People with dementia are capable of more than we can imagine! One overlooked area is the ability to read and the world it opens up for our elders who are living with cognitive decline.
Reading is a skill that is generally preserved and intact in the procedural memory of an elderly person. Like brushing teeth or using a spoon, the ability to read is automatic and often remains to some degree functional even in the later stages of dementia.
Why do adults with memory challenges stop reading?
Despite having the retained ability to read, most people living with dementia and other neurogenic conditions stop reading in the early stages of their disease. Generally, their reluctance to read is not because they can’t read, but because they can’t read conventional published material. Their deficits in areas related to reading (such as ocular motor control, light perception, simultaneous processing, working memory, and attention) make reading mainstream newspapers, magazines, and books extremely difficult. With its low visual contrast, condensed text, extraneous visual stimuli, and lengthy syntax, everyday reading material can become inaccessible.
Besides cognitive impairments, environmental factors (e.g., low lighting, poor book placement, and background noise), physical symptoms (e.g., pain, discomfort, fatigue, hunger, thirst, weak postural support), and psychological experiences (e.g., anxiety, confusion) also negatively impact many older adults’ abilities to concentrate on reading.
What do some adults need in order for them to read?
Modifications to the reading material in regards to text, graphic layout, illustrations, language, and content can compensate well for a reader’s visual and cognitive deficits. Making these adaptations without compromising the intelligence and integrity of a piece of writing and without creating a juvenile quality to the work is critical.
Support partners’ sensitivity to and understanding of the older adult’s immediate environment, physical comfort, and emotional state are also necessary for reading success, especially if the reader cannot clearly express his/her needs.
Practical and easy-to-adapt training must educate support partners on the power of modifying materials and the environment in order to reduce the need for staff direction and to allow older adults to independently engage in and lead reading activities with their peers.
How do we know they are reading?
Determining reading accuracy and comprehension level of some memory-challenged adults may not be a needed area of focus. Nurturing engagement with the text and enjoyment of a book is often more important than assessing conventional reading.
As is true for any reader, adults with degenerative conditions can interact with a book in many ways, for example by focusing on the pictures, decoding without comprehension, rereading one section, reading out of sequence, or randomly exploring the pages with intermittent reading. Signs of engagement with the text include visual focus, visual tracking, mouthing of the words, reading aloud, turning pages, commenting, smiling, and laughing. We all can derive enjoyment and mental stimulation from books in a variety of ways.
How do adults living with cognitive changes benefit from reading?
Research shows that the cognitive stimulation of processing written material can slow down the progression of dementia and the decline of language skills. Reading connects older adults with their memories, their sense of self, their loved ones, and the world at large.
Professionals and families report that well-chosen reading material lessens the reader’s feelings of boredom, depression, restlessness, and anxiety. Books can be calming and shift one’s focus to positive thoughts. As an autonomous activity, reading enhances one’s self-image, renewing a sense of self-respect and dignity.
Dr. Peter Dixon states, “Books bring vitality into minds that are still alive albeit declining. Nurturing the world of ideas, memory, and imagination is increasingly important as bodies become fragile.”
Why encourage reading?
If an adult is engaging with a book in some way, then that book is stimulating some degree of cognitive-language processing. The adult is most likely experiencing to some extent rekindled memories, autonomy, conversation, and amusement. The primary goals of making written material accessible to adults with limited memory are to provide a pleasurable activity and to stimulate thought processes.
Books also provide a platform for discussion and sharing. With conversation sparked by books, support partners see more clearly the person behind the disease. They naturally become more invested and more personal in their care for that person.
Adult children visiting their parents see adapted books as making their visits more interactive and pleasurable and, ultimately, bringing them closer to their parents
Finally, when sharing and discussing literature, older adults express their unique views, landscapes, and voices that one would not hear from other age groups. We can all benefit from the quiet, contemplative thoughts of those with the most life experience.
Find out how you can bring engaging reading material to your elder care community, library, memory cafe, adult day center, volunteer program, or even your home!