Vision and Hearing
When someone seems more forgetful, confused or less able to manage everyday things, it is easy to think first about their memory.
But sometimes the problem is simpler:
- Could they hear clearly?
- Could they see clearly?
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Vision and hearing have a big effect on how we take in information, understand what is happening around us and manage everyday tasks. If hearing or vision is reduced, someone may look more forgetful or confused than they really are.
Hearing: You Can't Remember What You Didn't Hear
Imagine the television is on. Someone says:
“Your appointment is at ten tomorrow. The letter is beside the kettle.”
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But you only hear:
“…appointment… tomorrow…”
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Later, someone asks:
“What time is your appointment?”
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You don't know! That might look like a memory problem. But if you did not hear the information clearly in the first place, how could you remember it?
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What Hearing Difficulties Can Look Like
Someone who is having difficulty hearing may:
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seem to forget conversations
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misunderstand questions
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lose track when several people are talking
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give an answer that does not quite fit the question
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ask for things to be repeated
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struggle to follow conversations on the phone
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become quieter in groups
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withdraw from conversations they previously enjoyed
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Hearing Matters for Brain Health Too
Hearing is not only important for conversation. Research has linked hearing loss with a higher risk of dementia, and it is considered one of the most important potentially modifiable risk factors. This does not mean that hearing loss causes dementia or that someone with hearing loss will develop it.
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It simply means hearing health is worth taking seriously.
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If someone is struggling to hear, it is worth getting their hearing checked rather than putting it down to ageing.
Make Conversation Easier
Small changes can help:
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turn off the television or radio
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face the person when speaking
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get their attention first
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have one person speak at a time
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speak clearly and naturally
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avoid shouting
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give them time to respond
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check hearing aids are available and working, where relevant
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Sometimes the problem is not the conversation. It is the environment around the conversation.
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Vision: Seeing Is Part of Understanding
Vision affects much more than reading.
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We use it to:
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find things
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recognise people
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read medication labels
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prepare food
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judge steps and distances
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move around safely
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use phones and technology
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find our way in unfamiliar places
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If someone cannot see clearly, they may look confused when the real difficulty is visual.
Imagine This
Someone asks you to find the medication on the kitchen counter.
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The packet is white. The worktop is pale. The lighting is poor. There are several other things around it.
You cannot find it.
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Someone says:
“It's right in front of you.”
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It may look like you have forgotten where it is. But it may simply be hard to see.
Image 1: The medication is there — but is it easy to see?
Image 2: Good contrast and less clutter can make things easier to find.
The Environment Can Make a Big Difference
Someone may manage well in one place and struggle in another. Poor lighting, glare, clutter, background noise or too much information at once can make everyday tasks much harder. For example, stairs may be easy to judge in good lighting but much more difficult when there are shadows or little contrast between each step. Finding keys on a clear table is easy. Finding the same keys amongst letters, cups, chargers and medication can be much harder.
Image 1: With cataracts, reduced clarity and contrast can make keys much harder to pick out when they are surrounded by letters, medication and other everyday items.
Image 2: Keeping the counter organised and placing the keys in one consistent, high-contrast place can make them much easier to see and find, even when vision is reduced.
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It is also important to remember that seeing something and making sense of what you see are not always the same thing. Someone may struggle because they cannot see clearly, because their brain is having difficulty interpreting what they see, or because both are contributing.
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Simple changes can help:
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reduce background noise
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speak face-to-face
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improve lighting
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reduce glare
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use good colour contrast
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reduce clutter
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keep important items in the same place
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If you notice changes in someone's vision or hearing, consider an appropriate eye or hearing check. If memory or thinking changes are also present, mention this to their GP or healthcare professional.
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The Main Message
Before saying:
“You've forgotten again,” ask, “Did you hear it clearly?”
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Before saying:
“It's right in front of you,” ask, “Can you see it clearly?”
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Sometimes a small change in the environment can make a surprisingly big difference.
Common Vision Problems
Different eye conditions affect vision in different ways.
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These are just examples. Everyone's vision is different.
Age Related Macular Degeneration
Age-related macular degeneration, or AMD, mainly affects central vision.
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This can make it harder to:
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recognise faces
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read
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see detail
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use a phone
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prepare food
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Imagine looking directly at someone's face but not being able to see the detail in the centre clearly.
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Let's look at the difference
In the first image, with clear vision, you can see the path ahead, people, signs and obstacles clearly, including the centre of what you are looking at.
Age-related macular degeneration can affect central vision. This can make the middle of what you are looking at blurred, distorted or missing, making it harder to recognise faces, read signs and judge details ahead.
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This image is an illustration. Age-related macular degeneration affects people differently, and changes in vision can vary from person to person.
