13/02/2025
DEMENTIA SENSORY ISOLATION
Dementia progression commonly alters the five senses and affects their cognitive abilities and behaviors. Sensory overload short-circuits the brain with a flood of information the person can't control. This commonly causes panic, confusion, or violent behavior.
Sensory deprivation, which is a lack of sensory information, often accelerates dementia progression, emotional withdrawal, and refusals to cooperate or participate in activities.
As humans, we depend on a functioning sensory system. Our visual, auditory, tactile, olfactory, and gustatory sensations are essential for us to “make sense” of our world. When even one of these senses isn’t functioning, our perception differs significantly from others.
SIGHT
Blindness is a disability for some people, and children with vision problems typically have difficulty learning. Most seniors experience visual loss with aging; many wear glasses and contacts or have laser treatments. Some develop cataracts and require surgery to prevent blindness.
Dementia progression commonly creates visual impairments, such as loss of depth perception, which causes misinterpreting distances, depth, and width and misjudgment of how fast something moves. Also, visual distortions create problems such as dark rugs resembling a hole in the floor, colorful patterns appearing to move, what’s in the distance seems right next to them, and stairs having no depth and resembling flat lines.
Peripheral vision is also lost, causing “Tunnel Vision,” where the outer edges of the visual field darken or blur. If you’re sitting next to the person and talking, they can’t see you, or if you stand in front of them while they are sitting, they only perceive your mid-section. This is why it is essential to always make eye contact when talking to them.
Another problem is visual focusing, where they can’t locate items surrounded by clutter,r like the inability to find their fork on a table full of items or with a patterned tablecloth.
AUDITORY
Aging commonly damages hearing, and some people need hearing aids. If we are totally deaf, we lose the everyday environmental sounds, people talking, or awareness of danger. Deafness is like being in a vacuum of silence.
Once, I lost my hearing completely when my ears didn’t adjust to the altitude pressure in an airplane. Although the deafness only lasted about an hour, I was terrified as I walked through the busy terminal,l seeing people’s mouths moving and not hearing a single sound. I couldn’t communicate in that nightmare of total silence, something I had never before experienced. I felt vulnerable and afraid.
Watching people’s lips move voicelessly, the television’s inaudible images, a pet’s soundless barking, cars whizzing silently, and worse yet, the feeling of dead silence can cause people with hearing loss to experience fear, frustration, and anger. Hence, they often begin to disengage from people and their environment.
Most people with advanced dementia possibly have hearing loss, but cognitive problems prevent them from following hearing test instructions or responding to the questions. This creates difficulty in knowing how much hearing is damaged. Worse yet, they’ll commonly remove their hearing aids or misplace them.
Dementia deterioration causes the brain to lose or misinterpret incoming sounds. Voices might seem garbled, or some words disappear. If they have tinnitus, a constant ringing in the ears, it's distracting, and what people say becomes confusing. They have trouble hearing high tones, so speaking to them using lower tones is essential.
Hearing loss increases dementia progression and symptoms, and the person often disengages from their surrounding,s refusing to interact with people. They may appear asleep or refuse to do anything asked of them.
TACTILE
Skin is our largest organ, encompassing our entire body. It has over five million nerve endings that sense touch, pressure, temperature, and pain. We are “in touch” with our environment through our skin, which signals the brain to activate the muscles. However, if our arm is numb, this feels like a “dead zone,” and muscles won’t respond.
Dementia typically causes disruption of tactile perception, thus sending the wrong signals to the brain. During progression into later stages, the mind/body connection becomes damaged, and the ability to interpret or locate pain is lost. The person might have numb areas or feel the pain but can’t tell you what is happening or localize where it hurts. Pain typically causes dementia symptoms to suddenly spike. The most common cause is a urinary infection (UTI) requiring medical attention.
Sometimes, there’s a hypersensitivity to tactile sensations, hot or cold, which is felt more intensely because the brain’s ability to regulate temperature is damaged.
Even the perception of the feel of textures becomes different. One woman with dementia described the water of the shower as needles hitting her skin. Commonly, eating disorders are related to the texture of the food. At dinner in a nursing home, a man said his mashed potatoes felt like tasteless mud in his mouth, and I’ve heard complaints about how a wool sweater felt like a wire brush.
As we age, collagen breaks down, and the hypodermis, the fatty layer under the skin, becomes thinner. It leaves blood vessels closer to the surface, which quickly causes bruised or torn skin. Be careful when handling the person.
The manner of touching a person with dementia is also a way of communicating, and they should never be grabbed roughly or shoved. It’s essential to touch them in a way they feel secure and cared for.
OLFACTORY
Our sense of smell creates our strongest memories as the olfactory system directly influences the brain's hippocampus region, which is responsible for memory formation.
People with dementia often lose their olfactory sense early in their symptoms, especially those with Alzheimer’s, possibly because the hippocampus is one of the first areas damaged by the disease. Doctors consider olfactory loss as a possible early indicator of the disease.
Our senses of smell and taste are interconnected, and we even taste the air we breathe. When we lose our ability to smell, we lose our taste. I’m so hypersensitive to strong perfumes that sometimes I can taste the scent in my mouth for hours afterward.
Our sense of smell alerts us of dangerous situations like a gas leak or spoiled food. It also stimulates the appetite or repulses us. The smell of freshly baked cookies makes us salivate. However, the smell of Limburger cheese can cause gagging.
TASTE
We have an average of 10,000 taste buds on our tongue, which detect sweet, sour, bitter, salty, or savory. These are replaced about every two weeks. This is why when we burn our tongue, it heals so quickly.
Because our senses of smell and taste are interrelated, losing both can become a major contributor to the development of eating disorders in those with dementia. It’s also dangerous for those still living independently.
One of my friends had undiagnosed early Alzheimer’s and had lost both smell and taste. She would forget how long food had been in the fridge, and because of it, she couldn’t tell if the food was spoiled and was continually getting sick.
SENSORY STIMULATION
Sensory stimulation activities and exercises are a necessary part of slowing the progression of dementia and managing symptoms. Time should be set aside to make sure all five senses are activated, even if the sense of smell and taste seem absent. We never know how many of these senses still remain.
Help your loved one to “Make sense out of their world.”
Katya De Luisa resides in Costa Rica and is a dementia educator/consultant, writer, and author.
www.dementialearninginstitute.com
