By Teepa SnowJune 25th, 2020
5 Challenging Dementia Behaviors Explained!
Have you ever struggled with these situations, commonly seen in those living with dementia?
Vision changes in dementia can be dramatic, and can account for numerous unusual actions, including:
1. Picking at or grabbing at things that are not there
Your first thought may be that the individual is hallucinating. While this could certainly be true, it is equally likely to be caused by vision loss. At a more advanced state of dementia, when depth perception is lost, the individual could actually be trying to turn off the ceiling light or fan, not realizing that it is more than six feet away. Or, they could be trying to pick up objects from the floor, not understanding that they are actually far from reaching them.
2. Startling very easily
Have you noticed that people living with dementia often seem to be startled easily when you approach them? Sometimes they may even react by striking out, verbal anger, or losing their balance. Since people living with dementia lose peripheral vision early, and lose even more visual field as the disease progresses, it is very difficult for them to tell when someone is approaching from the side or behind. This often results in a reaction of surprise or fear or anger. Approaching from the front, in the middle of their visual field, is the best practice.
3. Trouble with eating or drinking
Although difficulties with eating or drinking can be caused by a variety of issues in dementia, vision loss definitely contributes to these difficulties. When their visual field and depth perception is reduced, people living with dementia may not easily be able to see their utensils, plate, or beverage. Also, since visual discrimination is diminished, it may be difficult for them to clearly see the food if it is not a contrasting color with their plate. This can result in not eating or drinking, eating without utensils, or spills.
4. Losing objects in plain sight
People with dementia often spend a lot of time looking for objects that, to you, appear to be right in front of them. The main reason for this is due to vision changes in dementia. Without properly functioning peripheral vision and depth perception, it can be challenging to see the pair of glasses that are sitting on the table right in front of them or the remote control that is on their lap.
5. Wearing clothes that are visibly soiled
There are several reasons that people living with dementia may do this, but changes in vision definitely contributes. If they have lost significant peripheral vision and have a very narrow visual field, it is extremely challenging for individuals to see whether or not they have spilled down the front of their shirt. So, it is quite possible that they are unaware that the clothing is stained, simply because they are unable to see it.
Visual abilities change drastically throughout the GEMS States progression of dementia. For instance, in a Diamond state of early dementia, an individual loses peripheral vision. By the Ruby state of late dementia, an individual experiences monocular (single eye) vision without depth perception.
Understanding and responding appropriately to vision changes can significantly improve your daily interactions and reduce stress, both for yourself and the person for whom you are caring.
Learn more about vision changes and the GEMS States from these Positive Approach to Care Resources:
Interested in learning about even more challenging behaviors? View our follow-up blog post by clicking here.