A sustained, often blank, gaze from a person with dementia can be unsettling, but this behavior is not typically intentional or personal. The stare is a common manifestation of underlying neurological changes that affect how the brain processes the world. Dementia compromises a person’s ability to communicate and interpret sensory information, which often makes nonverbal actions, like fixation, a default behavior. Understanding that the stare is a symptom of brain dysfunction, not a sign of rudeness or malice, is the first step toward responding with empathy and patience.
Changes in Cognitive Processing and Visual Perception
The brain’s reduced ability to process visual information is a major cause of prolonged staring in dementia. Even when the eyes are healthy, damage to the occipital lobes and other areas responsible for interpreting what is seen can slow down the visual process. This requires the person to use a sustained gaze just to register and interpret the input coming from their eyes.
One specific challenge is visual agnosia, which is the inability to recognize familiar objects, people, or environments despite intact vision. When a face is seen, the brain may struggle to connect the visual data with existing memory or context, forcing the person to fixate while attempting identification.
Visuospatial difficulties further contribute to fixation by distorting how the person perceives depth, distance, and patterns. Shadows may be misinterpreted as holes, a patterned carpet as a barrier, or a reflection in a mirror as a stranger. The person may stare at these confusing visual cues as they try to reconcile the distorted image with reality, leading to confusion.
Staring as Nonverbal Communication
When verbal communication becomes difficult, staring can become a powerful, silent form of expression. The sustained gaze often reflects a deep sense of confusion or anxiety, acting as a nonverbal plea for help or stability. By fixating on a person or object, the individual may be attempting to ground themselves in a world that feels increasingly disorienting.
The stare can also be a desperate search for recognition, particularly when facing a person who is familiar but cannot be identified. The person is trying to place the face or recall the context of the relationship, causing them to hold their gaze for an extended period.
Dementia can also result in the loss of social inhibition, removing the learned social filter that normally prevents prolonged eye contact. What appears to be a rude or intense stare is often just unfiltered observation, without the social awareness to modulate the gaze.
Alternatively, some people with dementia may fixate on a single point, like a wall or the floor, to block out over-stimulation from a noisy or busy environment. This is a self-soothing mechanism, attempting to create a calm space when the senses are overwhelmed.
Strategies for Responding to Fixation
When a person with dementia is staring, the first step is to remain calm and approach them gently. Avoid moving quickly or approaching from behind, as sudden movements can be startling and increase confusion. It is helpful to get down to their eye level, perhaps by sitting, which makes you appear less intimidating.
A gentle, reassuring touch on the arm or shoulder can help to draw their attention and convey a sense of security. When speaking, use a soft, calm tone and keep sentences short and clear. Instead of forcing eye contact, use a warm facial expression and open body posture to communicate calmness and approachability.
To redirect the focus away from the fixation, introduce a simple distraction or activity. You might offer a familiar object or suggest a change of scenery, such as moving to a quieter room or going for a short walk. It is helpful to acknowledge the potential confusion without directly mentioning the staring, perhaps by saying, “It looks like you’re thinking hard,” to validate their emotional state. Reducing sensory overload by lowering noise levels or minimizing clutter can also prevent the staring behavior.