affects your executive function, you may find it hard to:  

• Work out how to do certain things. This could be a task that seems quite simple, like changing the channel on the TV remote control. Or it could be more complicated, like making a meal. You might find working out how to do a new task particularly hard. 

• Plan how to complete a task. You may not be able to think of all the steps needed to do something, such as making a cup of tea. Or you may struggle to put the steps in the correct order. 

• Begin or finish a task on your own. You may not realise you need to do something, like get dressed, until someone tells you. Or you may need someone to prompt you throughout a task to help you to complete it. 

• Solve problems on your own. You may not be able to work out what to do if something goes wrong. 

• Do more than one thing at a time (multi-task). You may find it hard to switch between tasks and remember where you were with each task. 

What can I do about my planning and problem-solving? 

Practise, practise, practise 

• Planning and problem solving can be improved, but only with lots of practice. Your occupational therapist, clinical psychologist or clinical neuropsychologist can help you decide what activities to focus on, as it will be different for everyone. 

• Once you’ve mastered one task, like making a sandwich, you’ll move on to more difficult ones, like cooking a meal. 

Keep to a routine 

• Dressing yourself in the same order every day will make it easier for you to relearn the steps and spot when you miss one. 

• Developing a weekly routine can also help. If you know that Tuesday is laundry day or Wednesday is shopping day, it will prompt you to do these things. 

• A daily timetable may be useful. This can also be helpful if you have problems getting motivated, also known as apathy, which is fairly common after a stroke. 

Use prompts and reminders

• Write instructions or checklists to follow when you do something. 

• Stick notes around the house to remind you of things that you may not think of on your own, like brushing your teeth. 
• You could use brightly coloured stickers on the microwave or TV remote control, to remind you which buttons to press. 
• Prompts do not have to be written down. Use pictures or recordings instead. Some people make up songs or acronyms to help them remember how to do things. 

Talk it through 

• It can help to talk through a task with someone before you do it, to go over the steps. 

• Also think about what could go wrong, so that you know what to do if that happens.