Why Executive Function Breaks Down After Stroke & PPA – And What You Can Do About It

Struggling to stay on task after stroke, PPA, or brain injury? Learn why executive function breaks down & get expert-backed strategies

Why Executive Function Breaks Down After Stroke & PPA – And What You Can Do About It

Ever walk into a room and forget why you’re there?

I did this just the other day. I walked into the laundry room, opened the fridge, and stood there, completely blank. What was I looking for? No clue.

Two minutes later, it hit me—I needed baking soda from the laundry cabinet. But instead of thinking through my actions, I was on autopilot and did what my brain is used to: open the fridge.

For me, it was just a distracted moment. But for people with aphasia, stroke, PPA, Parkinson’s, or other neurological conditions, these lapses happen more often and in more frustrating ways.

Take Brad. After having a brain tumor removed, he’s struggled with focus and staying on task. One night, he planned to get to bed early for class. But when he walked into his room, he saw his baseball cards. Just for a minute, he thought. Next thing he knew, it was 10:30 PM, and he had forgotten to set his alarm.

Then there’s Allison. She has Primary Progressive Aphasia (PPA) and needed to declutter her house before moving. She walked into her closet, looked at the piles, and froze—overwhelmed by too many decisions. So she walked out and did nothing.

So why does this happen? Because executive function—the brain’s ability to plan, focus, and follow through—isn’t working properly.

What Is Executive Function & Why Does It Break Down?

Executive function is like the brain’s manager—it helps us:

Plan and organize
Start and finish tasks
Stay focused and avoid distractions
Make decisions without feeling overwhelmed

But when executive function breaks down, we get stuck, sidetracked, or shut down completely.

Why Executive Function Gets Impaired

Stroke & Brain Injuries – Damage to the frontal lobes or their connections can impair problem-solving, decision-making, and memory.
Primary Progressive Aphasia (PPA) – PPA is a neurological condition that progressively affects language and cognition, making focus and planning harder over time.
Neurological Conditions (Parkinson’s, Dementia, Brain Tumors) – These conditions slow processing speed, making it difficult to switch between tasks or stay engaged.
Even stress, fatigue, and aging can impact executive function—which is why so many people experience “Why did I come in here?” moments.

How Can You Improve Executive Function?

Goal Management Training (GMT) is an evidence-based therapy designed to improve problem-solving and awareness of cognitive challenges. Research shows that GMT leads to small to moderate improvements in executive function, and the benefits often last over time. If you or a loved one struggles with staying on task, learn more about GMT here or consult with a certified provider.

As GMT providers, we have extensive experience helping people strengthen executive function skills. Curious how we can help? [Schedule a consultation](INSERT LINK), and we’ll work with you to formulate a personalized plan to move forward.

In addition to GMT, here are five simple strategies to help you stay on task:

1️⃣ Pause & Set an Intention Before Starting a Task

➡ Before entering a room, say out loud what you’re about to do.
💡 Brad learned to pause before entering his room and set his focus on getting to bed instead of getting lost in baseball cards.

2️⃣ Break Down Tasks into Smaller Steps

➡ Instead of “Clean the kitchen,” say “Wipe counters, then unload the dishwasher.”
💡 Allison created decluttering rules: “If I haven’t used it in a year, donate it.”

3️⃣ Use Time-Blocking & The 20-Minute Rule

➡ Set a timer, work for 20 minutes, then take a break.
💡 This reduces decision fatigue and helps with follow-through.

4️⃣ Use Verbal Checklists to Stay Present

➡ Say tasks out loud as you do them. “I’m putting the laundry in the dryer.”
💡 This trick helps people with aphasia and executive function struggles stay engaged.

5️⃣ Work with a Certified Speech-Language Pathologist (SLP)

➡ SLPs play a key role in assessing and treating executive function difficulties in people with aphasia, PPA, and stroke.

Final Takeaways: What You Can Do Today

If you notice executive function challenges, don’t ignore them. Talk it over with a spouse or friend.
Pick one strategy from this article and try it today.
If executive function issues are impacting your daily life, we have extensive experience in executive function training and are certified Goal Management Training (GMT) providers. Schedule a Free Consultation Here, and we’ll work with you to create a personalized plan.

🎧 For more on this, listen to our full podcast episode HERE

GET YOUR FREE RESOURCES

📌 For People with Aphasia: Progress is always possible! Download 3 Key Reasons Aphasia Progress Never Stops to keep moving forward.

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📌 A Special Thanks to Our Sponsor –LIFE Aphasia Academy®
At LIFE Aphasia Academy®, we empower people with aphasia to achieve their communication goals. That’s why we created the free guide,3 Key Reasons Aphasia Progress Never Stops, to provide hope and strategies for ongoing progress.

Categories: : Stroke Recovery