How Vision Affects Dementia | Understanding Dementia Behaviours

Summary

In this video we address how dementia affects a person’s vision and perception, focusing on the challenges these changes can bring to daily life. As dementia progresses, damage to the occipital lobe; the area at the back of the brain responsible for interpreting visual information—can alter depth perception and colour differentiation.

This can make it difficult for someone to interpret their surroundings accurately. For example, they might struggle to see the difference between objects of similar colours or to judge how far away things are, which can lead to uncertainty and hesitation.

Our dementia expert, Jayne, explains that as people with dementia age, many may develop additional vision issues, such as glaucoma, which impacts their field of vision, adding a “honeycomb” effect to what they see. She illustrates how this affects everyday tasks, such as recognising a white plate on a white table, which might appear indistinct and cause difficulty.

Jayne highlights that flooring can be a major source of confusion for individuals with dementia. Changes in flooring types—like moving from wooden floors to carpet—can appear as steps or barriers due to the brain’s altered perception.

Similarly, certain colours, such as blue flooring, may look like water to the person, creating hesitation or even fear. Jayne recommends a compassionate and practical approach: rather than dismissing their concerns, caregivers should reassure them by demonstrating that the surface is safe, such as stepping onto the carpet or floor first.

She also discusses the need for caution with black mats, which can seem like holes to someone with altered depth perception, leading them to try to avoid stepping on them. Jayne advises Caregivers to consider removing rugs or mats that might become tripping hazards due to their appearance.

Overall, Jayne encourages Caregivers to be mindful of these changes in perception to create a safer, more comfortable environment for loved ones with dementia, while offering practical ways to help them feel more secure in their surroundings.

FAQ: Vision Changes in Dementia - Your Questions Answered

Why do I keep noticing my loved one stopping at doorways and between different floor surfaces?

Changes in flooring can be particularly challenging for people living with dementia. When the brain's visual processing is affected, even simple transitions from one surface to another can appear confusing or unsafe.

What's happening is that your loved one might be seeing changes in depth that aren't actually there. They might wonder if there's a step up or down, even on a flat surface.

Here's what you can do to help:

Stand beside them at transition points
Show them it's safe by walking first
Keep pathways well-lit
Remove unnecessary floor coverings
Maintain consistent flooring where possible

With understanding and simple adjustments, you can help maintain their confidence moving around familiar spaces. Each successful transition builds their trust and independence.

Why are they struggling to see items on the table during mealtimes?

When dementia affects visual processing, it becomes difficult to distinguish between objects of similar colours. For instance, a white plate on a white tablecloth might appear as one flat surface.

Practical solutions include:

Using contrasting colours for plates and tablecloths
Placing darker placemats under light-coloured dishes
Ensuring good lighting during mealtimes
Keeping table settings simple and uncluttered

These small changes can make a significant difference to mealtime independence and enjoyment. Many people find that once they make these adjustments, mealtimes become much more relaxed and successful.

How can I help maintain connections with my loved one?

Blue flooring can sometimes be perceived as water by people living with dementia. This isn't imagination - it's a real visual processing challenge that makes the floor appear unsafe to walk on.

To help with this situation:

Walk onto the surface first to demonstrate it's safe
Provide gentle reassurance through actions rather than words
Consider changing to a more suitable floor colour when possible
Ensure good, even lighting

Remember, your calm and supportive presence makes a real difference. Focus on showing rather than telling, and celebrate small successes together.

What should I know about rugs in our home?

While rugs can make a home feel cosy, they can present challenges when dementia affects visual processing. Some people may not see flat rugs at all, while others might perceive them as obstacles to avoid.

Practical steps you can take:

Remove rugs from main walking routes
If keeping a rug, ensure it's securely fixed down
Choose rugs with simple patterns
Position any remaining rugs away from high-traffic areas
Consider non-slip mats instead

These adjustments can help prevent trips and falls while maintaining a comfortable living environment. Safety and confidence in moving around the home are key priorities.

What should I know about black entrance mats when we're out and about?

Black mats, commonly found in shops and public buildings, can appear as holes in the floor to someone living with dementia. This is because the brain may struggle to process the depth of dark surfaces.

