When we think of dementia, we normally associate it with memory loss, but many types of dementia may also affect the five senses. Most people who are diagnosed with dementia are not aware of this and do not realize that their changing and/or declining senses may be affecting how they feel and behave.
If all of us were more aware of the sensory issues that affect people living with dementia, we could make changes in the way we communicate as well as make physical changes at home and in public places. People with sensory issues would feel more comfortable and could enjoy a greater freedom of independence.
Visual Changes with Dementia
There are many changes to sight that can occur with age and/or with dementia. One change is a decrease in the visual field size which causes a loss of peripheral vision. This is the ability to see what is on your sides while looking forward.
In Validation, when we work with an older client who has more advanced dementia, we always approach the person slowly from the front. If we approach from the side, we might startle them because they can’t see us coming.
Another visual difficulty may be the inability to process what one sees.
A simple object can suddenly be troublesome or frightening. A black welcome mat in front of a door can look like a black hole causing a person who has dementia to be scared to go inside. Blue tiles may look like water and keep a person from going into the bathroom.
An elevator with a dark floor may also look like a hole and even more scary if there are mirrors in the elevator that make it seem like there are people staring. Mirrors can also cause people with dementia to be scared to take a shower because they may think there are people in the room.
Non-contrasting colors can also make understanding what someone is seeing very difficult. A white toilet seat on a white bathroom floor makes the seat invisible. This may cause a person to continue to miss when they need to go to the toilet and might be looked at as strange behavior. If we know about the need for contrasting colors, we could replace the toilet seat with a black or red seat and the person who was having trouble, could now find the toilet easily.
How Dementia Affects Hearing
We hear many sounds all day and often at the same time. We can talk to someone while the TV is playing because we can concentrate on the voice of the person and filter out the background noise of the TV. Many people who are living with dementia can no longer filter out the background sounds so listening to someone speak becomes difficult. Not understanding what is said can lead to frustration, irritation and anger.
You can help a person with dementia understand you better if before speaking, you make sure to turn off all background sounds. Turn off the TV, Vacuum cleaner, Washing Machine and other appliances and make sure there isn’t another conversation going on in the room.
When we Validate, we sit close, make sure we have eye contact, and we speak slowly, clearly and in a tone that is appropriate. In this way our client can follow our voice and understand us.
Many times I have been told that my clients do not hear well, but when I Validate them in this way, they can understand and do not seem to have a hearing issue. When I asked one of my clients if he had difficulty hearing, he said not when I talk to him. That is because I make sure there is not background noise and that they can hear me well.
Background music, which may seem enjoyable and calming, can also make hearing a conversation difficult. For many people with dementia, music in a public place can be overwhelming and can induce anger.
Loud noises can be frightening and often people with dementia, do not realize that it is the noise that is making them upset. Today there are apps you can download on your phone to measure in decibels how loud the noise level is. This can help judge whether an area is appropriate for someone who is sensitive to loud noises. Announcements on the loudspeaker in a hospital can startle a patient every time it comes on. It is hard to understand how today, when we live in such a high-tech world of communication, they are still using a loudspeaker in hospitals. I’m sure this is one of the factors that leads to hospital delirium, a confusion that older people, even those who do not have dementia, who are hospitalized experience.
A person who is living with dementia may also have difficulty processing the information they hear. It’s important to give the person time to understand and react/answer. We normally don’t feel comfortable with silence in a conversation, but in this case silence may be exactly what is needed to allow someone more time to process and answer.
How Dementia Effects Taste and Smell
Some people with dementia lose their sense of taste. For some this is the first sign of dementia, before there is even cognitive decline. Before you get scared, sensitivity to taste diminishes with age. A lack of taste can make eating difficult. It’s hard to eat something that has no taste.
For others, there may be a change of taste. A food that was once loved is no longer tasty or someone may suddenly enjoy eating or drinking something they did not enjoy before.
The sense of smell may also diminish. This can be challenging to know if what you are eating is still fresh or has spoiled. Some people who are living with dementia have reported that they have phantom smells such as smelling something burning. This can cause someone to think there is a fire. Unpleasant smells can also reduce appetite.
Sense of Touch Changes with Dementia
One of my greatest pleasures is taking a hot shower after a run, but for someone with dementia. who has become over sensitive. a shower can be painful. It can feel like needles pushing into the skin. In this case it would be better to offer a bath or sponge baths.
Dementia may also reduce sensitivity and people may no longer feel temperature changes. This can be extremely dangerous. Someone may not be able to feel the difference between hot and cold and could easily get burned. To avoid burns, make sure the temperature setting on the thermostat for the hot water in the house is not too high.
Some people with dementia often feel cold. I have heard many family caregivers complain that their loved ones want the house to be heated in the summer when it is very warm inside.
It’s important to understand these sensory changes for both the person who is living with dementia and for family members and carers. By learning more we can all help our communities be more accessible for people who are living with dementia.
I have learned about sensory changes and dementia form the work of Agnes Houston. This inspiring woman has been living with dementia for 10 years and realized that she was experiencing sensory changes. Agnes has researched, published and educates people who are living with dementia as well as the general public on how the senses may change and how to overcome these changes. You can hear Agnes speak on this podcast and download her book
Talking Sense: Living with sensory changes and dementia” for free here:
It’s so important for all of us to understand dementia from those who are living with it. ----
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