Caregiving: What Do Your Senses Need?

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 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.

Ideas for sensory-friendly activities

Whether your challenge is combating sensory decline or toning down sensory overload, the good news is that there are many simple activities you can do that will attend to your and your loved one’s sensory needs. (You’re probably already doing some of them without realizing the benefits they provide.) Here are some ideas for a soothing “sensory diet” to offer your loved one at home to proactively reduce dysregulation, make transitions easier, boost brain activity, and improve quality of life:

Get outside: There’s a reason we almost always feel better after spending time in nature — the rich multisensory input from feeling a breeze, smelling fresh air, or seeing the changing leaves helps us regulate and decrease stress. Gardening or taking a walk also provides some exercise. Whenever you or your loved one need a reset, try to get outside.

Cook together: Kneading dough, smelling a familiar dish in the oven, and savoring a delicious bite or a cold drink are all positive sensory inputs. Bonus: Cook something new together to encourage novelty and making new memories.

Take a warm shower or bath: Feeling the warmth, smelling a favorite soap, and listening to the water are calming. If taking a shower or bath is too involved, you can try turning down the lights and letting your loved one soak their feet in a foot bath.

Light a candle: Inhaling a favorite candle scent and watching the dancing flame is an easy sensory activity perfect for fall.

Create a sensory box or collage: Collect familiar items that are special to your loved one, such as family photos, treasured knick-knacks, a favorite perfume, an old driver’s license or wallet, and anything else dear to the person. You can have a regular time of day where you bring this out and look through it with your loved one, especially if it’s around a time or transition that tends to be difficult for them. If your loved one enjoyed going to the beach, you could fill a tray with sand and seashells for them to touch. If they love flowers or leaves, bring some in from outside and arrange them together.

Art and music: Painting, working with clay or play-dough, listening to music from your loved one’s younger years, or playing an instrument all exercise different senses and encourage regulation. Water paint sets like Relish Aquapaints (available on Amazon) limit mess.

Massage: If your loved one enjoys tactile input, a shoulder rub or back scratch always feels good. A weighted blanket can provide a feeling of security. Professional massage therapy can soothe aches and pains, and it can also be beneficial for sensory needs with its quiet music, low lights, aromatherapy, and warmth.

Rhythmic motion: Babies love it, and adults can benefit from it as well — rocking in a rocking chair or on a porch swing or glider offers an outlet for calming movement.

Spend time with a pet: A soft, warm companion can be soothing. There are even simulated pets available, such as cats that purr (but won’t cough up furballs).

Attend a sensory-friendly outing: If taking your loved one on an outing tends to exhaust or overstimulate them, you can try a sensory-friendly program that some organizations offer for people with autism, dementia, or other sensory sensitivities. The Louisville Zoo has oncea-month Sensory Sundays that provide an exclusive, self-paced program with fewer stimuli and additional places for quiet time. The Kentucky Performing Arts Center offers sensory-friendly performances with lower lights, limited seating, and a quiet room available. Louisville Nature Center’s sensory garden is another accessible destination.

By Jessica Alyea

Fall 2024 | Today's Transitions