Picture Books for People with Alzheimer’s or Dementia
Focusing on ~ NATURE ~ HOME ~ HOBBIES ~ familiar personal experiences.
My Picture Books are designed to support memory stimulation of past experiences for people with Alzheimer’s disease, dementia and memory loss, and aged people in care.
A key finding in my research was that we should never assume a person with later Alzheimer’s disease or dementia does not understand or appreciate something simply because they do not respond how we think they should.
Each book is more than a book of pictures – they are uniquely designed, without text, to flow, engage and tell a short story within the theme of each title. How the design works to stimulate memories is detailed below:
The Design
~ a picture is worth a thousand words ~ I know the quote has been used to the maximum but it is exactly what my storytelling with pictures is all about.
If you think about it, you were able to ‘read’ the information in the two images very quickly, without conscious attention. We register the scenario instantly. We just seem to know, we take it for granted. For a person with reduced cognitive ability this simple pairing may require extra time to identify the connection.
The image above is from two facing pages in the book Busy in the Garden. It was necessary to provide a visual barrier between the images. The purple assists in not only avoiding visual confusion at the centre of the two pages but also, it focuses the eye on the completed activity of drying the Statice flowers.
This example of joining pages also explains why these books for aged care will not be converted to electronic books to read on tablets etc. I feel the opportunity to view and read a double page, such as this one, or pages with cues or different perspectives, is integral to supporting memory stimulation within my use of visual storytelling. This tactile, printed and familiar media is currently the most appropriate for the visual interaction that I have created. (Images from Busy in the Garden)
Why Step-by-Step Images of Activities?
Procedural Memory (also known as Implicit Memory) is the longest remaining memory for people with Alzheimer’s. Hobbies require procedures therefore these memories may be stored under autobiographical and/or procedural memory. Something such as baking a cake may also be stored under episodic memory, for example baking for a birthday or special event, autobiographical memory because it was a personal experience, or procedural memory.
Experiences in our lives such as the procedures for doing things, like hobbies and everyday routines, become implanted in our memory, they become automatic. A great example is the elderly lady typing. The procedure is the same even though the technology is different.
Therefore procedures relating to everyday experiences and hobbies are integral to these books and may support memories of past experiences. (Images from Cupcakes and Tea Parties)
Why Close-up Detailed Pictures?
Closeup photograph/y to draws attention to the subject, provides impact and easy recognition of the subject. Both the above and following double pages are examples of defining what is going on in the busier paired image. The tomatoes in the closeup are arranged on a plain background at different angles to assist recognition. The Lavender Bag is on a contrasting background to assist definition of the shape of the bag and the finer detail, none of which is clear in the portrait – what is the girl smelling? (Images from The Vegie Patch)
Why Include Pictures of Children?
For well over twenty years the visitation of children’s groups to aged care facilities is well recognised for the joy and well-being experienced by people in care. Also, most elderly people have been parents, grandparents, aunts or uncles, or teachers in education, sports or hobbies. Seniors respond to the honesty, naivety, and non-judgemental attitude of children. To support these experiences, some pictures of children are included in some books. (Images from Moments in Lavender)
Why a Plastic Yellow Bucket?
Visual processing and contrast sensitivity may be affected for some people with Alzheimer’s disease therefore colour contrast and less busy images are used to allow for easier processing and recognition. The changes in composition and use of colour, complimentary colours, and tonal contrast are important for stimulation and engagement. A collection of similar shaped, same coloured images would be very boring for a reader.
For the Gone Fishing book it was particularly important to have some complimentary yellow to counteract the use of blue tones throughout the book. Yellow is a standard contrasting colour to dark blues, although both are primary colours, the contrast is more striking than blue and orange. Additionally, an old grey metal bucket, although Retro, may not be as clearly viewed as the yellow bucket.
I have also balanced the use of contrasting green colours where red objects are presented. With regards backgrounds on studio shots in pages, visual processing and contrast sensitivity may also affect the defining of a subject or object on a bright white background, therefore I rarely use the popular stark white background.
