Halloween Through a Different Lens: Understanding How Dementia Can Change What We See
Halloween brings some interesting changes to our neighborhoods. Pumpkins appear on doorsteps, skeletons sit on porches, witches hang from trees, and life-sized figures suddenly move or make noise as someone approaches. For most of us, these decorations are easily recognized as part of the Halloween season. We understand that they're not real, and we may even enjoy the creativity and surprise they bring.
But have you ever considered how someone living with dementia might experience these same decorations?
A skeleton sitting on a neighbor's porch may not be immediately recognized as something artificial. A dark figure standing near a doorway may appear to be an actual person, while shadows cast by decorations may make a familiar walkway look unfamiliar or difficult to navigate.
To understand why someone might respond differently to these surroundings, it's helpful to look beyond memory loss and consider how dementia can affect the brain's ability to process and interpret what we see.
Seeing and Understanding Are Not Always the Same
We often think of vision in terms of how well our eyes are working. However, seeing something and understanding what we're looking at involve different processes.
Our eyes receive visual information from the environment, but it's the brain that organizes and interprets that information. Different areas of the brain work together to help us recognize objects, understand where they are in relation to other things, judge distances, and make sense of what we're seeing.
Depending on the type of dementia and the areas of the brain affected, some of these abilities may change. A person may have relatively good eyesight but still experience difficulty recognizing an object or understanding what it represents.
Imagine walking past a house where a life-sized witch is standing beside the front door. Most of us would quickly recognize the pointed hat, broom, and artificial face as part of a Halloween display. Our brain connects these visual details with our knowledge of Halloween, allowing us to understand what we're seeing almost immediately.
For someone experiencing changes in visual processing, making those connections may be more difficult. They may see the figure clearly enough but struggle to recognize that it's a decoration rather than an actual person.
This is an important distinction because the person isn't necessarily seeing something that isn't there. They may be looking at an actual object but interpreting it differently.
These changes aren't experienced by everyone living with dementia, and they can vary considerably depending on the individual and the areas of the brain affected. Understanding that vision involves more than eyesight can help explain why someone may respond to their surroundings in ways we don't immediately understand.
How Shadows, Lighting, and Contrast Can Change the Experience
Halloween decorations often rely on darkness, unusual lighting, and shadows to create a spooky atmosphere. While these features may add to the enjoyment for some people, they can also make an environment more difficult to interpret for someone experiencing changes in visual perception.
Our brain uses information about light, contrast, shape, and spatial relationships to help us distinguish objects from their surroundings and understand where things are located. When these processes become less reliable, shadows and changes in flooring may create uncertainty about what is actually there.
For example, a dark shadow stretching across a walkway might appear to be a hole or a change in the level of the ground. A black decoration placed on the floor may look like an obstacle, while artificial spiderwebs hanging near an entrance may make it difficult to distinguish where the doorway begins.
It's worth understanding that contrast itself isn't necessarily a problem. In fact, good contrast can be very helpful for someone living with dementia. A toilet seat that contrasts with the surrounding fixture or furniture that stands out from the flooring may be easier to recognize. The concern is often with unexpected changes in contrast, confusing patterns, or shadows that make surfaces difficult to interpret.
Imagine someone approaching a familiar front entrance that has been decorated with dark fabric, artificial cobwebs, and dim orange lighting. Although the physical structure of the entrance hasn't changed, the visual information available to the person has.
They may hesitate, stop walking, reach for support, or decide not to continue. Without considering the possibility of visual processing changes, we might interpret this as resistance or an unwillingness to participate. In reality, the person may be uncertain about where it's safe to step or how to move through the space.
Looking at the environment from this perspective allows us to consider what might be contributing to the person's response rather than focusing only on the behavior we're observing.
When Decorations Are Mistaken for Something Real
Halloween decorations have become increasingly realistic. Life-sized figures, detailed facial features, and artificial animals can sometimes be difficult to distinguish from the real thing, particularly from a distance or in poor lighting.
Recognizing these objects requires the brain to interpret what the eyes are seeing and connect that information with previous knowledge and experience. When dementia affects these processes, a person may incorrectly identify something in their surroundings.
This is sometimes referred to as a visual misperception or misidentification.
A misperception occurs when something that is actually present is interpreted incorrectly. For example, a shadow may be mistaken for an animal. Misidentification involves incorrectly recognizing a person or object, such as believing a mannequin is a real person.
These experiences differ from hallucinations, which involve perceiving something without a corresponding external stimulus.
Consider someone looking through a window and noticing a life-sized figure standing on a neighbor's porch. They may become concerned that someone has been standing outside for a long time and repeatedly ask who the person is or why they aren't moving.
Our natural response might be to explain that it's simply a Halloween decoration. Sometimes that explanation, particularly when accompanied by better lighting or a closer look, may be enough to help the person understand what they're seeing.
