A dementia simulation recreates the sensory confusion, communication breakdown, and disorientation that people with dementia experience daily. You can build one with inexpensive household materials and a structured plan. The core idea is to impair participants’ vision, hearing, touch, and comprehension simultaneously, then ask them to complete ordinary tasks. What feels simple under normal conditions becomes frustrating and disorienting, which is exactly the point.
These simulations are used in nursing programs, caregiver training, and community awareness events. A study of 45 nursing students who completed a dementia simulation found their empathy scores increased significantly, and every single participant reported wanting to be more patient with older adults afterward. Building one yourself takes planning across four areas: vision, hearing, motor skills, and communication.
Simulating Vision Loss
Most forms of dementia impair visual processing. People with dementia are less sensitive to contrast, meaning edges, boundaries, and objects blend together. Peripheral vision narrows. Colors become harder to distinguish. To recreate this, you need glasses that distort or restrict what participants can see.
Commercial dementia simulation kits, like those from Realityworks or Ohio State University’s “Dementia Experience” program, include specially designed vision-impairment glasses. To build your own, start with safety goggles or old sunglasses. Apply petroleum jelly or translucent tape to the lenses to blur central vision, mimicking the effect of macular degeneration. You can leave small clear patches at the edges or center depending on which condition you want to simulate. For peripheral vision loss, attach cardboard or tape around the edges of the lenses to create tunnel vision. Yellow-tinted lenses simulate the color distortion common in cataracts.
Layer these effects. A person with moderate dementia doesn’t experience just one type of visual impairment. Combining blurred lenses with narrowed peripheral vision creates a more realistic and unsettling experience.
Creating Auditory Overload
The second layer targets hearing. People with dementia often experience auditory processing problems: difficulty filtering background noise, heightened sensitivity to certain sounds, and in some cases, auditory hallucinations. The simulation should make it hard for participants to understand what’s being said to them.
You’ll need headphones or earbuds and an audio track. Record or compile a looping audio file that layers multiple competing sounds: a television playing, people talking over each other, a phone ringing, dishes clattering, music from a different era. Add occasional jarring or unexpected sounds (a door slamming, a dog barking) to simulate the startle responses common in dementia. The Ohio State program uses MP3 players loaded with audio files that replicate both auditory hallucinations and sensory overload.
If you’re running the simulation for a group, you can create several different audio tracks so participants have varied experiences. Keep the volume high enough to interfere with comprehension but not so loud it risks hearing damage. The goal is confusion, not pain.
Reducing Fine Motor Control
Dementia affects the ability to use everyday objects. Buttons, zippers, pens, and utensils become difficult to manage. The simplest way to simulate this is with thick gloves. Rubber dishwashing gloves, gardening gloves, or winter gloves all work. The thicker the glove, the more dexterity is lost.
With gloves on and vision impaired, participants will struggle to pick up small objects, write their name, open containers, or sort items. That struggle is a core part of the experience. Some facilitators tape two fingers together inside the gloves or insert cotton balls into the fingertips to further reduce sensation.
Designing the Communication Breakdown
This is the element that separates a basic sensory exercise from a true dementia simulation, and it requires the most preparation. People with dementia often experience a form of language impairment where words they hear don’t match what the speaker intended. Instructions sound garbled. Familiar words are replaced with nonsense.
The Baycrest Centre for Geriatric Care developed a detailed simulation toolkit that scripts this effect. Facilitators deliver instructions using jumbled language where key words are swapped for unrelated ones. For example, instead of saying “Do you have a history of any serious illnesses?” the facilitator says “Did you buy ginger cereals?” Instead of “Do you have any allergies?” it becomes “Did you buy any aferbies?” A direction like “It’s time for snack now, let’s go before they close the kitchen” is delivered as “Estimate lounge now. Shy no no this closet chicken.”
The effect is deeply disorienting. Participants can tell someone is speaking to them and expects a response, but the meaning is just out of reach. To write your own garbled scripts, take a set of ordinary instructions and replace roughly half the content words (nouns, verbs, adjectives) with phonetically similar but meaningless substitutions. Keep the sentence rhythm and tone of voice normal. The mismatch between confident delivery and incomprehensible content is what creates the anxiety.
