Some days in dementia care feel heavier than others, and there is no clear reason why.
What worked yesterday suddenly does not work today.
They refuse help they accepted before.
Simple routines turn into tense moments.
By the end of the day, you are worn down and wondering what you did wrong.
If this sounds familiar, you are not failing.
You are seeing what happens when the brain can no longer stay regulated the way it used to.
I often remind caregivers of this truth:
They are not giving you a hard time. They are having a hard time.
Most of the time, that hard time does not start with behavior.
It starts in the sensory system.
Why Behavior Is Not the Whole Story
Behavior is what we see.
But behavior is usually the signal, not the problem.
When the brain struggles to take in, organize, and make sense of sensory information, everyday function begins to fall apart. Eating, dressing, bathing, walking, communicating. All of it depends on a nervous system that can stay regulated enough to do its job.
Dementia changes how sensory information is received and processed. Sounds may feel louder. Touch may feel confusing or threatening. Visual information may no longer come together in a way that makes sense. The brain can become overwhelmed by too much input, or unsettled by not enough.
And even when you understand this, it can still feel like too much sometimes.
Understanding why something is happening does not make it easy to live through.
It simply gives you a steadier place to stand when things feel heavy.
The Sensory System and Daily Function
The sensory system is often a big part of the picture, but it is not the only factor.
Pain, illness, fatigue, fear, past experiences, and emotional stress all play a role, too. Dementia care is layered, and no single explanation covers every moment.
As we move through this series, we will talk more about how these pieces overlap. For now, it helps to know that sensory strain is often present, even when other factors are at work.
When the sensory system is struggling, function is often the first thing to unravel.
Not all at once.
Not in obvious ways.
But in the everyday moments that suddenly feel harder than they used to.
How Sensory Overload Shows Up in Everyday Tasks
Eating
Meals are one of the first places caregivers notice something is off.
The room may feel louder than it used to. Plates, silverware, conversations, and background noise all compete for attention. Food textures may feel unfamiliar or unpleasant. Temperature changes can be confusing. Too many items on the plate can feel overwhelming.
Refusing food in these moments is not about being difficult. It is often a sign that the brain cannot organize all the sensory information coming at it at once.
The body pulls back because the system is overloaded.
Dressing
Getting dressed requires far more coordination than we realize. The brain has to process touch, pressure, visual information, and movement all at the same time.
Fabric that once felt neutral may now feel irritating or threatening. Sleeves and waistbands can feel confusing. Visual information can be harder to interpret, making it difficult to know where the body is in space or what step comes next.
Resistance during dressing is often a hard time organizing sensation and movement, not a refusal to cooperate.
Bathing
Bathing combines many sensory inputs all at once. Sound, touch, temperature, balance, and vulnerability.
Water hitting the skin can feel startling. Changes in temperature can be uncomfortable or even frightening. The echo of a bathroom can amplify sound. Losing visual cues or footing can create a sense of danger.
When bathing becomes a struggle, the brain may be reacting to sensory overload, not the task itself.
Late Afternoon and Evening
As the day goes on, the sensory system gets tired.
Fatigue lowers the brain’s ability to filter input. Lights feel brighter. Noise feels sharper. Small frustrations pile up. The system no longer has the reserve it had earlier in the day.
This is often why late afternoons and evenings feel harder. Not because something new is happening, but because the brain is running out of regulation.
In these moments, agitation, pacing, or withdrawal are signs that the system needs support, not correction.
When Understanding Still Feels Like Too Much
This is the part many caregivers carry quietly.
When care becomes harder, it is easy to turn inward.
You wonder if you are pushing too much.
If you are doing something wrong.
If you should be more patient, more creative, more calm.
You may even tell yourself that if you just explained it better or tried harder, things would go more smoothly.
But here is the truth most caregivers are never told.
You cannot talk a brain into regulation.
You cannot explain a nervous system out of overload.
When the sensory system is struggling, effort alone does not fix it. In fact, more talking, more prompting, or more pressure often makes things worse.
And even when you slow down, simplify, and support the sensory system, some days will still be hard.
That does not mean you did it wrong.
It does not mean you failed.
It means you are supporting a brain that has real limits, even on its best days.