At other times, the explanation may not resolve their concern. The person may continue to have difficulty interpreting the figure, or changes in memory may make it difficult to retain the explanation.
Rather than repeatedly correcting them, it may be more helpful to acknowledge their concern, offer reassurance, and consider whether changing the view or moving away from the decoration would make them more comfortable.
The response should always be guided by the individual and what seems to help them make sense of the situation.
Why Unexpected Movement and Sounds May Be Distressing
Motion-activated Halloween decorations are designed to surprise us. A figure may suddenly jump forward, begin speaking, or make a loud noise when someone approaches.
Anyone can be startled by an unexpected movement or sound. Our brain responds quickly to sudden sensory information, often before we've had an opportunity to fully identify what caused it. Once we recognize the source and understand that there's no danger, we're generally able to make sense of the experience.
For someone living with dementia, changes in attention, sensory processing, or the ability to interpret unfamiliar situations may make it more difficult to understand what caused the surprise.
Imagine approaching a doorway when a decoration suddenly begins moving and making noise. The person must process the sound, recognize the movement, identify the object, and understand that it doesn't represent a threat. These processes happen quickly and often without conscious effort for someone whose brain is functioning typically.
When dementia affects the ability to organize and interpret this information, the situation may become confusing or overwhelming. The uncertainty itself may contribute to continued distress, particularly when the person is already tired, distracted, or in an unfamiliar environment.
This doesn't mean that everyone living with dementia will be frightened by motion-activated decorations. Some individuals may find them entertaining or recognize them immediately. What matters is understanding that the person's response may be influenced by how their brain is processing the experience.
Understanding the Person's Emotional Response
One of the most important considerations is recognizing that someone's emotional response may make sense based on what they believe they're experiencing.
If a person interprets a decoration as a real individual, sees a shadow as an obstacle, or doesn't understand the source of an unexpected sound, their concern or hesitation may be entirely understandable.
We may be tempted to respond by saying, "There's nothing to be afraid of," or "It's not real." Although these comments are usually intended to reassure, they may not address what the person is actually experiencing.
Instead, acknowledging the feeling and offering a calm explanation may be more helpful. We might say, "That startled you, didn't it?" or "That figure does look unusual. Let's walk another way."
Sometimes a simple explanation will help. Other times, changing the environment or moving away from the source of concern may be more effective.
Our tone of voice, facial expressions, and body language can also influence how supported someone feels. Giving the person time to process what they're seeing, without rushing or insisting that they accept our interpretation, can help reduce unnecessary frustration.
The goal isn't to prove that our interpretation is correct. It's to understand what the person may be experiencing and respond in a way that supports their comfort, dignity, and sense of security.
Looking Beyond Halloween
Although Halloween provides a timely opportunity to discuss visual perception, these changes can influence how someone experiences their surroundings throughout the year.
A dark floor mat may appear to be a hole. A patterned carpet may make the floor look uneven. Reflections in mirrors or windows may be mistaken for other people, while poor lighting can make familiar objects more difficult to recognize.
These experiences may affect someone's willingness to enter a room, move through a doorway, or participate in an everyday activity.
When we understand how dementia can influence visual interpretation, we begin to look at these situations differently. Rather than assuming someone is being uncooperative because they won't enter a room, we can consider whether something about the environment is making them uncomfortable or uncertain.
This understanding also gives us opportunities to make practical changes. Improving lighting, reducing confusing shadows, reconsidering the placement of realistic decorations, or turning off unexpected sounds and movement may make an environment easier to understand.
It's equally important to recognize that not every change in perception is related to dementia. Vision problems, medication effects, illness, and other medical conditions can contribute to these experiences. New or worsening symptoms should be discussed with a healthcare professional, and sudden changes in perception or confusion require prompt medical evaluation.
The larger message extends well beyond Halloween. Dementia can affect much more than memory, including the way someone interprets and makes sense of the world around them.
When we recognize that a person may be experiencing the same environment differently, we have an opportunity to adjust our expectations and the support we provide.
Sometimes, rather than asking the person to adapt to surroundings that have become difficult to understand, we can make thoughtful changes to the environment.
Understanding the why behind someone's response helps us move beyond what we observe and consider what the person may actually be experiencing.
And that understanding can make a meaningful difference in how we support someone living with dementia.
Looking for support? Reach out. Let’s navigate this together.
Stay Connected – Join Our Mailing List
References and Further Reading
Alzheimer's Society. How Dementia Changes Perception.https://www.alzheimers.org.uk/about-dementia/stages-and-symptoms/how-dementia-changes-perception
Dementia UK. Changes in Perception and Hallucinations in Dementia.https://www.dementiauk.org/information-and-support/health-advice/changes-in-perception-and-hallucinations-in-dementia/
Alzheimer's Society. Dementia-Friendly Environment Checklist.https://www.alzheimers.org.uk/get-involved/dementia-friendly-resources/organisations/dementia-friendly-environment-checklist
