During #VisionHealthMonth, we are shining a spotlight on the changes in vision that occur as we age and how to support our aging loved ones through these changes. Today, we want to discuss an often overlooked aspect of vision loss—peripheral vision loss—and its impact on individuals with dementia.
Peripheral vision refers to the ability to see objects on the sides without moving your eyes or head. It's like noticing something out of the corner of your eye. To understand how peripheral vision works, try extending your arms to the side and wiggling your fingertips. You should be able to see the movement while looking straight ahead.
Reduced Peripheral Range
As we age, our peripheral vision naturally narrows. However, for individuals with dementia, this narrowing happens at an accelerated rate. They may not notice someone approaching from behind or even see a plate of food in front of them if they're not looking directly at it.
This reduced peripheral range can lead to accidents, like bumping into furniture, and increased startle responses since they may not see someone approaching from the side. That's why you often hear the advice to approach a dementia patient from the front or side, not the rear. Their visual field becomes limited, and they may no longer sense or see you approaching.
Why does this happen? Vision is controlled by the brain, and diseases like Alzheimer's and dementia can affect it, along with other senses. However, the shrinking visual field presents more challenges than just approaching from behind. Peripheral vision loss becomes significant in the later stages of the disease, sometimes resulting in binocular or telescopic sight.
For example, consider how peripheral vision loss affects individuals with dementia during meal times. Imagine holding your hands up to your eyes as if looking through binoculars. What do you see? Only what is directly in front of you. Now, think about feeding a loved one with dementia. They won't see that you are feeding them, even if you tell them. All they see is a fork coming at them at the last second. They can't see the food on the plate or that you're trying to help them. All they perceive is something heading toward their face.
Peripheral vision loss not only affects movement and awareness of objects but also impacts the brain's ability to process visual information correctly. This can lead to illusions, misperceptions, and misidentifications of faces.
Caregivers commonly observe vision decline in individuals with dementia. Individuals living with dementia commonly experience changes to their vision beyond what’s expected as part of the normal aging process. As dementia-related illnesses cause progressive brain deterioration, a person will experience certain sight deficits because the brain is no longer processing what the eyes see in the same way. Other common problem areas include:
Depth perception
The person may struggle to navigate steps, grab objects, and distinguish between two- and three-dimensional scenes. With the latter, for instance, the person may try to pick up flowers from a floral-printed tablecloth. Depth perception can be seriously affected by visuoperceptual mistakes. When a patient is walking, they may be unable to tell when, for example, the floor changes from carpet to tile. If the tile or carpet is patterned, this can disorient them even further, which can certainly contribute to falls. A shadow or dark throw rug on the floor can also appear to them as a hole in the ground, which can be very frightening.
Facial recognition
Dementia symptoms include confusion and memory loss. But that may not be all that’s in play when an individual seems not to recognize a loved one or frequent visitor. Damage to certain parts of the brain may cause misidentification of people, like thinking a man is one’s brother instead of a husband. The problem similarly manifests in instances like seeing a red ball and calling it an apple.
Colour and contrast decline
Problems detecting contrast are common in the bathroom, where the white toilet and seat disappear against a white tile floor. Mealtimes, already a challenge for some who struggle with swallowing, are problematic when, for example, white mashed potatoes aren’t noticed when served on a white dinner plate. Additionally, a reduced ability to distinguish colours may result in a person picking out mismatched clothing.
In conclusion, peripheral vision loss is a significant issue for individuals with dementia. It affects their ability to see objects and people around them, leading to difficulties in daily activities and potential safety hazards. Understanding and addressing these vision deficits is crucial for providing appropriate care. Caregivers can adapt their approaches and environments to enhance the quality of life for those living with dementia.
At Ideal Caregivers 4u, we are here to support your senior loved ones in navigating their surroundings and assisting with daily tasks affected by vision loss. Contact us today for more information!
"Improving the quality of life for our clients since 1998 while providing peace of mind to their families."
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