Dementia-friendly design for photo books and life story books

Why does design matter for someone with dementia?

Dementia can affect vision and perception as well as memory. The NHS notes that dementia can change how well someone tells colours apart, and advises avoiding bold patterns and stripes because they can be confusing and disorientating. Many older people also have some sight loss. A page that looks stylish to a designer can be hard work for the person it's meant for.

The good news is that the rules are simple, and they make a book easier for everyone to read, including tired carers at the end of a shift.

What are the main dementia-friendly design rules?

These rules draw on Dementia UK's advice for life story books (one font and size, no more than two contrasting colours, simple text and photos) and Alzheimer's Society's tips for dementia-friendly documents.

Which font is best for someone with dementia?

Choose one plain sans-serif font with clear, open letter shapes and use it for everything. Alzheimer's Society's guidance for printed documents is to use at least Arial 14 as a general rule. For a book that's held on a lap or a tray, go considerably larger for captions: 20 point or more is comfortable, with headings bigger still.

Good, widely available choices include Arial, Verdana and Tahoma. Atkinson Hyperlegible, a free font created by the Braille Institute for readers with low vision, is designed so that easily confused letters and numbers (such as I, l and 1) look clearly different. It's the font Still Me uses in its printed books.

• Use bold for headings rather than a second font.
• Avoid all capitals for anything longer than a word or two: mixed case is easier to read.
• Left-align captions. Centred and justified text makes the eye work harder.
• Leave generous space between lines.

What colours and contrast work best?

Strong contrast between text and background matters more than any particular colour. Alzheimer's Society notes that some people find stark black on white hard to read, and that cream or yellow paper with dark text often gives good contrast. A deep navy, forest green or plum on a warm cream page is both readable and gentle.

• Pick one dark "ink" colour for text and one pale "paper" colour, and use them throughout.
• Never put text over a photo.
• Avoid pale grey text, red-on-green and other low-contrast pairs.
• Keep borders and dividers minimal so they don't compete with the photo.

How should each page be laid out?

Consistency is the most useful design choice you can make. When every page follows the same pattern (heading at the top, photo in the middle, caption underneath), the person always knows where to look, and turning a page brings one new thing rather than a new puzzle.

1. A short heading: "Growing up", "My wedding day", "Bramble".
2. One large photo, filling most of the page, with the important part (usually a face) clearly visible.
3. A caption of one or two sentences, in the first person: "I married Jim in 1968."

Keep a generous margin around everything, especially near the spine of a bound book, so nothing important disappears into the fold.

How do you choose and prepare photos?

Alzheimer's Society's document tips favour photographs of real places and things over cartoons, and the same goes for a life story book. Choose photos that are easy to read at a glance.

• Clear faces beat big group shots. If the best photo is a wedding group, crop in on the couple.
• Good light and contrast: a slightly dark photo looks darker in print. Brighten it a little if you can.
• Crop with care. Leave space around heads; don't cut off chins or tops of heads.
• High enough resolution. A photo that looks fine on a phone may print blurry at A4. For old prints, photograph them flat in daylight without flash, or scan them.
• Familiar over impressive. A blurry photo of the family dog may mean more than a perfect landscape.

How should captions be written?

Write as if the person is speaking, use the names they use, and keep it short. "We went to Filey every summer" invites a conversation; "Holiday, Filey, approximately 1974" doesn't. One idea per caption, no more than two sentences, and avoid anything that could feel like a quiz ("Do you remember who this is?"). For prompts, see our life story questions.

What paper and binding should you use?

A life story book is handled a lot, often at mealtimes. Dementia UK suggests laminating the pages to protect them, or using plastic pockets in a ring binder. Matte lamination is kinder than gloss, because glossy surfaces reflect light; the NHS advice on dementia-friendly homes recommends reducing glare and reflections.

• Thick pages are easier to turn for stiff or shaky hands.
• Wipe-clean surfaces survive tea, lunch and lots of hands.
• A simple binding that opens easily. Avoid anything with loose parts.
• A manageable size. A4 gives big photos and text but stays light enough to hold.

A quick checklist before you print

• Is there only one photo and one idea on each page?
• Is the same font used everywhere, at a large size?
• Are there no more than two colours, with strong contrast?
• Are all backgrounds plain?
• Are captions short, in the first person and using familiar names?
• Are faces clear, and nothing important lost near the edges or the fold?
• Will the pages survive a spilled cup of tea?

If laying this out yourself sounds like a lot, Still Me applies every one of these rules automatically: you add the photos and words, and each page is laid out for you. Or start with our free template, which already follows them.