“The difference between TV as comfort and TV as chaos isn’t the screen — it’s understanding how the changing brain experiences what’s on it.” Allyson Schrier
Do you rely on television to help occupy your loved one’s time? Does your care receiver seem agitated or anxious when the TV is on? Have you noticed them leaving the room when a show is playing or struggling to follow programs they once enjoyed?
We are Sue Ryan and Nancy Treaster. As caregivers for our loved ones with Alzheimer’s and other types of dementia, we’ve learned that what soothes us as caregivers can actually cause distress for people living with dementia. We spoke with Allyson Schrier, co-founder and president of Zinnia TV, and former caregiver for her husband with frontotemporal dementia, both about why regular TV can be problematic and what we can do about it.
We’re exploring four essential tips for supporting people living with dementia’s and their television experience.
Understanding Why TV Becomes Difficult
Before we dive into our tips, it’s important to understand what’s happening in the brain of someone with dementia when they watch television.
Allyson shared a powerful story from a panel she facilitated at the Michigan Assisted Living Association conference. When she asked panelists — all people living with dementia — what they liked to watch on TV, nearly all said the same thing: “I don’t watch TV.” They described it as “too much,” “chaotic,” and “anxiety-provoking”. They couldn’t track what was being said, follow the plot, or keep the characters straight.
Allyson explained what’s happening. When someone is living with dementia, they’re losing neurons and connections between neurons. The brain of a person who has died from dementia can be up to a third smaller than it would otherwise have been.
The processing delay is significant. A simple question like “What would you like for lunch?” can take up to 20 seconds to process and answer, as the brain tries to connect with neurons that are no longer there. People with early dementia can miss one in every four words being spoken.
Audio and video compete for bandwidth. When watching TV, data is coming in rapidly through both sound and images. These compete for processing power in a brain that’s already struggling, and neither gets processed effectively.
Memory challenges compound the problem. Often, for those living with dementia, their memory is affected. By the time they reach the end of a paragraph in a book, they may not be able to keep in mind what happened in the first sentence. The same happens with TV — they have more and more difficulty following plots and/or keeping track of characters.
Allyson described an incredibly frustrating situation when visiting her husband one day in the long-term care community where he was living. She found him parked in front of a TV in his wheel chair. His shoulders were up around his ears. His eyes were pinched shut. He was gritting his teeth, sometimes pounding his chest and shouting swear words. Her husband couldn’t leave the room. He couldn’t turn off the TV, and he had lost his verbal skills to ask for help — except for swear words.
Tip 1: Be Thoughtful About What’s On TV
The answer isn’t to take TV away completely. We need to be thoughtful about what we put on the TV and pay close attention to how our loved ones respond.
Look for predictability and familiarity. Allyson shared the example of a community that watched the same episode of The Golden Girls every single day. Why did this work? Because people who watched it could pay attention. They’d seen it so many times there was predictability. Even though the brain is dying and losing neurons, it’s also still growing new neurons, so people can learn over time. The predictability made them feel good and made them laugh.
Consider these options:
- Recorded concerts for music lovers (people playing music adds visual engagement).
- Reruns of sports games, especially if they feature your loved one or their favorite team.
- Playing shows they’ve always loved — but watch for if/when they stop enjoying them.
Watch for signs they no longer enjoy the show. One caregiver shared that her mother had always loved the show Gunsmoke. She had recently begun jumping and getting upset every time she heard a gunshot. She was worried about the person who was shot. When something like this happens and your loved one no longer enjoys the show, it’s time to consider a different show.
Pay attention to how your loved one feels afterwards. Are they nervous, anxious, or fearful? If so, the programming may not be right for them anymore.
TV works best when watched with another person. While it’s reasonable you will use TV for respite time for you, be aware that research shows television is most beneficial for people with dementia when they’re watching with someone else.
Tip 2: Target Something That Creates Curiosity Without Agitation
The goal is to find programming that engages without overstimulating or causing your loved one to fall asleep (because daytime sleeping can lead to nighttime wakefulness).
