Understanding and Supporting Sensory Changes in Dementia

Your loved one winces at sounds that never bothered them before. They pull away from touch they once welcomed. The bright lights you've always had seem to cause distress. You're not imagining these changes—and they're not being difficult. Their brain is processing the world differently now.

You know that look—the one where your person seems suddenly overwhelmed in a room that feels perfectly normal to you. Maybe they cover their ears at the television volume you've watched together for years. Perhaps they refuse to wear certain clothes or become agitated during what used to be a peaceful shower.

These aren't behavioral problems. They're sensory processing changes, and they're one of the most misunderstood aspects of dementia care.

As dementia progresses, the brain's ability to filter, interpret, and respond to sensory information changes significantly. The world can become simultaneously too much and not enough—sounds are louder, lights are harsher, touches feel different, and the sensory input that once brought comfort can now cause genuine distress.

Understanding these changes won't just help you create a calmer environment. It will help you see challenging moments through a completely different lens—one that leads to connection instead of conflict.

Understanding How Sensory Sensitivity Changes

The brain you're caring for is working harder than ever to make sense of everyday sensations. What was once automatic—filtering out background noise, adjusting to bright light, interpreting the sensation of clothing against skin—now requires conscious effort that may no longer be possible.

Think of it this way: imagine trying to have a conversation in a crowded restaurant where every nearby discussion sounds equally loud, the clinking dishes feel like crashes, and the lights seem to pulse. That's often what a normal day feels like for someone with dementia-related sensory processing changes.

Some sensations become amplified. The hum of the refrigerator that you barely notice might sound like a roar to them. A gentle touch on the shoulder might feel startling or even painful. Patterns on floors can look like holes or obstacles to step over.

Other times, there's reduced sensitivity. They might not feel pain from an injury, notice extreme temperatures, or register hunger and thirst cues. This isn't stubbornness—their brain simply isn't receiving or interpreting these signals correctly anymore.

Visual processing changes can be particularly confusing. Shiny floors might look wet and slippery. Dark rugs can appear as holes in the ground. Mirrors can be frightening when they no longer recognize their own reflection. A black toilet seat against a white toilet can become invisible, making the bathroom harder to use independently.

Creating Environments That Feel Safe

Your home doesn't need a complete renovation, but small, thoughtful changes can make an enormous difference in daily comfort and calm.

Start with lighting. Harsh overhead lights and glare create genuine discomfort for many people with dementia. Softer, diffused lighting feels safer. Consider table lamps and floor lamps instead of bright ceiling fixtures. Pay attention to glare on floors and reflections in windows—these can be genuinely distressing. If evening shadowing (sometimes called "sundowning") is an issue, maintaining consistent, gentle lighting as day transitions to evening can help.

Reduce visual complexity where possible. Busy patterns on floors, walls, and furniture can be overwhelming or create confusing illusions. Solid colors and simple patterns are easier for a changing brain to process. Remove or cover mirrors if they're causing distress. Consider how contrasts can help—a soft-colored toilet seat against a white toilet, dishes that contrast with placemats, dark light switches against light walls.

Sound deserves your attention too. We become so accustomed to background noise—the television no one's watching, the radio in another room, multiple conversations happening at once. For someone with sensory processing changes, these sounds don't fade into the background. They all demand equal attention, creating exhausting overwhelm. Quiet becomes a gift.

Temperature matters more than you might think. The ability to regulate body temperature and recognize being too hot or cold often changes with dementia. Pay attention to their comfort cues rather than what the thermostat says.

Finding the Right Amount of Sensory Input

Here's the paradox: while reducing overwhelming sensory input matters, providing the right kind of sensory engagement is equally important. A sensory-friendly environment isn't a sensory-empty one.

Meaningful sensory experiences can anchor someone in the present moment, provide comfort, and create connection. The key is choosing activities that engage the senses gently and purposefully.

Touch can be powerfully comforting when done right. Think soft textures—fleece blankets, velvet fabrics, smooth stones. Hand massage with unscented lotion can be soothing. Folding soft towels or sorting buttons provides tactile engagement without overwhelm. But always approach from the front where they can see you, and watch for signs that touch isn't welcome in that moment.

Music often remains accessible even when other forms of communication become difficult. Songs from their young adult years can bring joy and calm, but keep the volume moderate. Live singing—even if you're not confident in your voice—can be more soothing than recordings. The key is familiar and gentle, not stimulating.

