2. REFLECTION & DISCUSSION: WHAT IF GRAPHIC DESIGN WAS AFFECTED BY ALZHEIMER’S DISEASE SYMPTOMS?
Can communication design provide a better understanding on Alzheimer’s disease?
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This group of experiments seek to graphically represent some of the symptoms experienced by people with dementia. They are based on the first-hand experience with my two grandparents, who are both diagnosed with Alzheimer’s disease.
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CAN COMMUNICATION DESIGN ADD VALUE TO THE CONTEXT OF ALZHEIMER’S DISEASE?
Can communication design provide a better understanding on Alzheimer’s disease?
1. INFORMATION: Mapping Dementia 1st year
2. REFLECTION & DISCUSSION: What if graphic design was affected by Alzheimer’s disease symptoms? Memory loss vs. book narrative
Can communication design aid people with Alzheimer’s disease?
P. 7
Confusion vs. typography
P. 13
Desorientation vs. mapping
P. 19
Ideas not pursued
P. 31
2nd year – before Work in Progress show
3. SUPPORT: Tools for interaction between people with Alzheimer’s disease and their relatives or carers 2nd year – after Work in Progress show
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The research focused on observing my grandparents and, together with some members of the family, recollecting past stories and episodes throughout the years they have been living with the disease. These stories were organised according to the symptoms more noticeable in my grandparents. The experiments try to get inside the mind of someone with Alzheimer’s disease, exploring their reality through graphic design. By doing so, the project intends to get a deeper understanding of the disease, both for people dealing with it (like me and my family) and raising awareness in the general public.
grandparents’ diary on Christmas holiday. Everyday, I documented what they did, said, and some special situation.
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MEMORY LOSS VS. BOOK NARRATIVE
The symptom of memory loss, which characterizes Alzheimer’s disease, was represented through book narratives. With three second-hand books, different ways of how memory loss could affect the plot structure were explored.
DIGGING UP THE PAST The book Digging Up the Past was modified to reflect on how memory is affected by Alzheimer’s disease. In the early stages, the disease starts to have an effect on short-term memory, while leaving long-term memories intact. However, with the progression of the disease, semantic memory (the meaning of things), procedural memory (how to do things) and long-term memories can also be affected. In advanced stages, it seems as though the disease keeps ‘digging’ at their memories, their identity, until they are almost empty. Moreover, as parts of the text are cut on every page, the book resembles what physically happens in the brain of people with Alzheimer’s disease.
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A DELICATE BALANCE A Delicate Balance is a play about a family and their friends. I chose one of the characters to have Alzheimer’s disease: Tobias, the father of the family. He progressively forgets the other characters, starting with his friends, his sister-in-law, then his daughter. By the end of the book he is only able to recognize himself, and, from time to time, his wife. Each of the three acts in the play represents one of the three stages of Alzheimer’s disease. Early stage / act 1 Tobias can always recognize Agnes. Sometimes he forgets Julia (daughter) and Claire (sister-in-law) and, more often, his friends, Harry and Edna. Moderate stage / act 2 Tobias still knows Agnes most of the time; he recognizes Claire and Julia just a few times; and Edna and Harry only once or twice. When a character speaks for a long time he also tunes out. Severe stage / act 3 Tobias cannot follow more than three or four lines of speech. He is also unable to keep a conversation going. He is starting to have some difficulty recognizing Agnes. The other characters are not there anymore.
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PLAYBACK In the book Playback, I explored the symptom of repetition, associated with the fact that people affected with Alzheimer’s disease often lose their short-term memory. Although diagnosed for many years, my grandfather still reads a lot. However, whenever he stops reading he has trouble remembering where he left off. So he always starts from the beginning, and making it difficult to reach the end of the book. This experiment shows exactly this, by repeating the first pages throughout the book.
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CONFUSION VS. TYPOGRAPHY
The second symptom addressed was confusion. People with Alzheimer’s disease are not able to remember things that most people take for granted. To communicate this, I redesigned the Book of Genesis according to Vasco Branco, my grandfather. I have two grandparents living with Alzhemer’s disease: my grandfather on my father’s side, and my grandmother on mother’s side. Although my grandfather was the main inspiration for this experiment, I refered to episodes of both. I used the Book of Genesis, which is a book of authority for them and many, to represent the progressive state of confusion that they live in everyday. They have difficulty remembering objects – and where they put them –, recognizing the people around them – even if they are part of the family –, and the places they live or frequent. As the disease progresses, they also become unaware of time. As a result, they easily get confused and lost because they are unable to indentify their surroundings. In the first pages of the book, the four types of confusion identified are described through episodes that my grandparents experienced.
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2. people vs. typeface
3. places vs. rotation of the text
1. objects vs. baseline
4. time vs. spacing
PROGRESSIVE TYPOGRAPHIC CHANGES A system of progressive typographic changes was created according to the types of confusion: 1. objects vs. baseline: misplacing objects corresponds to misplacing the baseline of text. 2. people vs. typeface: confusion about people – not being able to recognize them – is represented by changing the typeface of names in the book. 3. places vs. rotation of the text: The loss of direction and sense of place is given by rotating the direction of parts of the text that mention locations. 4. time vs. spacing: The misunderstanding and lack of awareness of time is shown by the increasing width of the text columns, eliminates the white space and makes the texts overlap.
