How to manage a fear of reflection in dementia care

Many of those who work in the care of people with dementia will be aware of the issue of reflection; that is when a person with dementia is no longer able to recognise their own reflection. This isn’t something that affects everyone living with dementia, but it is more likely to occur during the later stages of the condition. It is not necessarily frightening for all those who do experience it, but it is a very real issue that can have a serious impact on individuals and their state of mind.

There are a couple of factors that contribute to the inability to recognise one’s own face in a mirror. One is the development of visuoperceptual difficulties, which are issues with vision and perception. This is a combination of problems with perception that are dementia related and the general deterioration of eyesight that tends to come with old age. It can make you less sensitive to contrast, less able to detect colour and lead to problems perceiving depth and perspective. Naturally this affects the clarity and definition of what you can see. 

The other significant issues are memory loss and perception of self. Often people with dementia lose memories of the past 20 to 30 years (or more), but retain their long term memory. The period in their lives that tends to be recalled best is when they were in their 20s and 30s, when they were first married and raising their families. If the past few decades are hard to remember, but you have perfect recall of being in your 20s, then that is how you will see yourself.