Scent can trigger memory and emotion powerfully, but be cautious. Strong artificial fragrances often cause distress. Think subtle and natural—the smell of coffee brewing, bread baking, or lavender sachets. Notice what brings a smile and what causes them to pull away.

Nature provides sensory input that rarely overwhelms. Feeling sunshine, watching birds, touching plants, listening to wind chimes—these experiences engage the senses in ways that feel inherently calming rather than demanding.

Recognizing and Responding to Overstimulation

You'll get better at reading the signs, but they're not always obvious at first. Overstimulation doesn't always look like agitation. Sometimes it looks like withdrawal, fatigue, or what others might mistake for lack of interest.

Watch for these signals: pulling away, covering ears, closing eyes, increased repetitive movements, fidgeting, pacing, trying to leave, verbal expressions of discomfort, or simply going quiet and distant. These are all communication—their way of saying "this is too much right now."

When you notice overwhelm building, respond with reduction and calm. Lower voices, turn off background noise, dim lights slightly, reduce the number of people in the room. Give space if they need it, but stay nearby. Sometimes simply moving to a quieter room changes everything.

Your own calm matters more than you might realize. When they're overwhelmed, they're looking to you—not consciously perhaps, but instinctively. Your steady, quiet presence provides the regulation their brain can no longer provide for itself.

Don't try to reason or explain during overwhelm. Keep your words simple and your voice soft. "You're safe. I'm here. Let's sit down together." That's often enough.

Learning to see the world through changing sensory processing isn't something you'll master overnight. You'll have days when you recognize overstimulation early and adjust beautifully, and days when everything feels like too much for both of you. Both are part of this journey.

What matters is understanding that when your person seems uncomfortable, agitated, or resistant, they're often not being difficult—they're being honest about how the world feels to them right now. That honesty deserves your respect and your response.

You're not expected to create a perfect sensory environment. You're invited to notice, adjust, and approach each day with curiosity about what might feel different for them today. Some days will require more accommodation than others. Some strategies will work beautifully for weeks and then stop working. That's not failure—that's dementia.

Give yourself permission to experiment, to adjust, and to let go of how things used to be. The goal isn't to eliminate all discomfort—that's impossible. The goal is to reduce unnecessary overwhelm so there's more room for the moments of connection and comfort you're both seeking.

Action Plan: Creating Sensory Comfort

This Week:

• Observe one daily routine (morning routine, mealtime, evening) specifically watching for signs of sensory overwhelm or comfort

• Identify the single loudest background noise in your home and find a way to reduce or eliminate it

• Check your lighting—are there harsh overhead lights you could replace with softer alternatives?

• Note any times they pull away from touch or cover their ears—these are valuable clues

This Month:

• Experiment with reducing visual complexity in one frequently used room—remove busy patterns, reduce clutter on surfaces

• Try three different calming sensory activities (music from their era, hand massage, folding soft fabrics) and notice which brings the most comfort

• Address glare issues—consider curtains for bright windows, area rugs over shiny floors

• Create a simple "calm down" space with soft seating, gentle lighting, and minimal visual stimulation

Ongoing:

• Build a routine of checking in with yourself about sensory environment before assuming challenging behaviors are about anything else

• Keep a brief log of what sensory experiences seem to bring comfort versus overwhelm—patterns will emerge

• Adjust expectations around social gatherings—fewer people, shorter duration, quieter settings may all be necessary accommodations

• Remember that sensory needs will change over time; what works today may need adjustment tomorrow

As Needed:

• If overwhelm happens, respond immediately with reduction—lower noise, dim lights, reduce people, slow down

• When someone is visiting, brief them in advance: "Dad does better with softer voices and one person talking at a time"

• Before appointments or outings, consider sensory demands—waiting rooms, fluorescent lights, unfamiliar sounds—and plan accordingly

• If certain care tasks (showering, dressing) consistently cause distress, rethink the sensory elements—water temperature, lighting, number of steps, amount of skin exposure at once

You're learning to care for someone whose experience of the world is changing in ways that are hard to fully understand. Every adjustment you make toward their comfort is an act of love and dignity. Trust yourself, stay curious, and remember that perfection was never the goal—connection is.

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