Caring for a loved one with Alzheimer’s disease brings a unique set of challenges, from managing emotional outbursts to dealing with restlessness and agitation. Among the more unexpected issues is dealing with vision loss, which can significantly affect your loved one’s quality of life.

“I wish Alzheimer’s didn’t steal so much from a person. It is taking my husband’s vision as well,” shared one myALZteam member.

If you’re a caregiver, it’s important to understand the types of vision changes associated with Alzheimer’s and learn how to make adjustments for them. In this article, we’ll provide practical tips to manage vision changes in a loved one living with Alzheimer’s disease.

1. Learn the Types of Alzheimer’s-Related Vision Loss

As people age, most experience vision changes such as presbyopia (difficulty focusing on nearby objects). In addition, older adults with Alzheimer’s disease face specific challenges with their eye health and sense of sight. It’s important to keep the following symptoms in mind.

Peripheral Sight Loss

Alzheimer’s may lead to reduced peripheral vision, which means your loved one may have trouble seeing movement or objects out of the corner of their eye. This may mostly affect the lower field of vision, which can interfere with reading, eating, and other near tasks, as well as lead to additional feelings of disorientation and an increased risk of falling.

Worsened Color Vision

It’s been reported that people with Alzheimer’s have a reduced ability to tell the difference between similar colors. This change can negatively affect many aspects of one’s life, such as locating food on a plate, doing puzzles, or enjoying television.

Poorer Night Vision

In low-light settings, people with Alzheimer’s often have worsened vision. This is in part due to decreased sensitivity to contrast — the ability to see different levels of brightness between two objects or between an object and its surroundings.

2. Know How To Recognize Vision Issues

It may be difficult to tell if your loved one is experiencing vision issues while living with Alzheimer’s. They may not be able to communicate with you about their vision trouble, and symptoms are often masked by symptoms of cognitive decline. However, as a caregiver, you can look out for subtle signs that may indicate a visual impairment. These clues include:

Changes in Gait and Mobility

“My husband is very slow and shuffles his feet when he walks,” one member shared. Shuffling, taking hesitant steps, or falling can be signs of a loss of vision in adults with Alzheimer’s — your loved one may be struggling to avoid obstacles.

Difficulty or Lack of Interest in Activities

Having issues with simple daily tasks or gradually losing interest in visual activities such as reading may indicate a visual problem. “My husband no longer reads, writes, does puzzles, watches TV,” one member shared.

Disorientation and Agitation

Losing one’s vision can be frustrating and scary, especially for someone living with all the other symptoms of Alzheimer’s. They may struggle to make sense of their surroundings, which can trigger confusion and even outbursts.

3. Visit an Eye Doctor

Regular eye exams with an optometrist or ophthalmologist can detect sight issues early on, reducing their impact.

Some caregivers fear that eye exams can’t be performed effectively for their loved one with Alzheimer’s. “How can eye examinations be done accurately?” one member asked. “My husband is not able to answer or differentiate between up, down, right, left, yes, or no.” According to the American Academy of Ophthalmology, however, many sight tests can be done without verbal feedback.

Adults over age 65 should have an annual eye exam to detect eye conditions such as glaucoma, cataracts, and age-related macular degeneration. In people with Alzheimer’s, regular eye care is crucial to also look out for Alzheimer’s-specific changes.

4. Maintain a Well-Lit, High-Contrast Space

Because of reduced night vision and ability to detect contrast, maintaining a well-lit home is important for people living with low vision, including those with Alzheimer’s. A neatly organized space with minimal clutter can provide a sense of familiarity, improve visibility, and reduce the risk of falls.

Additionally, incorporating high-contrast items into everyday use, such as brightly colored cups and dishes during meals, can make it easier for your loved one to identify food on their plate. Drinking milk out of a dark mug, eating mashed potatoes on a colorful plate, or using a tablecloth that’s a different color from your plates can make mealtimes a bit easier for both of you.

5. Use Physical and Verbal Cues

“Has anyone noticed their loved one having difficulty seeing things when you hold it out for them?” one myALZteam member asked. Keeping in mind that your loved one may have lost peripheral vision, speak to them at a close distance while directly in front of them.

Offer verbal cues as well as visual cues, and provide assistance when they’re navigating unfamiliar environments. Effective communication strategies, such as clear and simple language, can help your loved one adapt to their vision changes.

6. Incorporate Nonvisual Activities

If your loved one seems less interested in visual activities, such as coloring, watching television, or reading, it may be because of a visual impairment. Members of myALZ team have offered tips for alternative activities, such as the following:

• “I played audiobooks for my mother just to stimulate her mind. She enjoyed lots of music that seemed to brighten her mood.”
• “I put on old movies that my mother enjoyed in her younger years.”
• “We loved to ballroom dance. If I hear a song we like, I ask him to dance.”

Plenty of activities don’t heavily rely on vision and may be good to incorporate when your loved one is struggling with visual decline.

If you notice any potential visual issues, talk to your loved one’s doctor, who can help you get the right care to address these concerns.

Talk With Others Who Understand

On myALZteam, the social network for people with Alzheimer’s disease and their loved ones, more than 85,000 members come together to ask questions, give advice, and share their stories with others who understand life with Alzheimer’s.

Has your loved one experienced vision impairment while living with Alzheimer’s? What suggestions do you have for others who have Alzheimer’s vision problems? Share your experience in the comments below, or start a conversation by posting on your Activities page.