Sensory Overload — How People with Dementia Are Impacted by Noise

At the age of 46, Kris Bakowski was diagnosed with early-onset Alzheimer’s disease. Kris has been blogging about her diagnosis since 2003 to advocate for awareness and help educate others living with the disease and their caregivers.

In one of her blogs, Kris discusses the topic of sensory overload. Since her diagnosis, she has been prone to panic attacks when faced with overstimulation, crowds of people, or noise. According to Kris, “(n)oise is one of my biggest problems. I carry earplugs with me all the time. I cannot filter out noise very well, so it is very hard for me to be in a car with the radio on or with several people talking at once. I cannot concentrate with the noise.”

Sensory Overload Was One of Her First Symptoms

One of Kris’ first symptoms of Alzheimer’s was not being able to follow conversations in meetings because there were too many people talking or extraneous noise in the room. She realized that she could not filter it out, that she was in sensory overload.

When she attended an Alzheimer’s luncheon for those in early-stage Alzheimer’s and their significant others, the noise in the room was so overwhelming that she felt almost claustrophobic. The same thing happened at a luncheon with some close friends. She realizes that she can’t socialize in this manner anymore, and she is sad she has to give up something that used to bring her joy but now makes her feel confused and agitated.

The Impact of Noise on People with Dementia

Extraneous noise is thought to be particularly distressing and disorientating for many people with Alzheimer’s and other forms of dementia, especially at busy times of day such as mealtimes. Background noise that may be acceptable to some people is often overwhelming for those with dementia, leading them to become increasingly and unnecessarily distressed. And there is a reason for this:

• Of all the senses, hearing is the one that has the most significant impact on people with dementia in terms of quality of life.
• Dementia alters how the person with the disease perceives external stimuli, such as noise and light.
• As hearing is linked to balance, this also leads to a greater risk of falls either through loss of balance or through an increase in disorientation as a result of people trying to orientate themselves in an environment that is overstimulating and noisy.
• If other senses are overloaded at the same time as hearing (such as sight, touch, smell, and taste) the overstimulating effect can cause a dramatic change in the behavior of a person with dementia.

How Alzheimer’s Patients Act When Overstimulated

Research shows that those with Alzheimer’s and other forms of dementia are more likely to pick at objects if subjected to continual noise, thus increasing their agitation. Wandering behavior may also be a way for the person with dementia to try to remove themselves from an overstimulating situation.

Which Noise Problems Occur in the Home?

Specific rooms can have specific problems:

• Acoustics in the bathroom can be particularly difficult. Running water and the flush of the toilet, for example, can create a confusing or sudden noise. Yet singing in the bathroom can be lovely and may even help with reducing agitation if it is a song or tune that is recognizable and enjoyed by the person with dementia.
• The noise from a television or radio, especially if there are simultaneous sounds such as from conversations, children playing, or background street noise.
• Many people talking to each other, such as at parties or family gatherings, often along with the clatter of dishes and cutlery — all contribute to a sense of disorientation.
• In open spaces, some sounds appear louder. For example, noises from a kitchen and dining area or the sound of conversations or laughing can be especially noisy, and this is often noticed most in common open spaces.
• Noise at night can result in disturbed sleep, which in turn can lead to problems during the day, such as lack of concentration and difficulty communicating and performing during the day.
• Noise from equipment such as a washer/dryer may be absorbed into the normal sounds of daytime but seem much louder during the quiet of the night.

Physical Changes to Help Reduce Noise Levels

Physical changes can be made to lessen noise and other stimuli and support people who have dementia, enabling them to remain independent for as long as possible. These are some changes you can consider making in your home to make someone with dementia feel more comfortable and content:

• Make sure there are no air passages or gaps around doors.
• Use floating floors to reduce impact noise from footsteps or doors closing.
• Use sound-absorbing curtains plus wall and floor coverings to limit the amount of reverberation.
• Limit the use of background music. Find out what music or songs your loved one prefers, and play them at an appropriate level for short periods of time.
• Turn off the television in the living room unless your loved one is specifically watching a program.
• Turn off the television or radio before you start to speak to the person with dementia.
• Be aware of noise from specific devices, such as alarms, doorbells, or cell phones. Try to minimize these types of noises, which can be intrusive, especially when combined with other background noise and at night.
• Speak clearly and slowly, and expect to repeat what you say.
• Be aware of any noises in the home such as a clock ticking loudly, the central heating system, water pipes when the toilet is flushed, or any sounds that the person with dementia may no longer recognize and may be frightening or otherwise contribute to sensory overload.

Managing Noise

A limited amount of noise can be a good thing. For example, familiar music can be played and enjoyed at a volume that could be heard but is not overly loud or overstimulating. Calming and quiet music or singing may be helpful too, for example, on a one-to-one basis if a person with dementia is awake during the night.

Appropriate sound levels can improve communication as the person can focus on one interaction or task. While having no background noise at all may feel strange to some people, silence or the simple low-level noise of conversation may actually help a person with dementia to concentrate on the task before them. A person with dementia may respond after being spoken to if they are given enough time to process the information. He or she may need silence to process information.

Hearing Impairment in People with Dementia

Many people with dementia also have hearing loss, and many people with hearing loss often dislike wearing hearing aids, or simply refuse to wear hearing aids, which often causes distress among their family members who don’t understand why their loved one refuses to wear their hearing aids or think their loved one with hearing loss is just being stubborn. If you have a loved one with dementia and hearing loss who often refuses to wear hearing aids, consider the possibility that your loved one is very intentionally creating peaceful silence by not wearing the hearing aids and therefore not subjecting themselves to sensory overload from the noise in their environment.

If a Loved One is Overstimulated and Upset

When someone with Alzheimer’s or another form of dementia is distressed or upset from overstimulation or for another reason, the first thing to do is help them calm down. In these situations, whatever threat or concern they’re experiencing is very real to them. Using a few simple techniques that rely on the body’s natural responses can help calm the person down. Click here for a video where expert dementia educator Teepa Snow demonstrates these helpful techniques.

Plan Ahead if You or a Loved One Has Dementia

If you or a family member has received a diagnosis of dementia, it is highly recommended that you update your estate planning documents as soon as possible, giving strong consideration to creating a long-term care plan that includes an asset protection trust such as our Living Trust Plus® to protect your assets from probate PLUS lawsuits PLUS the potentially devastating expenses of assisted living or nursing home care that may be required toward the end of the dementia journey.  We offer all potential new clients an initial consultation:

Fairfax Elder Law: 703-691-1888
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