You can also add pressure. The Baycrest scenarios include facilitators who act impatient, repeat garbled instructions faster, or express frustration when participants don’t respond quickly. “It’s five this chicken nuggets. Eat bart” means “We only have five minutes. Eat fast.” That combination of confusion and time pressure mirrors what many people with dementia face during routine care.
Setting Up the Physical Environment
The space itself should contribute to disorientation. Research on dementia-friendly design reveals what makes environments confusing for people with cognitive impairment, and you can reverse those principles deliberately.
Reduce visual contrast. Use tablecloths that are the same color as the plates. Place white forms on white surfaces. Make doorways and furniture edges harder to distinguish. Lower the lighting or use uneven lighting so some areas are dim while others are bright. Research shows that people with dementia need stronger contrast than typical adults to notice boundaries, so removing contrast makes everyday objects functionally invisible.
Create sameness. Identical-looking doors, repetitive hallways, and removal of distinctive landmarks all increase spatial disorientation. Studies on wayfinding in dementia confirm that corridors looking similar is the single most common factor causing people with memory problems to get lost. If you’re working in a large space, set up stations that look alike and remove signage.
Add clutter. Place unnecessary objects on tables and countertops. The combination of visual impairment, low contrast, and clutter forces participants to search for items they need, replicating the daily experience of someone who can no longer efficiently scan their surroundings.
Structuring the Tasks
Participants should be asked to complete multi-step tasks that would normally be trivial. Good simulation tasks include:
- Filling out a form. Hand participants a medical history form on a clipboard, but give them a toothbrush instead of a pen. See how long it takes them to realize the problem while wearing thick gloves and impaired glasses, with garbled instructions playing through headphones.
- Getting dressed. Ask participants to button a shirt, tie shoes, or zip a jacket while wearing gloves and vision-impairing glasses.
- Eating a snack. Set out food in low-contrast containers with utensils that are hard to grip. Deliver garbled instructions about what to eat and how much time they have.
- Following directions. Ask participants to walk to a specific location in the simulation space using only verbal directions delivered in garbled language.
- Sorting objects. Place pills, coins, or colored items on a table and ask participants to sort them by category while wearing impaired glasses and gloves.
Each task should last 5 to 10 minutes. The full simulation typically runs 15 to 30 minutes. Going longer risks genuine distress without adding educational value.
Running a Safe Debriefing
The debriefing after the simulation is not optional. It’s where participants process what they felt and connect it to how they interact with people living with dementia. Without it, the experience can leave people shaken rather than informed.
Hold the debrief in a private, comfortable space separate from the simulation area. The International Nursing Association for Clinical Simulation and Learning recommends starting with a reaction phase where participants simply describe what they felt. Use open-ended questions: “What was the hardest part?” or “What surprised you?” Listen actively, maintain a nonjudgmental tone, and acknowledge that each person’s response is valid.
Then move to reflection. Ask participants how the experience changes the way they think about common caregiving moments: rushing someone through a meal, repeating instructions louder, or taking over a task instead of waiting. In the nursing student study, 84% of participants said they would give people with dementia more time after the simulation, and 44% said they would stop asking them to complete multiple tasks at once. These are the specific behavioral shifts you want the debrief to surface.
Have support available in case anyone becomes unexpectedly distressed. People with family members who have dementia may find the experience emotionally intense. Let participants know before the simulation begins that they can stop at any time.
Materials Checklist
Here’s what you need to build a basic simulation kit for one participant:
- Vision impairment: Safety goggles or old sunglasses, petroleum jelly or translucent tape, cardboard for peripheral restriction, optional yellow-tinted film
- Hearing: Over-ear headphones or earbuds, an MP3 player or smartphone, pre-recorded audio tracks with layered background noise
- Motor impairment: Thick gloves (dishwashing, gardening, or winter), optional cotton balls or tape for added finger restriction
- Communication: Printed garbled-language scripts for facilitators, a list of the “translations” so facilitators know what they’re actually asking
- Environment: Low-contrast table settings, dim lighting, clutter items, identical-looking stations
- Tasks: Medical forms, clipboards, wrong-object substitutions (toothbrush for pen), food items, clothing with buttons or zippers, small objects for sorting
Commercial kits from companies like Realityworks sell 10-person setups with pre-made glasses, audio files, gloves, and curriculum materials. Building your own is cheaper and fully customizable, but expect to spend several hours preparing the garbled scripts, recording audio tracks, and setting up the physical space.