Why Pictures of Ordinary Everyday Activities?
Reminiscing supports self identity for people with Alzheimer’s disease. Familiar, generic experiences make us all part of society. These books are about familiar, homely activities and hobbies because reminiscence resources need to be part of a person’s experience. (Images: Left from Creating a Garden, and Right Cupcakes and Tea Parties)
Why Use a Landscape Format?
The landscape orientation is a natural, relaxing viewing perspective, and is often used for photo books. It enables the side-by-side viewing of connected images as described above/top. It is a familiar framework to view photos, television, and movies. The horizontal format, especially where double pages are presented, also invites the reader into panoramic landscape images, or for example the studio shot showing a simplified detail image of shells on sand. (Image from Beside the Seaside)
Why Use Themes?
The use of themes, particularly for people with Alzheimer’s and dementia, may assist the opportunity for association and reminiscence. Additionally, a theme’s repetition facilitates the flow and continuity of the presentation, whether that be in a book, game, or movie.
By focusing on recognisable procedures and experiences stored in our Long-Term Memory the themed imagery provides support for memory stimulation with the aim to making reminiscence and chat times easier.
Tips for Carers
Before sharing my printed Picture Books with your person in care I suggest pressing the pages flat to make reading and handling the book easier. Start at the front cover and press open each page. When half way through the book flip it over and repeat pressing from the back cover to the centre.
. View the book with your care-recipient in a quiet area with no distracting noises or activities nearby . Sit beside your care-recipient in a non-invasive position, express your interest & respond to care-recipient’s engagement.
· Make sure there are no bright lights or bright windows to the viewer’s side or in front, as these will be distracting.
. Make sure there are no shadows or reflecting lights falling on the pages.
· Provide focus by avoiding distracting patterns within the viewing area. If sitting at a table place a plain cloth (not bright, fluro or white) over fabric patterns, clutter or other activity resources.
. Provide a plain covered pillow or cushion on your care-recipient’s lap to support their hands and the book.
. Check that care-recipient’s glasses are clean.
. Where possible allow your care-recipient control of turning the pages and pausing for engagement and reminiscence.
. Make a note of interesting stories or memories that your reader has talked about or images that attracted attention for future interaction.
. A sigh, nod, smile or other non-verbal expression may be considered as social interaction for some persons in care.
If your person-in-care pauses and is engaged with an image, ask the question:
‘Does this picture have a story?‘ – rather than a closed comment, for example for the image above, saying ‘The little girl is dancing‘ may not encourage further comments.
The important thing is to enjoy the pictures together. You can say a lot without saying very much at all.
PICTURE BOOKS – Paperback – 21cms x .5cm x 15.2cms (8.2 x 0.2 x 6 inches). Printed on quality matte paper to avoid reflections that can be distracting for people with dementia.
Links to outlets and more info: https://artistjudiparkinson.com.au/care-activities/
Judi is a Multidisciplinary Artist who has been working with various media for over fifty years.
Since 2005 she has combined her art forms to produce reminiscent Picture Books for use in the Aged Care Industry. While working in Alzheimer’s and Dementia Specific areas she realised that there was a need for recreational resources that were relaxing and engaging, without being childish. Her research for these books was conducted as a Master of Arts (Hons) in Visual Art degree.
All her Picture Books are designed to support and stimulate memories of past experiences. They portray familiar, everyday experiences in short, visual stories, presented within the theme of the title.
Research Dissertation and Survey Reports – The Evaluation of Engagement and Response to Images Prepared for People with Alzheimer’s disease (published by Griffith University in 2007 available at www.worldcat.org). Judi’s MA(Hons)VA Honours Dissertation and Research Report assessment was conducted by lecturers at the Griffith University Faculty of Nursing and Faculty of Psychology at Nathan campus. In 2007 Judi was granted the Master of Arts with Second Class Honours, Division A in Visual Arts.
More Background about these books: https://artistjudiparkinson.com.au/2023/12/08/artists-books-the-lavender-journey/
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