Do vision and hearing problems worsen confusion?

I've noticed my husband gets more confused and scared at the end of the day, and he already has poor vision and hearing. Are these problems making his confusion worse? Is it worth treating?

That's a very perceptive observation on your part. When someone already has difficulty understanding the world, poor vision and hearing make everything even more frightening and confusing — and fortunately, this is one of the areas where you can help the most.

Why it happens

A person with dementia already interprets reality with difficulty. If they also can't hear well, they lose the thread of conversations, become isolated, and may become suspicious. If they can't see well, they might trip, be startled by shadows, or misinterpret their surroundings, feeding fears and confusion. Low light at the end of the day aggravates this.

Practical strategies

• Ensure they are wearing clean glasses and that hearing aids are switched on and functional.
• Regularly check hearing aid batteries and for earwax build-up.
• Speak face-to-face, slowly, and in an environment without background noise.
• Keep the house well-lit, especially in the evening, reducing shadows.
• Have regular vision and hearing screenings.

What NOT to do

• Do not speak louder abruptly; approach and speak calmly.
• Do not dismiss complaints as "it's just the dementia".

When to seek professional help

Ask your GP for an ophthalmological and audiological assessment, and earwax removal if necessary. Correcting these senses can greatly improve mood and orientation. If in doubt, NHS 111 (or local emergency number) can provide guidance.

"It was only when we got his hearing aid fixed that we realised: he wasn't more 'broken', he just wasn't hearing anything we said." — Anonymous Carer