Magazine started by Oregonians helps keep joy of reading alive for people with dementia

According to a recently published study, more than 40% of adults over the age of 55 in the U.S. have a lifetime risk of developing dementia. New cases of dementia are also projected to nearly double to 1 million a year by 2060.

The cognitive decline and memory impairments associated with Alzheimer’s disease and other forms of dementia can make it difficult to follow the branching storylines of a novel or the flow of facts in a newspaper or magazine article.

But as traditional avenues for literary enjoyment close, new ones can and should open for this growing population. That’s the guiding mission behind Mirador, a quarterly magazine Nikki Jardin co-founded in Portland nearly four years ago to be accessible to people with dementia. From the font style and size, to the way paragraphs are structured or photos are displayed to accommodate changes to vision and recognition, the whole magazine is designed with dementia in mind.

Jardin joins us to talk about the inspiration for starting Mirador and the magazine’s recent international expansion and collaboration with other dementia-friendly publications.

Note: The following transcript was transcribed digitally and validated for accuracy, readability and formatting by an OPB volunteer.

Dave Miller: From the Gert Boyle Studio at OPB, this is Think Out Loud. I’m Dave Miller. More than 40% of adults in the U.S. over the age of 55 have a lifetime risk of developing dementia. That’s according to a recently published study. New cases of dementia are projected to nearly double to 1 million a year by 2060. The cognitive decline and memory impairments associated with Alzheimer’s disease and other forms of dementia can make it difficult to follow novels, newspapers or magazines, but as traditional avenues for literary enjoyment close, new ones can open for this growing population.

That is the basic guiding mission behind Mirador. Nikki Jardin co-founded the quarterly magazine in Portland nearly four years ago to be accessible to people with dementia. She joins us now to talk about it. It’s great to have you on Think Out Loud.

Nikki Jardin: Thanks so much for having me, Dave. It’s great to be here.

Miller: I’ve read that your personal impetus for starting this magazine was that you became your aunt’s primary guardian a few years ago when she was diagnosed with young onset or early onset Alzheimer’s - that was at the age of 63.

Jardin: That’s right.

Miller: Can you tell us about her?

Jardin: Rebecca was great, she was living up in Seattle at the time. She wasn’t married and didn’t have kids, so it took the family a little while to figure out what was going on with her dementia diagnosis. Rebecca was a pet sitter, she was very active in her community, she was a volunteer, she did a lot of docent work. She was a naturalist, she actually would go to the library and read to kids out loud. She just was a very generous, vivacious person.

So, when this diagnosis actually came to be, we found out through one of her pet sitter clients [who] realized that something was going on. They contacted my other aunt, my Aunt Sharon. And we got together as a family and tried to figure out how we could best help Rebecca. One of the things that we decided was that she should move down here to Oregon and be closer to me so that I could help with what she needed during the course of that journey, which was about seven years.

Miller: What had reading meant to her, maybe even magazines in particular?

Jardin: She was a big reader, she loved magazines in general, because she loved the short form of them. She was a very curious person, and she loved learning about art, culture, science and nature. She loved animals, she liked to be informed. She liked to share with us the things that she was learning. So magazines were really the kind of publication that she was drawn to, magazines and newspapers.

But she liked a lot of different kinds of magazines across the spectrum. She wasn’t much of a book reader, but she liked being able to call us up and say, “hey, I learned about this,” or, “did you see this,” because we shared some publications. Reading was a big part of her life – and in fact, when she lived in long-term residential care, she really wanted me to keep those subscriptions going. That was a big part of what she asked me to do.

Miller: Was she able to read, understand and follow the articles in the magazines that had previously been a major part of her life?

Jardin: That was one of the first things that I started to notice, was that she would carry the same issues around with her all the time, but not interact with them in a way that I was used to her interacting with them. Like she wouldn’t open them up and read with me, or she wouldn’t show me things. She would just let them sit. And at first, because I didn’t really know much about Alzheimer’s when I came into this role with her, I just figured that it was her dementia, that she was no longer interested in reading.

Miller: That reading was over for her?

Jardin: That it was over, yeah.

Miller: What made you decide to actually change that and challenge that assumption?

Jardin: I had a really good friend at the time named Judy, who worked in memory care and had for a couple of decades. She turned me on to a woman named Teepa Snow, who a lot of people in the dementia care community recognize as a leading care expert in this field. So, I started watching Teepa’s videos on YouTube. She just happened to have been doing a live, eight-hour seminar in Salem, and I went and saw that seminar. And one of the things that I learned about dementia at that talk was that visual acuity is affected pretty early on in a dementia diagnosis. Something in that conversation clicked to me, that maybe it wasn’t that Rebecca wasn’t interested in reading, maybe it was that she couldn’t.

