Breathe these in:
Your mom’s cinnamon rolls.
A hot shower.
A meaningful conversation.
The vibrant autumn leaves.
It’s our senses that enable us to experience these joys of life — and be connected to the world. Our ability to see, touch, taste, smell, and hear what’s around us is something we usually take for granted. But like so many of our body’s systems, our sensory system can decline with age, leading to challenges that leave us struggling to engage. And if you’re caring for someone experiencing sensory decline — or its counterpart, sensory overload — then knowing how to support your loved one’s sensory needs can help make things easier, for you and the person you’re caring for.
Our sensory system’s important role
According to the National Council On Aging (NCOA), different factors can contribute to sensory decline: genetics, disease, or just gradual deterioration. It shows up when we strain to read fine print, hear the TV, or move around the house — anything that involves our senses not working how they used to.
These declines might just be minor irritations at first, but they can snowball into bigger problems if not addressed. For example, hearing loss can cause someone to avoid long conversations out of embarrassment or frustration. That can lead to isolation, which can contribute to depression and reduced brain stimulation — all of which accelerate cognitive decline, says the NCOA.
Deficits in other senses can also become concerning. “As you get older, you have a reduced ability for taste and smell, which can impact your appetite and safety,” says Dr. Stephanie Olson, occupational therapist and assistant professor at Spalding University. “If someone is alone and they don’t realize food has spoiled, they can get sick. Their hygiene can suffer. Losing sensitivity to touch can make it difficult to detect temperature changes. Even your proprioception [your internal sense of moving through space], that’s where a lot of falls come into play as we see a decrease in balance and spatial orientation. There are huge sensory changes as you grow older.”
What can we do about these concerns? First, we just need to be aware of them, especially since these declines tend to happen gradually. Keep in touch with your doctor about sensory changes you notice. If you’re caring for someone, take steps to ensure that communication lines are open, says Dr. Olson: talk loudly, use visual aids, make sure hearing aids and glasses are properly used. Throw away expired foods, and keep the water temperature at 120 degrees.
After these basics, the next thing we can do is limit the decline by regularly giving our brain a sensory workout. The NCOA reports that when we stimulate our senses, especially in novel ways, we encourage our brain to keep making new neural connections and help it stay primed to support sensory function. Multisensory experiences, where more than one sense is engaged, up the benefits even more.
Give yourself and your loved one a brain boost by incorporating varied sensory experiences into your day. Cooking something together, gardening outside, or eating lunch at a new place can make a big difference in your day — and with consistency over time, in your loved one’s quality of life.
Professional guidance is also available if sensory decline is causing your loved one a lot of problems with everyday tasks. You can ask a doctor about sensory integration therapy, which can help the brain strengthen its sensory processing. In this therapy, a specialist such as an occupational therapist will evaluate your loved one’s needs and design a strategy (called a “sensory diet”) using repetitive physical or mental activities that stimulate the senses. The research is promising for this therapy improving mood, memory, and cognition in those with dementia or Alzheimer’s disease, says the NCOA.
People have different levels of sensory needs
In addition to addressing sensory decline, learning about how we individually take in sensory input can help us better navigate life.
Everyone has sensory sensitivities, even if they don’t realize it, says Dr. Olson. If a loud noise, a crowded store, or a powerful smell has ever made you think, ‘I’ve got to get away from this,’ you know you’ve experienced sensory discomfort. And some people reach that level of ‘too much’ more quickly than others. That’s called dysregulation: when our brain can’t process everything we’re taking in, and our body goes into fight-or-flight mode due to the overload.
What determines this difference in reaction and in what sends us into dysregulation? A major factor is how our brain is wired.
Those who study the brain continue to learn more about neurodiversity, or differences in brain wiring. Think of it like different operating systems on a computer or smartphone (Apple or Android? Windows or Mac?). People whose brains operate on the autism spectrum or with ADHD experience neurodivergence, as do people with a trait called high sensitivity, says therapist Kim Whitt of Empathic Counseling. These different ‘operating systems’ affect how we process sensory input (sights, sounds, smells, tastes, and textures) throughout our day. And for neurodivergent people, the threshold of overload tends to be much lower. Add dementia to the mix, and you’ve got a complicated sensory challenge on your hands.
We don’t have a lot of research yet on the neurodivergent experience in older adults. The first diagnoses of autism mainly occurred in children in the 1940s, so those people are just now reaching their seasoned years. Much later has high sensitivity (also known as sensory processing sensitivity) been more understood, with the term being coined in the ’90s by psychologist Dr. Elaine Aron. But if your loved one has a really tough time with sensory issues, neurodivergence could be something to talk about with your doctor or a counselor.
Kim herself is highly sensitive and specializes in this area with the clients she serves virtually in Kentucky and Ohio. She says that when people realize they are highly sensitive (and about 20% of the human population is, according to Dr. Aron), it often changes their whole outlook on life.
“Highly sensitive people are more sensitive in all aspects,” she says. “You are more attuned to the world around you, you’re more aware of little things, you feel things very deeply, and you typically are using a lot more energy doing all these things. That can be very draining for people, especially if they don’t know what’s happening.”
That’s where overstimulation can happen more easily, Kim continues, leading to dysregulation that shows up in angry outbursts, anxiety, and resistance to changes in routine. If you’re highly sensitive, you probably also experience an aversion to harsh sensory input like bright lights, chaotic scenes, strong smells, and certain textures in food or clothing. Dr. Olson recalls one client who could not tolerate the tight feeling of her diabetic compression socks, even though she’d been medically ordered to wear them. Dr. Olson encouraged the family and medical team to make an exception.
“To that person it probably feels like knives on their legs,” Dr. Olson says. “You have to know this isn’t intentional; the person you’re caring for is not out to be difficult. You have to meet them where they are. Once you understand that, it’s going to help you care for them better and be better for your mental health.”
Both Dr. Olson and Kim stress that for someone who has sensory sensitivities, environment is everything. Lower lights, a decluttered room, quiet music, and gentle aromatherapy can go a long way toward calming a dysregulated person. (For you, the caregiver, going into a dark bathroom and taking some deep breaths counts if you’re not able to take a longer break.) Talking through upcoming changes with your loved one and moving slowly through transitions can help, too. And remember, dysregulation is not the time for trying to reason and rationalize with someone; it’s the time for finding soothing input. Experiment with calming activities, give it time, and you will learn what brings you and your loved one back into balance.
By Jessica Alyea
P.S. Go With The Flow: Caregiving For Someone With Dementia Might Require A Little Acting.
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