No Dementia Diagnosis without Sensory Checks
Why I’m Supporting Sensory Checks in Dementia Diagnosis – And What British Sign Language Taught Me
I’ve just completed entry level training in British Sign Language (BSL), and it’s been one of the most rewarding and eye-opening learning experiences I’ve had in years. As someone who has worked in dementia care for decades, I thought I understood the challenges of communication. But this course made me realise just how invisible—and profound—sensory barriers can be.
That’s why I’m now calling for mandatory hearing and vision checks as a routine part of every dementia diagnosis. It seems so obvious, yet it’s not currently standard practice. And the consequences of missing sensory impairments can be devastating—not only for the person with dementia, but also for their families and care teams.
Why this matters
Imagine being told you have dementia when, in fact, your confusion and withdrawal could be due (at least in part) to unrecognised hearing loss. Or imagine trying to follow instructions, social cues, or even television programmes when both your memory and your eyesight are failing—but no one has picked up on the sight issue.
We already know that sensory impairments can mimic or exacerbate dementia symptoms. Unaddressed hearing loss is associated with faster cognitive decline. Poor eyesight can lead to misinterpretations of the environment—shadows becoming holes in the floor, or people’s faces becoming unreadable. The evidence is clear: if we don’t check sensory function as part of diagnosis, we are failing to give people the best chance of living well.
What BSL taught me
Learning BSL was a revelation. I became acutely aware that how the health and social care system works is dependent on all patients and carers having a full range of senses. And there’s little requirement for staff to be fluent or even basically aware of other languages such as BSL for effective communication. The expressive power of BSL is astonishing—but it also demands a level of concentration and clarity that many people with dementia struggle to achieve.
My classmates included teachers, carers, students, and people learning for family reasons. In every case, communication wasn’t just about vocabulary—it was about inclusion, empathy, and respect. The same principles apply in dementia care. People with dementia are already navigating a world that can feel alien and overwhelming. If we ignore hearing or sight loss, we’re making that world even harder to navigate.
A missed opportunity
Right now, when someone begins to show signs of memory problems, they might get a cognitive assessment. But they won’t necessarily be referred for hearing or eye tests unless there’s an obvious issue. This is a huge missed opportunity.
We don’t need new technology. We don’t need expensive innovation. We simply need the will to standardise good practice. Every dementia assessment should include sensory screening. It’s no more radical than checking blood pressure or weight—it’s just common sense.
And beyond the diagnosis, there’s a chance to help people live better. Properly fitted hearing aids, appropriate lighting, visual contrast in home design, glasses that are actually worn—these small interventions can make a disproportionate difference to quality of life.
Let’s stop setting people up to fail
If someone can’t hear what’s being said, they look confused. If they can’t see what’s around them, they may seem unsteady or disoriented. Too often, we misinterpret these as signs of cognitive failure, when they are sometimes signs of unrecognised sensory loss. We’re setting people up to fail in a system that doesn’t fully check what might be going wrong.
As I continue my BSL journey, I’m more committed than ever to promoting communication in all its forms. That starts with giving people the best possible physical foundation for connection. Hearing and sight are not optional extras. They’re fundamental to understanding and being understood.