So I went home and started researching. I was going to just buy her dementia-friendly magazines. I literally was like, “oh, I’m going to just get all of them that there are,” thinking that why wouldn’t there be …

Miller: … And we’ll see which one she likes.

Jardin: See which one she likes.

Miller: What’d you find?

Jardin: Nothing.

Miller: Did you consider magazines for kids? Magazines that might, because of the layout or the complexity of the sentences, be more easily read, even if the subject matter would be completely inappropriate?

Jardin: Yes, and I think that that can be one of those avenues that people tend to go down …

Miller: Highlights, or something.

Jardin: Highlights, which is a classic, and a great publication, and I still love it myself. But she was really struggling with this diagnosis and it was hard for her. I think one of the things that was so hard about that journey for her was that she would call herself stupid or she would call herself dumb, and it was because she couldn’t interact with the things that she would normally do, things that made her her.

I didn’t want to compound this by giving her children’s books and I didn’t think it was necessary. And I was surprised that there was … There were some chapter books available for people, shorter chapter books, and I did get those. But again, it wasn’t her medium.

Miller: So, what was your starting point? Like so many inventors, you saw a hole, you saw something that should have existed, that didn’t, and you said, “I guess it’s up to me to actually create this thing.” But how did you start?

Jardin: I was lucky in that I had a freelance writing background, and I’d worked on a local publication as a writer and managing editor for Spot Magazine, which was a great pet-themed magazine here. So I had that background. I also was lucky to have some really talented friends. I was just thinking maybe this is something we can format together and put together.

I brought in my friend Tay Juncker, who was a graphic designer on Spot, and my dear friend Tavé Fascé, who I played music with in a band and who had a great graphics eye. So we started there. Then I was able to find out through some research that there was a guide out of the UK called the DEEP guide, which is the Dementia Engagement and Empowerment Project, where they used people living with dementia, along with other folks, to put together basically a protocol on how to develop pages so that they could be easier to read.

Miller: I’m curious about that. We can talk about the content in a second, but it seems like the design, layout and font, all of that, you have to put a lot of thought into it. Ideally, every magazine creative for every audience is thinking about that stuff. But you have a specific population in mind. What are some of the design choices that you made, and why?

Jardin: There was a prototype that I put together that has only been seen by a couple of people. So we started with that and then realized that that wasn’t the way to go. We talked with Judy, talked with other people. We looked at this DEEP guide and we just started molding something into what it is now.

Taking a look at how the typefaces, larger typeface … looking at the font – which is a sans-serif font – is easier to read, which is like an Arial, Helvetica.

Miller: It doesn’t have like, the little bits and curly q’s … straighter edges.

Jardin: … the little bobs, like Times New Roman, exactly, so that is a clearer thing to read. Color and contrast is used a lot to pop that text out a little bit, using bordering around paragraphs. All these things we started developing and looking at what makes a layout as clean as possible. Obviously no advertising, using photographs instead of illustrations can be easier for people to pick up. Having your content on one page or a double-page spread, not having to go to page seven to finish the story. Keeping the stories very short. All of our stories are between 50 and 250 words.

Miller: I’ve even read things like, if a word is going to go too long and there’s going to be a hyphen in the second half of the word, that would be in the next line – you don’t do that?

Jardin: We don’t do that.

Miller:  Why not?

Jardin: We just want to make sure that the flow is really clear and crisp. And if somebody is following a line and it breaks off, that could interrupt the flow to the brain as they’re trying to follow along the story. We want to try to find every piece of technical prowess we can find, I guess, to create that page.

Another thing that we’ll do is make sure that our sentences — we’re still using an adult vocabulary, but keeping sentences short, keeping paragraphs nicely delineated on the page.

Miller: What about the content choices? How do you decide what kinds of stories to focus on?

Jardin: All of our magazines are themed in a general way, but I think what I was going in with was that I did want to create a product that my aunt would really enjoy. So it had to have lots of stuff in it, and I wanted to make it interesting for anybody that picked it up. Maybe they wouldn’t find this one thing interesting, but maybe they would find another. I wanted to put in a lot of art, science, music and nature.

We have puzzles that we create in-house, crosswords and word searches. We do a “spot-the-difference.” We wanted to put in a photo comic, which originally was just my cats. Then Judy, Tavé and I were talking about it and realized that Judy was saying that seeing smiling faces of people is really important to this audience. It brings people in.

