Wellness Strategies Group logo

Discover Perceptions in Dementia

Perceptions in Dementia

Dementia is a complex condition, specific to each individual, and its impact goes far beyond memory loss.  One of the key challenges associated with dementia is the way it affects one’s ability to understand and interpret the world around them.  This is referred to as perception.  In this blog, I will share valuable insights and practical caregiver tips for navigating perceptions in dementia to improve quality of life for those traveling the dementia journey.

What Is Perception in Dementia?

Our brains process and make sense of the sensory information it receives.  This perception includes sights, sounds, tastes, smells and touch, which allows us to interact with others and navigate our environment.  In dementia, the messages in the brain are not processing as they should, and this disruption of signals can lead to altered perceptions of reality.  

Perception Changes in Dementia

These altered perceptions of reality in dementia may present in the following ways:

Depth Perception

These changes can make it difficult to determine transitions and depths in floor surfaces, which can increase the risk for falling.  It can also make it difficult to pour the correct amount into a glass or bowl.

Visual Misinterpretations

People and objects may become confusing or distorted.  This can lead to the inability to recognize a familiar person or an object, which is referred to as agnosia.

Spatial Awareness

Lack of spatial awareness can lead to difficulty with wayfinding or a loss in sense of direction.  Someone may have difficulty finding their way to the restroom or determining where the chair is making it difficult to sit down safely.

Auditory Fluctuations

Sensory information can be misinterpreted, and sounds are included.  Hearing loss may occur during the aging process too.  This can lead to fear, confusion and miscommunication.  

Tactile Sensation

Touch may change during dementia resulting in the lack of awareness between hot and cold.  This can pose a safety concern.  Feelings of discomfort or pain may also be altered.

Changes in Taste

A person living with dementia might experience a change in their taste buds.  They may begin eating foods that they didn’t previously prefer, or they may have a lack of appetite if food is no longer flavorful, or it has a bad taste.


These are false beliefs that the person with dementia interprets and insists they are true.  This can lead to paranoia, such as believing someone is stealing all of their money, or out to get them.


A person living with dementia may see or hear things that are not actually there. These are referred to as auditory or visual hallucinations.  Some hallucinations do not cause distress, and others can be quite troublesome.

How Do Perceptions in Dementia Impact Daily Life?

Some people living with dementia may have one or more types of changes in perception.  This can significantly impact the daily life not only for themselves, but for those caring for them as well.  Symptoms from altered perceptions for the person with dementia may include confusion, frustration, fear, depression and anxiety.  The caregiver may experience increased stress, frustration or a feeling of not knowing how to respond. 

Understanding that these perceptual changes are related to dementia is the first step for caregivers in navigating how to manage them.  The person is not being difficult or intentionally trying to cause a disruption. They are experiencing a result of changes in their brain.  It’s our responsibility as a caregiver to develop a supportive environment.   

Managing Perceptual Changes


Develop a Routine 

Creating and following a daily routine is so important and I can’t stress this enough.  Routines can reduce confusion and they develop expectations and familiarity for the person with dementia.  

Create a Dementia Friendly Environment

Clutter can be confusing, overwhelming and can increase fall risks.  Ensure pathways are well-lit and use wayfinding techniques when needed.  Explore using color theory to assist with navigating the environment.  

Provide Reassurance

Some perceptual changes can be frightening, so offer support and create a sense of a safe environment during episodes.  For hallucinations, you may try saying, “I know that you see ____ and it’s very real to you.  I’m here with you.”

Refrain From Arguing

During times of delusions or hallucinations, arguing will not change the outcome or persuade your loved one that what they believe is not true.  It’s best to validate what they are experiencing and try other techniques to redirect.

Use Concise Communication

Communicate in simple terms at a normal pace, always making eye contact.  Use one step commands and allow your loved one time to process what you have said.  Visual aids such as picture cards and gestures can help.  

Seek Professional Consultation

Dementia Care Consultants can provide a wealth of information and develop personalized strategies for managing these types of changes in dementia.  This is their area of expertise, and they can be a very valuable part of the care team.

In conclusion, perceptions in dementia are complex, and often a misunderstood aspect of the journey.  By understanding the challenges associated with perceptual changes and implementing effective strategies, caregivers can help improve the quality of life for their loved one.  Remember, each person is unique, so developing a tailored response will have the most beneficial impact.  Learning a sense of compassion, patience and flexibility are key in navigating dementia complexities.  If you need guidance, please contact me for a personalized plan to support your loved one’s perceptions in dementia.  You don’t have to travel this journey alone.