What illustration brings to the reading experience for older adults with dementia.

Reading a story together with a loved one or in a group can be a very positive social experience for those with dementia. A simple story can invite human connection through conversation and discussion, and a shared feeling of enjoyment. This kind of interaction is a valued part of the reading experience for older adults.

For some, though, cognitive changes can make it increasingly difficult to follow a story or read words on a page. The resulting frustration can lead to a lack of confidence and a reluctance to participate. For these individuals, it is possible to ease the challenges of following a story by using illustration to convey the narrative.

“Drawn” into the story

Illustrations in stories capture attention. In fact, where art meets text, art becomes the first point of engagement, immediately activating the brain. Older adults with dementia viewing an illustration in a story have shown, in the short term, an increase in attention and alertness, and an improvement in mood and verbal functioning.

For readers, the illustrations are a reference and an aid to interpretation of the story. For the person challenged by the printed word, illustrations in a story can convey much about the setting, the characters and the plot. Illustrations can convey emotion and stir the imagination. Taking cues from the illustrations can help the non-reader to “read” the story without negotiating the text. This expanded definition of reading means that rather than just listening to someone read a story, the non-reader can be an active participant, contributing to the conversation and enjoying the story with others.

Here is an example I witnessed observing a reading group for older adults with dementia:

Susan often joined the reading group offering non-verbal responses, at best, to the readings. It was evident that she wanted to be there but didn’t know how to contribute. The introduction of an illustrated story (Stories for Older Adults – A Sidewalk Garden) peaked her attention. Her eyes focused on the illustrations as others took turns reading the text. A few pages into the story Susan began to giggle at the illustration of a small dog on his back wiggling in the dirt. “That little rascal is so funny!” she exclaimed. Others in the group laughed with her validating her reaction. “Reminds me of my little dog, Benji,” Susan added. Others offered stories of their past pets.

In this example, the art of the story became the vehicle for conversation and for enjoyment. The result was an empowering interaction that boosted Susan’s confidence, bridging the gap between loneliness and engagement.

Stories to Tell

Art can also be used to prompt storytelling. In art museum programs, for example, elders viewing large pieces of art, with the help of a trained docent, are encouraged to express their feelings, interpretations and stories, both personal and imaginative, conveying a unique “reading” of the art.

But it doesn’t take a masterpiece to prompt a story. A single image can jog a memory or spark a bit of imagination. Here is one example using single illustrations of Classic Cars :

Charlie’s daughter knew that he loved classic cars from the 50’s and 60’s. What she didn’t anticipate was his reaction to seeing an illustration of a 1957 Ford Thunderbird. “This was my first car,” he said with a smile. “ I washed and waxed that car every Saturday morning – she was a beauty – you could see your reflection in the hood. Then I got up the nerve to ask your mother out on a date. It was our first date and I picked her up in this car. I really impressed her.” There was a tear in his eye for a moment, then he started to laugh. “Ya know, we ran out of gas!”

In this example, a single illustration has prompted Charlie to recall a part of his personal history, organize a structured story (beginning, middle and end) in his mind and share that story with his daughter, strengthening their emotional and social connection.

“Better to be seen” – Illustration quality matters

Attention to style, color, size and content matters when using illustration in reading materials for older adults. The materials used in the two examples above employ illustration rendered specifically for persons living with dementia or other cognitive impairment.

To create the optimal experience for non-readers and readers alike, especially those with sensory impairment, the Stories for Older Adults series uses full page, high-contrast color illustrations in a simple, less detailed style. Every illustration depicts people, colors are bright and there’s an illustration for every page of text.

Using another approach, every illustration for Themed Three-pt cards sets (including Classic Cars) is a large, detailed, single image set against a white background for optimal viewing. The cards are labeled with a single word which makes it easier for the non-reader to negotiate text.

Reading in all its forms is a lifeline  –  For those living with dementia, the social experience of reading together becomes more inclusive and enjoyable when we expand the definition of reading  to include the art of the story.  As they say, “a picture is worth a thousand words.”