Miller: This is called, “Chicken and dumplings.”

Jardin: It’s called “The Adventures of Chicken and Dumplings.”

Miller: Can you describe it?

Jardin: Oh, my gosh. So, it’s a ridiculous thing. It is myself and Tavé as these characters, the “Chicken and Dumplings,” who are really these vivacious characters and they bumble about in the world, but everything is beautiful to these characters, nothing ever really goes wrong. And they’re always just happy-go-lucky and kind of stumble into things, but people love it; and I was actually, honestly, resistant to do it because I didn’t necessarily think that my picture needs to be in the magazine …

Miller: It’s not like Oprah magazine. Oprah is on the cover of her magazine.

Jardin: No, no, absolutely not. Tavé and I had done some touring with the band, which was the Gerle Haggard Band, and we used to take these photos of each other, in costume or doing whatever, and we had all these pictures. So we put one of them together as this really ridiculous event that we had out in Idaho, and it just worked as a photo comic. We showed it to Judy and showed it to people, and actually that particular feature in the magazine is probably one of the most popular features in the magazine. People love it.

Miller: How do you assess whether what you’re doing is working, is accessible, is engaging, is interesting, for your intended audience?

Jardin: That’s a great question. We get a lot of feedback from our readers and that really helps us to develop content, keep content that works, change stuff up. I hear stories all the time from our readers that say that they’re so happy that their mom, their sister or their husband has something that they can really engage in themselves.

Miller: You said you get feedback from readers, but it seemed like you’re then combining the caregivers who are reaching out to you. Do you hear from people with dementia, as well, themselves?

Jardin: I do. There’s a gentleman I was just talking to, he’s actually in the UK. He has young-onset Alzheimer’s. I was just over there for a trip last year, and he said one of the things that he really likes about the magazine is that (a) it looks like a regular magazine, and (b) he likes that the format is easy to digest and he can follow along with it.

Miller: I noted that the issues don’t have dates. The latest one is called “Bubble and Pop,” that’s the theme, but it doesn’t say “Spring 2025,” it says “Volume 13: Bubble and Pop.” How’d you come up with that decision?

Jardin: One of the things we also really wanted to do is to make sure that the magazines were evergreen, so that if you picked one up, it didn’t matter what month you picked it up or what week. So if you saw an issue from 2021, it didn’t stop you in any way. We wanted to make sure that each magazine, whenever you picked it up, was current.

Miller: Does that mean that you’re also designing this magazine with the idea that it might be read many times?

Jardin: Absolutely. One of the things that we also really wanted to do, and we spent a lot of time on … Tavé, who ended up being a co-founder of the magazine, and our art director, we spent a lot of time at the printer before the first issue, feeling paper, making sure that the pages were thick enough that they could be turned easily. But also because we had a feeling that these were going to be looked at multiple times – whether they were in a long-term care facility, whether they were in residential care, community care, in a library, or whether they were just at home with people – that they’re gonna get picked up on a daily basis.

Miller: What do you think of as the biggest preconceived notions about dementia that you would like to overturn, or at least challenge?

Jardin: I think one of them, particularly in this conversation, is that people aren’t interested in reading or that they don’t like to read. I think a lot of autonomy for people gets removed the minute that a dementia diagnosis comes on board, and that’s a mistake. There are lots of people living well with dementia. And I think this has changed a lot, even in the last few years, that people with a dementia diagnosis are advocating more for themselves and saying, “I do have agency, you should talk with me about my decisions and what I want.”

Miller: You have a pretty small number of subscribers right now. What’s your plan for how to spread the word about this?

Jardin: Well, this is a great opportunity, but I think it’s a very grassroots publication, it’s very small. We have a lot of conversations. We talk to people, we talk with librarians, we talk with folks in residential care, just sharing, and we also collaborate. Currently, Mirador is collaborating with other … Since we started this, there have been a handful of other publications that have come on board: Nana’s Books, The Resense Register. Collaborating with those folks and talking about it through social media, about how important this resource is for people living with dementia, also can help get that word out.

Miller: The most recent issue just came out, but can you give us a sneak taste of the next theme?

Jardin: Oh boy, we don’t normally do this, but I can tell you it involves tracks.

Miller: Tracks?

Jardin: Yeah.

Miller: OK, we will stay tuned. Nikki Jardin, thanks very much.

Jardin: Thank you so much for having me.

Miller: Nikki Jardin is co-founder and publisher of Mirador Magazine. It was created to be accessible for people with dementia.

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