We all follow environmental cues
Most of us like to think we make conscious decisions throughout the day.
We decide when to get dressed. We decide what to eat. We decide when it’s time for bed. We decide what object to use for a particular task.
In reality, our environment is quietly guiding many of these decisions without us even noticing.
Think about what happens when you walk into a restaurant. You don’t usually need someone to tell you where to sit. Tables, chairs, menus and place settings all provide clues about what happens next.
If you walk into a bedroom and see a neatly made bed, you understand its purpose immediately. If you walk into a bathroom and see a toothbrush next to a sink, you know what it is for and how it should be used.
The environment constantly provides information, and our brains are remarkably good at interpreting it. Most of the time, we do this automatically. We don’t stop to think about it. We simply respond.
Imagine arriving home after a long day. You walk into the kitchen and see a kettle, a mug and a teabag sitting on the worktop. Without anyone saying a word, your brain has already started to anticipate making a cup of tea. Or imagine walking into a room where a dining table has been laid with plates, cutlery and food. You immediately understand that it is time to eat.
The objects around us provide clues. Our brains recognise those clues, interpret their meaning and help us decide what to do next. This happens thousands of times every day.
What happens when the brain changes?
Dementia can affect many different parts of the brain, including those involved in recognising, interpreting and responding to information from the environment.
This doesn’t mean a person suddenly stops seeing. It doesn’t necessarily mean they have forgotten everything. It doesn’t mean they are deliberately being difficult.
Instead, the brain may begin to interpret information differently. Something that once seemed obvious may no longer be obvious. Something that once stood out may now blend into the background. Something that once had a very specific meaning may now be understood in a more general way.
The environment is still providing clues. The person’s brain may simply be reading those clues differently.
When a brush is just a brush
Most of us immediately recognise the difference between a toothbrush and a hairbrush. We know that both are brushes, but we also understand their different purposes. This understanding feels automatic.
For someone living with dementia, however, recognising and categorising objects may become more difficult. The person may still identify both objects as brushes. What becomes harder is distinguishing between them and linking them to the correct task.
The challenge is not necessarily seeing the object. The challenge is understanding exactly what the object is and what it should be used for.
This doesn’t only apply to brushes. It can happen with many everyday objects that share similar features, appearances or purposes.
Why yesterday and today can look different
One of the most frustrating experiences for families is seeing someone do something successfully one day and struggle with it the next. A person may dress independently one morning but need support the following day. They may use an object correctly one moment and appear confused by it another.
This can feel inconsistent and unpredictable. However, dementia affects a living, changing brain. The person’s abilities are influenced by many factors, including fatigue, stress, illness, distractions, sensory changes, environmental demands and the particular brain pathways available to them at that moment.
The question is often not: “Can they do it?”
but rather: “What is helping or hindering them right now?”
Looking at the environment through different eyes
Because environmental cues become increasingly important, small changes can have a surprisingly large impact.
- A wardrobe full of clothing may be overwhelming, while a single outfit laid out clearly may be manageable.
- A cluttered bathroom sink may make it difficult to identify the item needed for the task.
- Objects that blend into the background may become harder to notice.
- Similar-looking items may become easier to confuse.
The goal is not to take over. The goal is to make it easier for the person to understand what the environment is asking of them.
Becoming curious
When something doesn’t go as expected, it is natural to focus on the behaviour. Why didn’t they do it? Why did they choose that? Why are they struggling with something they have done for years?
Sometimes a more helpful question is:
“What clues was the environment providing?”
and
“How might their brain have interpreted those clues?”
Approaching situations with curiosity rather than correction can help us better understand what the person may be experiencing. It can also reveal opportunities to make everyday tasks easier, reduce frustration and support independence.
Sensation-led: if I see it and want it, I’ll take it
As dementia progresses, behaviour becomes increasingly sensation-led and immediate. Social rules such as ownership, waiting, or taking turns may become less influential than the information available in the immediate environment. There is no strong sense of appropriate timing. There is simply: what is visible, and what feels desirable right now.
This explains why:
- Pyjamas left on the bed alongside day clothes may be put on — not because the person is confused about the time, but because it is simply “a top” that is there.
- Food left within sight may be eaten, whether or not it belongs to the person or was intended for them.
- A cup on the table may be picked up and drunk from, regardless of whose it is.
- Familiar objects may be used for unintended purposes if they are the first thing seen.
These behaviours are not deliberate, manipulative, or a sign of worsening mood. They are the brain responding to what is directly in front of it.
Sometimes the challenge is interpretation
Sometimes the challenge is not seeing an object but understanding exactly what it is. Two objects that appear very different to us may share enough similarities that they become confused. A brush may simply be recognised as a brush. A cup may simply be recognised as something used for drinking. The brain may recognise some features of an object without fully identifying its specific purpose.
This can help explain behaviours that initially seem puzzling. Looking carefully at the objects available in the environment can sometimes provide clues about why a person has responded in a particular way.
What you can do: working with visual cues
Because the person is increasingly guided by what they can see, small changes to the environment can make an enormous difference. The principle is simple:
Make visible what you want them to use. Hide or remove what you don’t.
✓ Make visible — want them to engage
- Lay out only the clothes you want them to wear — put everything else away first.
- Use high contrast: a coloured plate on a contrasting tablecloth helps them locate their food.
- Consider where the person naturally looks when positioning food, drinks and activities.
- Use bold, clear colours on objects you want them to notice and reach for.
- Put their cup in one clear, prominent spot — and remove others from view.
- Keep what you want them to use visible and within easy reach.
✕ Hide away — don’t want them to engage
- Put pyjamas away before bringing out day clothes.
- Remove your own food or drink from their line of sight before they sit down.
- Use cupboards, drawers and matching colours to reduce visual clutter.
- Keep surfaces clear — if they can’t see it, they won’t be drawn to it.
- A door painted the same colour as the surrounding wall is less likely to attract attention.
- Bold patterns and busy surfaces can cause confusion — simpler is better.
A note for carers
These behaviours reflect genuine changes in how the brain processes the world — not stubbornness, deliberate choices, or worsening mood. The person is responding to what is right in front of them.
Reducing frustration often means changing the environment, not the person. The environment has not changed. The way the brain interprets it may have.
Understanding this can help us move from asking “Why are they doing that?” towards asking “What might they be seeing or understanding differently from me?”
Sometimes that small shift in perspective changes everything.