Helpful strategies include:

Planning routes that avoid these mats where possible
Using alternative entrances if available
Walking alongside your loved one for support
Taking time to navigate these areas carefully

Understanding this challenge helps make outings less stressful and more enjoyable for everyone involved.

How can I best support someone who's experiencing these vision changes?

Supporting someone with vision changes requires patience and understanding. What looks perfectly safe to you might appear very different to them.

Key approaches that help:

Demonstrate safety through actions rather than words
Create contrast between objects where needed
Maintain consistent, good lighting throughout the day
Remove potential hazards before they cause problems
Allow extra time for moving between different areas

Most importantly, remember that these visual changes are very real to the person experiencing them. Your understanding and support can make a significant difference to their confidence and independence.

By making simple environmental changes and offering gentle support, you can help your loved one navigate their world more confidently. Each small adaptation contributes to maintaining their independence and dignity in daily life.

Remember: these changes in vision are a normal part of the dementia journey, and there are always ways to help. With the right support and understanding, many people continue to enjoy their daily activities and maintain their independence for longer.

Full Transcript

During dementia, we also have problems with our eyes, and this is called the occipital lobe, which is at the back of your head here.

Basically, what this does, unfortunately, as we get older, most of us – I'm not saying all of us – but most of us will get glaucoma, which is like a honeycomb vision thing.

If we get dementia within the occipital lobe, it can affect many things, including our perception of where things are and how deep things are.

For instance, if we put a white plate on a white table, it'll look all the same, so they won't be able to find the depth in it.

This is also true when we look at carpeting and flooring. You may find your loved one or client will get to a different carpet, like moving from a wooden floor to a carpet or vice versa, and they’ll stop because they're not sure of the depth.

They may wonder, “Have I got to step up? Is there a step here?” Sometimes, the colour of the carpet will also make a difference.

Now, you can't go into your home or your client’s home and say, “Oh, I want you to change all your carpets” because this affects them.

But there are ways that we can help. For instance, blue carpet or blue flooring like lino – if it is a high pile or lino – can look like water.

Their client will stop at the door and hesitate, unsure whether to walk in. The key thing here is we're not going to lie to them or say, “It’s okay; it's not that deep because it's not water.”

We're also not going to say, “Oh, don't be silly; it's not water.” Although they won’t be able to tell you it looks like water, you'll have guessed that they’re looking at it and thinking it is water.

So what we're going to do is put our foot into or onto the carpet or into the bathroom and say, “Look, Michael, it's safe.”

Then they will walk in with you because you've shown them, and that is the key – you need to show them.

One of the big issues we have is black mats, which are all over supermarkets and places like that. Be very careful with those because they will try and walk around them.

They won't walk over them because, in their perception, there’s no depth, so it looks like a black hole.

Think about that and think about carpets and rugs in the house. Rugs make the house look beautiful, but unfortunately, they’re very dangerous for somebody with occipital damage during dementia.

The reason for this is they’ll trip over them because they won't see them if they're too flat, or they may think they are something else, so they’ll try to avoid them.

With flooring, keep it simple. Take the rugs up if you want to put one in front of the fire, that’s fine, but make sure you move it.

Jayne Vale

Jayne is a highly experienced dementia care specialist with over 17 years in the field. She began her career in 2004, progressing through roles such as hourly visiting carer, coordinator in the live-in care department, and lead dementia trainer. Jayne completed Specialist Practice in Dementia (Mental Health) at Worcester University and has developed bespoke dementia training for managers, carers, and family members.

Recognised for her contributions, Jayne received the National Dementia Care Personality award at the Great British Care Awards 2012. She has also been a speaker at numerous conferences and reviewed dementia-related publications.

Now with Unique Senior Care, Jayne works as a recruitment consultant, recruiting carers both in the UK and overseas, contributing to dementia training for both staff and families. Jayne’s dedication to compassionate, person-centred dementia care is evident in her extensive experience and numerous achievements.

This article was last reviewed and updated on 10th July 2025

Speak to a care expert

Understanding Dementia Behaviours | How Vision Changes Affect Dementia