The Way We See Our World

The Way We See Our World post page

By Online Dementia JournalApril 14th, 2021

The Way We See Our World

by Gretchen M. Ashton, CFT, SFT, SFN, SSC, NBFE, and PAC Certified Independent Consultant

Sometimes a care facility is someone’s entire world. Ideal facilities are designed with the needs of residents and staff in mind; practically and aesthetically. Planning includes: how we move through the facility, how meals are served, where recreational and fitness activities take place, where residents live, gathering places, and entertainment rooms. Modern facilities consider our senses; hearing, smelling, tasting, touching, and seeing. Designs include: furnishings, colors, ideal temperatures and lighting, background music, hobby and experience spaces, indoors and outside. All in an effort to help us live and work in a safe environment while we attempt to defy aging and illness and enjoy the day.

When we perceive beauty and form (free and organized) and feel comfortable in our surroundings, we feel better. It is also the case that how we feel affects what we perceive. Sight, perhaps more than any of the other senses, changes with our mood. If we are happy, we are more likely to see the positives as we go through the day, versus feeling tired and grumpy which can produce negative perceptions. The combination of seeing our surroundings with any of our other senses is powerful for the human spirit and vision is primary to how we move our body, limbs, and navigate our environment.

What if we cannot see the beauty around us because of limited vision? How might this change our understanding of our surroundings, the people we meet, the practical aspects of care, how we move, and how we feel? Person(s) living with dementia (PLwD) experience brain changes that further complicate their vision and perceptions. For example, persons living with Lewy Body Dementia (LBD), may experience both hallucinations and visual disparities. Persons living with Alzheimers Disease (AD) might exhibit vision changes in combination with cognitive recognition of everyday objects. Visual expressions of dementia often occur without any evidence of eye disease, and include narrowing peripheral vision, being unable to see more than one object, blurriness, inability to locate an object with the hand, i.e., eye and hand coordination, and obvious changes in balance. Navigating our surroundings becomes increasingly difficult and our world becomes dramatically smaller, perhaps as small as a room, bed, or chair.

With the brain changes related to loss of vision, how can we bring quality of life and prevent our world from shrinking?

Prepare in Advance. Our understanding of the progressions of dementia gives us precious time to prevent physical decline through exercise. Even without a prior healthy lifestyle, practicing movement activities, making nutritional changes, and creating daily routines, can contribute to a better future of care and quality of life. With the loss and changes in vision, PLwD will be required to rely more on physical ability, and proprioception; the awareness of how their limbs move in relation to the body, spatial awareness; how to move through their environment, and responsiveness; quick involuntary reflexes.

Keep Moving. Atrophy of muscle occurs quickly with immobility. The muscles of the lower legs and particularly those on the front of the thigh (quadriceps) seem to change first and fastest. For PLwD that experience loss of vision, caring providers and therapists must keep them walking for as long as possible. If walking is already weakened, efforts to regain it after a bedrest is paramount. Consider water therapy in a pool to rehabilitate or maintain walking. Immobility leads to shortening and rigidity of muscles that help perform activities of daily living. Walking and swimming are aerobic activities that help oxygenate our brains and bodies and might slow the brain changes associated with dementia. Stretching after exercise helps maintain muscle balance and may be done independently or with therapeutic manipulation. Massage therapy can be an important aspect of restoring and maintaining mobility. All of the above improves balance and prevents falls.

Stay Positive. Physical activity lifts our spirits, helps balance our hormones, and prevents depression. Vision is important to our happiness. Recognizing faces of friends and family, going for a walk in the garden, or watching the sunset with all its vivid colors, satisfies all our senses and enhances the way we see our world.

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