Words, Image and Ideas: Pathways through Dementia

Pamela Atwood, MA, CDP, DCCP, CLL, Director of Dementia Care, Hebrew Health Care

CAN PEOPLE WITH ADVANCED DEMENTIA READ? Ask clients about their previous interests and older adults answer “Well, I used to like to read.” Has this favorite hobby been lost along with their memory of what they had for breakfast? Hebrew Health Care loves evidence-based practical activities for people with dementia and their families – we HAD to share this resource with you, so we’ve invited Susan Ostrowski to guest-author an article for you. Email us your feedback at http://www.agingcareacademy.org.

Memory-challenged adults may not speak well or comprehend language easily; maybe they can’t manage their hygiene independently. It is easy to assume that their ability to read has atrophied as well.

If we put a large print single word in front of a memory-challenged adult, and she can see it, there’s an excellent chance that she can read it, i.e., sound out the word and comprehend it. If we put a phrase or a sentence or even a small paragraph, printed in big, black letters, on a bright white piece of paper – would she read it? Most likely, yes.

For most memory-challenged adults with functional vision and functional language, reading is an intact, preserved skill. Then why are conventional newspapers, magazines and books so difficult for adults with dementia to process?

The answer lies in the format of typical published reading material.

Typical published material consists of condensed small print, low visual contrast and extraneous visual stimuli. These are major impediments to reading for seniors with dementia. However, if we present written language with large, bold font on white paper with wide margins and extra space between the sentences, they can usually read it.

To increase the readability of a text for this group of seniors, the following elements must be present:
-minimal visual distractions (which compensates for attention deficits),
-sharp visual contrast (decreases eye strain),
-spacious lines of print (compensates for visual tracking difficulties),
-short, direct syntax (lessens the burden on working memory),
-contextual photographs (prompts and maintains interest).

And here’s the exciting part: these lifelong readers generally do not require diluted vocabulary or juvenile subject matter. When presented with child-like material, they show little motivation to read. They can process sophisticated words and subject matter that are reflective of their spoken language. Generally it is only the presentation of the reading material that has to be modified.

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