Every five chapters correspond to one year. Therefore the fifty chapters represent ten years of the progressive disease. Those were divided in the three main stages of the disease: early stage: year 1-4 > chapters 1-20 moderate stage: year 5-7 > chapters 21-35 severe stage: years 8-10 > chapters 36-50 Headers refer to stage and year. Vasco 2:6 refers to the 2nd stage, moderate and year 6.
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randomly exchange paragraph styles of the orginal book of genesis.
playing with spacing, text direction, size.
exploring how to use changes in typeface to convey the confusion about people.
associating confusion about places and text direction.
PROCESS In order to build the typographic system behind the Book of Genesis experiment, many ‘free’ sketches were produced that play with several elements of typographic hierarchy. After that, these were associated to several types of confusion identified, based on behaviours and episodes of my grandparents. This created a more meaningful typographic changes.
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DESORIENTATION VS. MAPPING
The third experiment considered the constant feeling of disorientation experienced by people with Alzheimer’s disease. They are not able to identify most of the places that used to be part of their daily life. If they remember some of those familiar places they cannot recall the way to get there, even if they used to do it everyday. This was interpreted using a map, a common tool for orientation. Although the first map was presented on the Work in Progress show, I don’t consider any of the prototypes as final. I am working on the third concept aiming to exhibit in the degree show.
early sketch of the idea, and starting point for the experiment.
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BETWEEN THREE PLACES This map explores a particular situation of my grandmother. She mainly frequents three houses: her home, my mother’s and my aunt’s. She does not have trouble recognizing her home however, she confuses the three places. She usually forgets the journeys between them and she cannot recognize the routes anymore. When she is going to my mother’s or my aunt’s she does not have a clue where she is going, even if we tell her. When she is going home, she just realises it when she arrives there. This situation makes her very confused. When she is at my aunt’s or my mother’s she asks several times where she is, where she is going to sleep, and if she is going home soon. The different layers and colours represent the different routes between the three houses. The rotation reflects the progression of the disorientation symptom. This map was found too confusing and the situation itself was difficult to describe. However, making this map helped me in the next iteration.
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HOME IS THE CENTRE I then worked on another version of the map, with a simpler concept. This was shown at the Work in Progress show. I concentrated on the fact that the place people with Alzheimer’s disease usually recognize best is their home. Everything revolves around it. Therefore I used the house as the centre of rotation for the different layers. Each colour represents a forgotten regular route or a special place that they cannot remember anymore. The places that are most present in their memories have the smallest degree of rotation/ disorientation. I used the map of London, so that the people in the exhibition could relate to it. If I would use the map of my grandfather’s or grandmother’s hometown, it wouldn’t be so meaningful to people who are not familiar with those places. However, it also did not feel right to tell the story of my grandparents using the map of a city they have never been to. It lacks consistency. Therefore I looked for someone from London, who would be able to participate. This led to the third map.
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POCKETS OF MEMORY A third map is being developed, inspired by an English lady who is also diagnosed with Alzheimer’s disease. Having a London audience, it makes more sense to use the map of London. Therefore, I informally contacted another family that accepted to participate in research. Irene Brown was born and brought up in London. Apart from living some years in the USA, she spent most of her life in London, moving several times within the city. At present, Irene already has some difficulties remembering places in London, which used to be familiar. Those memories are still there, but dormant and dissociated. If stimulated, she can recall some of these places and stories related to them. Together with a second stakeholder, her son and carer, a session was conducted to gather her memories about the places where she lived, using her son’s knowledge about her life and old pictures as trigger for memories. Due to ethical considerations and time constraints, the second session was postponed. Therefore this experiment was not yet finished for the final hand-in.
notes from the session with Irene Brown and her son.
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The fact that Irene cannot recall the places and the routes to them, does not seem as disturbing and confusing to her as it does to my grandmother. Therefore, instead of communicating confusion, this new version of the map focuses on these existing pockets of memory, in the middle of the almost forgotten map of London. They correspond to the houses where she lived, schools she attended, places where she worked, parks where she used to go and other areas she used to frequent. In the map, the size of the areas and the hardness of their edges change according to how Irene remembered the places. The hardness of the edges corresponds to the help she needed to remember. Therefore, the more help she needed, the softer the edges are. The size of the area represents in how much detail she was able to tell about the place.
experiment on what Irene’s map of London should look like.
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IDEAS NOT PURSUED
In this group of experiments, there were some ideas that were not taken forward. These mainly consist of visually representing quotes, either of people with Alzheimer’s or their relatives. Colour, layers and hierarchy were used to illustrate these quotes, suggesting the symptoms. Here are some examples of sketches produced.
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Rita Maldonado Branco MA Communication Design Central Saint Martins College of Art and Design