Start with topics they enjoyed as a healthy person: baking shows, sports, gardening programs, or shows about animals. Pay attention to whether the music or dialogue has become distracting or agitating.
Consider muting the TV so only one sense needs to be processed. You can separately play music they love (for example on your phone or other device that plays music). They’ll be listening to beautiful music while watching meaningful images.
Explore free programming options:
- PBS nature programs.
- Subscription programs focused on nature content.
- Explore TV — free access to live cameras posted worldwide capturing hummingbirds in nests, eagles, bears catching fish.
- YouTube videos (consider staying in the room to monitor what comes up next in the stream).
Sue shared that her husband was a huge baseball fan. They would put baseball games on with the sound muted. He would watch, cheer, and get engaged without the overstimulation and frustration of the audio.
Tip 3: Leverage Simulated Presence Therapy
The innovative approach of simulated presence therapy takes advantage of how people with dementia can experience confusion between what’s on screen and what’s actually happening — and uses it to benefit them.
Examples of how it works:
- A daughter records a video saying: “Mom, it’s time to take your medication. Take the pills from the nurse’s hand.” When the nurse shows the video, Mom takes the medication.
- The wife of a man who has to wear a helmet due to frequent falls records herself putting on a helmet and saying: “Hank, look at me. I’m putting my helmet on. You need to put yours on too.” Hank complies because she’s the person he listens to.
Examples of ways you can use this at home:
- When visiting the doctor, record a video of the doctor giving instructions about taking a medication. Play this at home when it’s time to take the medication.
- If you’re traveling while your loved one is in long-term care, record videos caregivers can show them.
- Create short videos for times when a helper is with your loved one. For example: “I’m reminding you that I love you and you’re safe.”
- To help your loved one with daily care transitions, record yourself doing activities such as brushing your teeth.
Tip 4: Create Engaging Alternatives On Your Own
Beyond television, there are creative ways to provide visual engagement that work better with how the dementia brain processes information.
Use the visual-verbal-touch approach. Teepa Snow’s technique works beautifully: If you’re going to brush someone’s hair, start by holding up the hairbrush (visual), say “let’s brush hair” (verbal), then do the brushing (touch).
Bring objects to look at during visits. Allyson found conversations with her husband went much better when he had something to look at — like a hockey glove or hockey magazine. The visual gave them something meaningful to talk about and helped him connect.
Create a memory box. Sue put together a box of items that interested her husband — a baseball he could feel, an adding machine he loved from work. These engaged multiple senses and gave them things to discuss.
Use photos and create videos on your phone. Your mobile phone can create beautiful videos automatically from selected photos, set to music, with slow-paced images that are compelling. These are often better than regular TV programming because they’re personal and meaningful.
For example, your iPhone can turn photos into a video using the built-in Photos app to create a “Memory”. For a quick slideshow, simply select your photos, go to the “Albums” tab, find your album, tap the three dots, and then tap “Play Memory Movie”.
Consider specialized programming. Allyson’s experience led her to create Zinnia TV, a streaming service with content specifically designed to be digestible and engaging for people with dementia. It includes:
- Nature and animal channels
- Interest channels (fly fishing, baking, gardening, farm work)
- Videos to help with daily care (drinking water, taking a shower)
- Content that models activities using the visual-verbal-touch approach.
Intentional programming creates powerful connections. For example playing a video of someone sewing for your mom who used to sew. She suddenly begins to speak about what she’s seeing because it resonates so deeply.
Observe and Adjust
Managing the television experience for someone with dementia isn’t about finding one perfect solution. What works today may not work next month as the disease progresses, and that’s reasonable. The process is about observing how your loved one responds and adjusting accordingly.
The key is understanding the changing brain experiences television very differently than we do. Through being thoughtful about what’s on the screen, targeting content that engages without overwhelming, leveraging simulated presence therapy, and creating our own alternatives, we can turn TV time from a potential source of agitation into a positive opportunity for comfort and connection.
If you have tips about managing TV time with your loved one, please share them on our Facebook page or Instagram page.
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