People with Alzheimer’s disease can suffer from impaired vision that goes way beyond the age associated challenges of cataracts and yellowed eye lenses.  Caregivers should be alert to these issues so that they can recognize vision-related behaviors and make modifications to give better support.

What kinds of vision problems does Alzheimer’s cause?

Depth perception. Those with Alzheimer’s can lose their depth perception. They have a hard time judging distances, or in determining if something is a 3 dimensional object or a picture. You may see an Alzheimer’s patient trying to pick the flowers up off of a fabric with a floral design, or treating a border on a carpet as a step, either up or down.

Reduced field of vision. People’s field of vision narrows as they age. However, for some with Alzheimer’s disease, the field of vision narrows dramatically.  They are unable to see to either side, resulting in disorientation and a tendency to bump into things. The reduced field of vision is related to the inability to perceive depth and distance.

Color and contrast. Some with Alzheimer’s cannot pick out an object if it is surrounded by other objects of similar color. Colors in the blue end of the color spectrum seem harder to recognize than those at the red end.

Following motion. Following a moving object can be difficult. It has been described as watching something move as a series of still images.  These problems have serious implications for anyone who is still driving a car, but it also impacts people’s ability to comfortably watch television or any activity involving fast motion.

Ways to support Alzheimer’s patients with vision impairment

The goal of most families is to keep their loved one at home with them for as long as possible. Families who understand the nature of the visual challenges can more easily understand certain behaviors and make modifications in their care and in the physical environment to reduce the challenges that accompany visual impairment.  Here are some of the things that White Oak Cottages has done to support its residents, all of which can be done in a home environment as well:

Increase the lighting. The better the lighting, the easier it is for people to see. Bright lights do not need to be harsh.  Natural lighting is the best, but all settings require enhanced artificial lighting to maintain a bright environment. Lighting on a dimmer provides more flexibility, as does lighting that is “ganged” by area, so that you can turn up the lights only where you need them.

Avoid patterned carpets and upholstery. By using a single color or muted designs, you can eliminate the problems posed by carpets with borders and furniture with patterns. Floral patterns seem to pose a higher likelihood of confusion than geometric patterns.

Eliminate clutter on the floors, and make the pathways through a room obvious and wide.  A person with Alzheimer’s may easily trip on things left on the floor or have hard time figuring out how to move through a room.

Use color contrast.  Making sure that objects are clearly defined by contrasting colors can be extremely helpful in maintaining a person’s ability to function without help.  Examples include

• Painting the walls of the bathroom a dark shade so that the white toilet and sink stand out, or using bright colored toilet seat and grab bars to achieve a similar contrast.
• Using light-colored tablecloths on dark tables in rooms with dark floors.
• Using red china.  Many of the foods Americans eat are white (rice, pasta, chicken, fish, potatoes). When that food is placed on a white plate, it tends to “disappear”. By using bright red plates, people can see the food, and tend to eat more.

Get an eye exam. If your loved one has not had a recent eye exam and you notice problems that may be due to vision, get an eye exam. Proper prescription lenses or cataract removal can reduce the visual challenges.

Remember the sunglasses. Many people are light sensitive, and Alzheimer’s patients seem to be especially so. Remember to bring sunglasses when you go outdoors at all times of year.