Managing a Loved One with Dementia’s Sensory Challenges

The world can be an overwhelming place, filled with unending demands on our five senses: sight, hearing, touch, taste and smell. Each sense plays a role in how we process the world. Our sight can show us who and what surrounds us. Our hearing gives us a way to listen to our loved ones’ stories and laughter. Touch allows us to feel the closeness of another person and the warmth of their hand. Taste and smell give us our love for our favorite food and the aroma of it cooking—and our dislike for our least favorite foods.

Dementia can change a loved one’s ability to experience these five senses, and that can have a huge impact on how they view the world. Their favorite food might not taste the same way. They may be startled by the sound of laughter they used to love. They may draw away from a once familiar touch.

As a caregiver, it’s important to recognize these changes, and to help make your loved one’s world a more comfortable, less overwhelming place to be for each of their five senses. 

Sight

Sight is one of the senses most greatly impacted by dementia. Here are just some of the ways it can be affected:

• Field of vision: According to celebrated dementia educator Teepa Snow, the field of vision of those with dementia can narrow up to 12 inches, creating a sensation like wearing binoculars. If a loved one loses peripheral vision, they may not see someone approaching them from the side, or notice things that are not right in front of them.
• Spatial awareness and depth perception: A loved one with dementia may have trouble judging distances, navigating steps, grabbing items they need and recognizing the difference between 2D and 3D.
• Visual hallucinations: Those with dementia can sometimes see things that aren’t there. This is most common in those who have Lewy Body dementia. 

Like with any sense, a loved one with dementia can also be overloaded by seeing many things at once.

What can you do as a caregiver for a loved one with dementia experiencing vision challenges? Try:

• Using contrasting colors in your loved one’s environment. For example, using a red plate with a yellow placemat can make it easier for your loved one to eat
• Marking steps with colored tape to make it easier for your loved one to distinguish between them
• Making sure your loved one’s house is well lit
• Avoiding busy patterns in items like clothing, tablecloths, rugs, etc.
• Showing your loved one only one thing at a time when giving them visual options—such as when choosing clothes in the morning, or food in the supermarket

If your loved one is seeing hallucinations, don’t pretend like you see what they’re seeing, or invalidate their experiences by telling them that nothing is there. Instead, be calm and gentle, and assure them that you are here for them and will keep them safe. If you can, try to redirect them to an activity they find soothing. 

Hearing

Noisy environments can be overwhelming for anyone. Even city dwellers can have trouble hearing when horns are blaring, music is pumping and everyone is talking all at once.

For loved ones with dementia, these situations can be doubly frustrating. On top of that, sensitivity to noise and difficulty sorting out different sounds at once can make seemingly simple scenarios—like going to a park on the weekend or listening to friends talking over a commercial break—hard to deal with.

To help, consider:

• Discouraging people from talking all at once or interrupting when talking to your loved one
• Removing competing noises from your loved one’s environment. For example, if you need to talk to your loved one while watching TV, put the TV on pause or mute first.
• Paying attention to how your loved one acts in crowds. If they seem stressed, try moving them to a quieter location, or go home, if necessary. You can also schedule outings during quieter times of the day
• Invest in a good pair of earplugs, if your loved one is comfortable with them, to use in unavoidably noisy situations like 4th of July celebrations

 
Touch

Some older adults with dementia experience loss of sensation. This can impact their ability to distinguish between hot and cold. It can also make them less likely to notice a painful sensation—for example, being pricked by a rose thorn—when touching something.

As a caregiver, it can help to do a quick temperature test on things like bath water or tea to make sure your loved one won’t scald themselves. It’s also important to practice kitchen safety, especially in the later stages of dementia when a loved one might hurt themselves on stoves or kitchen knives.

It’s also important to remember that dementia can change the way a loved one reacts to physical touches. Some loved ones may not mind being hugged or held by the hand—some may even like it more than they used to! But others may dislike being touched, even if they didn’t mind previously, especially if they no longer recognize the person trying to touch them. If your loved one is touch averse, be sure to respect their wishes and touch them only when necessary.

Taste and smell

Many people with dementia experience a reduced sense of taste and smell, even in the earlier stages of the disease. Both of these senses play a role in mealtimes; if food continually smells and tastes bland, your loved one might lose their appetite.

If this happens to your loved one, it’s important to keep them eating a healthy amount of food each day. Using spices, marinades and tart flavors can help trigger your loved one’s taste receptors and make food more flavorful. Just make sure any new foods or seasonings you introduce into your loved one’s diet are safe for them to eat, and won’t aggravate any existing conditions.

While certain sensations can at times overwhelm or causes stress to loved ones with dementia, other senses can be very soothing or provide comforting stimulation. Pay attention to what sensations your loved one likes—touching soft fabric or watching birds—and redirect them to these more enjoyable things when they feel stressed. Sensory rooms can be helpful to people with dementia and their caregivers. For more ideas on how to create one, check out the Alzheimers.net guide to designing sensory rooms.
 

This article was written as a part of the Expansion of Dementia-Capable Communities within Urban and Rural Settings in Ohio using Evidence-Based and Informed Programming project, funded by the Administration for Community Living, Alzheimer’s Disease Program’s Initiative (#90ADPI0052-01-00). Learn more here.