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Dementia: Teepa Snow Explores Brain Changes

Dementia causes brain changes beyond forgetting names. Understanding the degradation of sensory perception and impulse control can help us better care for our loved ones.
dementia brain changes

Teepa Snow, one of WayWiser’s Trusted Advisors, is passionate about educating people on what dementia is, and also what it’s not. This includes exploring brain changes.

She’s devoted her life to raising awareness about this often misunderstood condition, and is driven to promote quality of life for those with dementia, and for their loved ones and caregivers. 

Because Teepa recognizes—dementia doesn’t only impact the life of the person who has it. It also deeply affects the lives of their families and loved ones. 

If you have a loved one who you suspect or know to be experiencing dementia, educating yourself about this condition is a crucial step in effectively navigating it. 

Thankfully, Teepa has helpful information and tips for those dealing with this complex issue.

If you haven’t yet watched or read Teepa’s Dementia 101 article, you can find that here.


When we think of dementia, we often focus on an individual forgetting the names and faces of family members. That’s understandable — it’s heartbreaking.

Unfortunately, that’s not all that a person with dementia forgets. As the disease progresses, they typically lose impulse control, struggle to make decisions, have a decreased vocabulary, and more.

It’s all because the brain is rewiring itself and shrinking. Teepa Snow, MS, OTR/L, FAOTA, an occupational therapist who specializes in treating patients with Alzheimer’s Disease and dementia, notes the brain can shrink to one-third of its full size. The brain is our body’s management system. As the brain changes, it shrinks and regions become smaller and less functional, it’s natural for a person to lose certain capabilities. 

Understanding what is literally going on inside of a patient’s head can help caregivers, family members, and friends plan, show empathy, and avoid taking certain behaviors to heart.

A Primer on the Human Brain

dementia and brain changes are important to understand

Snow says the brain can be divided into two broad groups: 

  • The deep brain. This part includes the limbic system. It develops first and serves as our mind’s engine. It helps an individual recognize hunger and thirst, regulate temperature, and identify threats (through the amygdala, which controls the flight or fight response).

  • The surface or cortex. This part of the brain is not fully developed until a person is in their mid-20s or early-30s. A male’s brain typically develops slower than a female’s. It controls impulses (i.e., not saying something mean), decision-making, and perspective and empathy. 

People with dementia usually hold onto their deep brain functioning longer. They’ll continue to recognize threats but may have issues controlling impulses, making decisions, and empathizing with others. This decline will be more noticeable and faster in some than others.

Brain Changes: Sensory Processing

Snow notes that the rest of the brain deals with sensory processing. You probably remember the five senses, but just in case, they are:

  • Sight
  • Hearing
  • Feeling/doing
  • Smell
  • Taste

Let’s discuss how Alzheimer’s Disease and dementia may affect each.

Sight

sight is a sensory perception that correlates with dementia and brain changes

Your center field vision is the ability to see straight ahead. It helps fuel an individual’s interest and curiosity. Edge vision aids in safety awareness. An individual with Alzheimer’s Disease or dementia can begin to lose that edge vision even in the early stages. It narrows what they can see, so they may startle more easily if a person approaches them and touches their shoulder. 

As the disease progresses, a person is essentially looking through narrow binoculars. They may forget where they last looked, which is why they may lose items more easily. They may also experience double vision or use just one eye, which results in a loss of depth perception. As a result, you may see them attempting to pick patterns off a carpet or confuse a picture of an apple for an actual piece of fruit.

Hearing

hearing can change along with dementia and brain change

A person uses their ears to hear, but they process the sense using the brain’s temporal lobes. There are two sides to the brain, and each boasts a temporal lobe. 

  • The left side controls language comprehension and remembering verbal instructions
  • The right temporal lobe is linked to non-speaking information, like music and poetry

Alzheimer’s Disease and dementia attacks the left side first. Individuals may jumble words or misuse them as their brain changes. But they’ll maintain voice inflections and the rhythm of speech, so they can engage in chit-chat. They will also retain their musical abilities, poetry, and prayer — a silver lining.

As a person loses empathy, they may become unfiltered. Racist or misogynistic statements may become common even in individuals who never expressed those feelings before. Try to remember it is the disease talking, not your loved one.

Feel/Do

touch

A person doesn’t lose their ability to feel or touch items as their brain changes. They can recognize what something feels like, but their ability to pick up on certain sensations declines. For example, they may forget something is hot and touch a stove without realizing the danger. As a result, safety becomes an issue.

Smell and Taste

smell and taste usually don't change with dementia

These two senses are primitive. A person will usually maintain them. But they may prioritize taste, such as salty or sugary foods, over nutrition. They may also only recognize what they love rather than what may bother someone else, such as the smell of spoiled food, because of their decreased ability to empathize. 

How to Help and Cope

dementia brain change care

It is challenging to watch a loved one decline, and nothing can completely change that. Keeping some things in mind and taking a few steps can reduce some of the emotional and physical burdens.

  • Research the disease. Speaking with your loved one’s provider or using reputable sources, like Alzheimer’s Association’s website, can help you gain a better understanding of what is happening and may happen to the individual. This knowledge can help you develop a plan, anticipate needs, and keep things like inappropriate comments in perspective.

  • Develop a care plan. Alzheimer’s and dementia are progressive diseases. While it can be extremely difficult to watch, there’s a silver lining: Time. When a loved one is still in the early stages, you can work with them on a plan for the future — where they prefer to live, who they would like to make decisions for them, etc. Understanding their wishes can cut down on family bickering when the time comes to make decisions and also allow you to move forward knowing that, at the very least, you are doing what the person wanted.

  • Don’t take things personally. An outburst, rude comment, or inability for a person to remember you is not a reflection of who you are or what you mean to them. It’s the disease talking.

Remember

Alzheimer’s Disease and dementia effect the brain by shrinking it and rewiring it. As a result, a person’s ability to control impulses, empathize, and process senses will decline as the disease progresses. Understanding what is to come will help you anticipate needs, plan ahead to keep a person safe and happy, and cope.

Make sure you’re caring for yourself during this process. It is long and challenging. If you need to get out of the house for some fresh air, try taking a 30-minute walk to clear your head. Organizations like Alzheimer’s Association also have resources for caregivers, friends, and family members, like support groups, to aid in coping.

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