This paper describes a framework for understanding compensatory behaviour in people with organic memory impairment. It builds on a theoretical framework proposed by Bäckman and Dixon (1992) who distinguish four steps in the evolution of compensatory behaviour: (a) origins, (b) mechanisms, (c) forms, and (d) consequences. Although this framework is useful in understanding compensation in neurologically impaired adults, other factors need to be taken into account. Using data from a long-term follow-up study it is shown that age, severity of memory impairment, and additional cognitive deficits are important variables in predicting independence and use of compensations several years post-rehabilitation. The paper concludes with a consideration of how the framework might be used in future studies.