Supporting the Sensory System Without Doing More
Supporting someone when the sensory system is struggling does not mean fixing everything.
It means shifting how you approach the moment.
Small changes can make a meaningful difference when the brain is overwhelmed.
Start by looking at the environment.
Too much noise, visual clutter, or movement can overload a system that is already working hard. Lowering background noise, dimming lights, or stepping away from a busy space can help the brain settle.
Then look at your pace.
Slowing down matters more than saying the right words. Move more slowly. Pause between steps. Give the brain time to process what is happening without rushing to the next instruction.
Touch matters, too.
Approach from the front when possible. Use calm, predictable touch. Sudden or rushed contact can feel confusing or threatening when sensory processing is altered.
Simplify what the brain is being asked to do.
Offer one cue at a time. Too many words or choices can overwhelm a system that is already struggling to organize information. Less input often leads to more cooperation.
And when things are not working, it is okay to stop.
Pausing, taking a break, or trying again later is not giving up. It is responding to what the nervous system can handle in that moment.
These shifts are not about control.
They are about support.
Bringing It Back to Function
When the sensory system is better supported, function becomes more possible.
Not perfect.
Not consistent every day.
But more possible.
Eating can feel less overwhelming.
Dressing can feel less confusing.
Communication can feel less strained.
Supporting regulation does not remove dementia, but it can soften how daily care unfolds.
A Free Tool to Help You Reframe Hard Moments
When care feels harder, it helps to pause and look underneath what you are seeing.
Behavior is rarely the whole story.
More often, it is a sign that the sensory system is overwhelmed, confused, or exhausted.
They are not giving you a hard time.
They are having a hard time.
If this way of looking at behavior feels grounding, I created a short, gentle free resource to support you when things feel personal or confusing.
The Caregiver Reframe Guide is a free download designed to help you pause, reframe what might be happening underneath behavior, and move forward with more confidence and less self blame.
It is not about fixing the person you care for.
It is about helping you make sense of moments that feel heavy.
Click here for your FREE guide.
You do not have to figure this out alone.
Notes
- Rhodus, E. K., Hunter, E. G., Rowles, G. D., Bardach, S. H., Parsons, K., Barber, J., Thompson, M. E., & Jicha, G. A. (2022). Sensory processing abnormalities in community-dwelling older adults with cognitive impairment: A mixed methods study. Gerontology and Geriatric Medicine. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8744206/
- Zhang, N. K. (2023). Sensory processing deficits and related cortical changes in Alzheimer’s disease: A literature review. Frontiers in Aging Neuroscience. https://www.frontiersin.org/articles/10.3389/fnagi.2023.1213379/full
- Calderone, A., et al. (2025). Multisensory stimulation in rehabilitation of dementia. Biomolecules. https://www.mdpi.com/2227-9059/13/1/149
- Dintica, C. S., et al. (2023). Association between sensory impairment and dementia. Journal of Alzheimer’s Disease Reports. https://www.ncbi.nlm.nih.gov/articles/PMC10357179/
- Smith, B. C., & D’Amico, M. (2020). Sensory-based interventions for adults with dementia and Alzheimer’s disease: A scoping review [Review of sensory-based interventions]. Occupational Therapy in Health Care. https://www.researchgate.net/publication/332954039_Sensory-Based_Interventions_for_Adults_with_Dementia_and_Alzheimer%27s_Disease_A_Scoping_Review
- American Psychological Association. (2023). Improving the quality of life for patients with dementia and caregivers [Article]. APA Monitor on Psychology. https://www.apa.org/monitor/2023/04/continuing-education-patients-dementia-caregivers
- APA Practice Guidelines Committee. (n.d.). Evaluation of dementia and age-related cognitive change [Practice guideline]. American Psychological Association. https://www.apa.org/practice/guidelines/guidelines-dementia-age-related-cognitive-change.pdf
Disclaimer
The information provided in this blog is for educational purposes only and should not be considered medical advice. Always consult with a doctor or a licensed physical therapist before starting any new exercise routine, using assistive devices, or following the recommendations mentioned. Every individual’s needs are different, and professional guidance is essential to ensure safety and appropriateness of care.
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