Dementia is now the leading cause of death in the UK [1]. Despite this, public understanding remains shaped by stigma, oversimplification and silence. To address this gap, boom saloon – a non-profit media organisation dedicated to democratising creativity – has launched 4,4,4&2, a publication that uses disappearing ink as a metaphorical and practical tool to engage with the lived experience of dementia.
A design-led intervention
The work builds upon an expanding body of evidence that positions creative practice as a valuable adjunct to dementia care and research. Like the University of Edinburgh Usher Institute’s Images of Care project [2], which demonstrated how visual storytelling can enhance empathy and professional reflection within healthcare settings, 4,4,4&2 harnesses design methods to engage audiences beyond traditional clinical communication.
Developed in collaboration with Maggie Watson, diagnosed with Alzheimer’s disease and vascular dementia in 2021, the book is structured as a “living cookbook”: part memoir, part sensory archive, part design innovation. Stories, recipes and photographs are printed in an ink that fades at different rates in each copy, creating a visual metaphor for progressive cognitive decline.
Positioning within dementia research and care
This approach aligns with current person-centred and co-design methodologies in dementia research. The Place Standard Tool with a focus on Ageing [3] has highlighted the importance of enabling older people, including those living with dementia, to actively shape their environments. Similarly, Marie Leahy’s Designing Books for Readers with Early-Stage Alzheimer’s Disease [4] evidences the impact of adapting typographic and material features to support accessibility, reinforcing that book design can operate as a tool for inclusion. 4,4,4&2 extends these principles by not only accommodating accessibility needs but also embedding the neuropathological processes of dementia within its material form.
Applications and implications
Initial responses from carers, dementia support organisations and clinicians suggest the work may have utility as a psychosocial intervention, supporting dialogue between people with dementia, families and healthcare professionals. This resonates with findings from design-for-health studies indicating that creative artefacts can mediate communication and mitigate carer burden [5]. By drawing on materials provided by Canon and GF Smith to ensure high production quality, the project balances metaphorical potency with usability, avoiding the risk of becoming purely symbolic.
The publication follows In the palm of a spider’s hand (2021), developed with Gerald King, diagnosed with young onset Alzheimer’s, further consolidating boom saloon’s contribution to arts-based dementia research. Together, these projects exemplify how co-produced creative outputs can challenge reductive narratives and expand the scope of non-pharmacological interventions.
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Conclusion
As the dementia research community continues to explore novel modalities of care, 4,4,4&2 demonstrates how interdisciplinary collaborations across design, neuroscience, and social practice can reframe the dementia experience. Positioned within a growing evidence base, the work highlights the potential of design-led interventions not only to represent neuropathological processes, but also to rehumanise those living with them.
Join Boom Saloon at the launch event in Edinburgh on Tuesday 16th December from 6-9pm.
References
- Office for National Statistics. Leading causes of death, UK. 2023.
- Usher Institute. Images of Care: Medical Humanities and Healthcare Practice. University of Edinburgh, 2019.
- Place Standard Tool with a focus on Ageing. NHS Health Scotland, Architecture & Design Scotland, 2020.
- Leahy, M. Designing Books for Readers with Early-Stage Alzheimer’s Disease. Design Regression, 2021.
- Zeilig, H. et al. “The arts in dementia care: scoping review of the evidence base.” Dementia. 2014;13(6): 659–676.
