What Their Eyes See is Not What They See

Recently our assisted living caregivers noticed a change in one of our residents. She was having trouble walking. Mechanically she can walk just fine. It was more her confidence.

She walks very tentatively. Like she’s near the edge of a cliff. She holds on to everything she can with her hands. She takes very small steps. And it takes her a while to move her feet.

The resident has dementia.

Maybe there was something wrong with her eyes? After talking to the family, we decided to bring her into an ophthalmologist. At the appointment, they performed a thorough exam. She already wore glasses and had cataract surgery in her past.

The conclusion? Other than normal aging her eyes were fine.

It probably isn’t the eyes that are the problem. It’s the brain. Just like a camera, the lens can be completely fine. If the processor is malfunctioning, there is no picture.

Same with hearing and other senses. If the brain can’t interpret the inputs, the signal is useless.

Let’s get back to the eyes. There are studies that show a strong link between poor eyesight and dementia. Conditions such as macular degeneration, cataracts and diabetes-related eye disease increase your risk of dementia.

Interesting that these studies don’t show much of a link between glaucoma and dementia.

A lot of eye conditions lessen or shut down optical inputs to your brain. The brain does well when it is stimulated. Dementia creeps in when it does not receive stimulation. Hence the relationship.

However, the reverse is also true. Dementia lowers the ability to ‘see’ because you are not as good at processing information. Typically people’s field of vision narrows and you see the world as if you were looking through some bad binoculars.

It’s difficult for people with dementia to see things in their peripheral vision. The CEO of A Mind for All Seasons helped train our caregivers to avoid walking up from behind or the side of people with dementia. It will really startle them.

Other problems they may have is that older people generally don’t have the ability to allow as much light in their eyes as younger people. They need up to 70% more light than young people. Often older people keep lights low to save money or because they worry about their appearance. They need the opposite! They need the house to be very bright.

Also elderly people have trouble seeing contrasting colors. That means when you try to help them sit in that white shower chair in the white shower, they may not see it.

Or they see contrasting colors such as different flooring from one room to another as a possible step up or step down. So they are very cautious when they walk from one color to another. This is what is happening we believe with our resident. We are trying to change the colors with rugs or having her walk a different path.

One of the largest challenges for caregivers is trying to see the world through the eyes of someone who has dementia. Easier said than done.