Monday, July 20, 2015

Dementia and the Five Senses



I have to thank Elizabeth Dunbar for this wonderful topic. Some times as my own body changes due to the Parkinson’s and/or dementia the changes in my senses become second nature and I don’t think of the changes as events and often times I adapt to them without realizing it. Unlike a sudden sly of hand card trick, changes with any of the five senses when it comes to dementia tend to be subtle. For example, when I lost my sense of smell I didn’t realize I was losing the ability to smell the subtle aromas in the kitchen as I cooked. I’m 40 and I’ve been cooking since I was a teenager. I needed my sense of smell. I’d been in the kitchen and restaurant business for twenty years. My taste buds were changing as well. 

Dementia can affect any of the five senses in two different ways; physically which is how they body literally physically transmits signals to interpret a sense and/or how each sense is interpreted by the brain and mind also known as sensory processing. If there some form of deficient behavior going on then it’s known as Sensory Processing Disorder(SPD). Take vision for example. A person can have sight problems in one of two areas, either the eyes itself could be damages (physical) or the brain (SPD). They eyes may be perfectly healthy. Maybe it’s the brain misinterpreting signals. I’ll explain vision more later but the possibility of either cause is the point.

Vision

Since my dementia has progressed I’ve noticed with the last 6 months my eyesight worsen for reading. My normal eyesight is fine. I have no problem with farsightedness. I even have no problem with night vision. I’ve always had very sight at night. Since childhood I’ve spent many countless sleepless night nights awake in the dark helping my eyes able to see better in the dark. But once I try to read I need reading glasses which I didn’t up until I was 37 which was right before I was diagnosed with dementia.

People with dementia may experience a number of changes in visual abilities. For example, they may lose their ability to comprehend visual images. That is they may see fine, but they may lose their ability to comprehend visual images. Although there is nothing physically wrong with their eyes, people with dementia may no longer be able to interpret accurately what they see because of changes in their brain. Also, their sense of perception and depth may be altered. This is one of the reasons I longer drive. Here are few safety concerns:



  • ·         Create color contrast between floors and walls to help the person see depth.
  • ·         Dishes and placemats in contrasting colors for easier identification
  • ·         Mark the edges of step with brightly colored strips to outline change in height
  • ·         Be aware that small pets that blend into carpet can cause tripping hazards


Smell

Smell was actually my first sense to go due to Parkinson’s. It’s also a common symptom of it. But a loss of or decrease in smell often accompanies different forms of dementia diseases, especially Alzheimer’s. As a matter of fact a loss of a sense of smell can be an early sign of Alzheimer’s.
I have Parkinson’s with dementia and a loss of smell is also a symptom of Parkinson’s. I gradually noticed my loss of smell. Actually it was noticing that I didn’t notice smells that others noticed that got me to noticed my loss of sense of smell. Now it’s obvious that it’s a loss. I’ve been cooking for almost 30 years and could distinguish pretty much each aroma in the kitchen. Not so now. The only way I can describe it is I can smell “food” cooking. I can still distinguish individual smells if they are strong enough but many of them I can’t name.


  • ·         Install smoke detectors and check them frequently. The person with dementia may not smell smoke or may not associate it with danger.
  • ·         This is a biggy. Keep refrigerators clear of spoiled foods. Most people with dementia cannot detect the smell of spoil foods.


Touch

I hate this one. I am always cold unless up in the 80’s or higher. My wife freezes me out in the house. It can literally be 100 degrees inside and I’m wearing a long sleeve sweater inside. I used to not be that way. It’s as if there is no comfortable ground.
·        People with dementia may experience loss of sensation or may no longer be able to interpret feelings of heat, cold, or discomfort.
  • ·         Adjust water heaters to 120 degrees Fahrenheit to avoid scalding tap water. Most water heaters are set at 150 degrees, which can cause burns.
  • ·         Color code separate water faucet handles, with read for hot and blue for cold.
  • ·         Place a sign on the oven, coffee maker, toaster, crock-pot, iron, and other potentially hot appliances  that says DO NOT TOUCH or STOP VERY HOT.

Taste

Many people with dementia may lose taste sensitivity. As their judgment declines, they also may place dangerous or inappropriate things in their mouths. I could tell my taste sensitivity decline. Foods didn’t taste as rich or salty. I started using more and more salt. I’ve now cut back on the salt even though it leaves food bland for healthier reasons. Foods don’t have to taste gourmet. They just don’t need to be bland.

  • ·         Keep all condiments such as salt, sugar, or spices hidden if you see the person with     dementia using excess amounts. Too much salt, sugar, or spice can be irritating to the stomach or cause other health problems.
  • ·         Remove or lock up medicine cabinet items such as toothpaste, perfume, lotions, shampoos, rubbing alcohol, and soaps which may look and smell like food.
  • ·         Consider a childproof latch on the refrigerator, if necessary
  • ·         Keep the poison control number (1-800-222-1222) by the telephone or on the fridge. Keep a bottle of ipecac (vomit-inducing agent) available, but use only with instructions from poison control or 911.
  • ·         Keep pet litter boxes inaccessible to person with dementia and do not store pet food in the refrigerator.

Hearing

People with dementia may have normal hearing, but lose the ability to interpret what they hear accurately. They may hear you just fine but miss what you mean completely. This loss may result in confusion or overstimulation. My hearing is fine. Like a sonar radar if you will.

  • ·         Avoid excessive noise in the home such as having the stereo and TV on at the same time
  • ·         Be sensitive to the amount of noise outside the home, and close windows or doors if necessary
  • ·         Avoid large gatherings of people in the home if the person with dementia shows signs of agitation or distress in crowds

It’s evident the senses are affected one way or another by dementia. Discovering how is the tricky part of a medical professional. Living with your senses out of whack is frustrating. Right now I just live with my sense of smell deteriorated and sense of taste not as refined. Some foods don’t taste as good to me anymore which makes it difficult to be hungry. My eyesight is ok except for the need of reading glasses and my hearing is perfect. 

We don’t often think of the loss of a sense as a big deal unless it’s traumatic like a sight going blind or hearing going deaf. When you lose your senses due to dementia you are slowly losing who and what you used to be. The things that once created joy in your life is slowly being torn from your life. And all life has to offer as treatment is “adjustment.” 

I started cooking when I was 14. That was 26 years ago. I’ve spent 20 years in the restaurant business mostly cooking. In my own home I’ve done the majority of the cooking. I love cooking. I love learning how to cook and I love new foods. But because Parkinson’s and dementia is taking my senses of smell and taste I rarely cook. I can cook from memory, but majority of the time I’m not sure of the taste. So the one room, the kitchen, I used to dominate I spend more time passing through rather than cooking. Maybe I can find someone to pass my wisdom on to.

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