Imagine a woman named Margaret. She’s sitting in a sunlit room, her hands trembling slightly, her eyes distant. She has dementia. Words often fail her, but when a caregiver plays a song from her youth—Blue Moon by Frank Sinatra—her face lights up. She hums along, her foot tapping to the rhythm. For a moment, she’s Margaret, the woman who danced to this song at her high school prom.

This isn’t just a heartwarming scene—it’s a masterclass in design. Designing for people with dementia, like Margaret, teaches us how to connect deeply with users who communicate differently. But these lessons aren’t confined to dementia care. They reveal universal truths about participatory design: the art of creating with people, not just for them. Let’s explore what we can learn—and how it applies to everyone.

1. Listen with more than your ears

The dementia lesson
When words slip away, caregivers tune into subtler cues: a smile, a frown, a hummed melody. Music therapy uses familiar songs to bypass broken language pathways. A personalized playlist can calm agitation, spark joy, or even unlock buried memories.

The bigger picture
Participatory design thrives on this kind of deep listening. It’s not about surveys or focus groups—it’s about noticing what people do, not just what they say.

• Try this: Use props like emotion cards or textured objects. A parent designing a school app might point to a “frustrated” emoji when describing clunky homework tools.
• Why it works: Not everyone communicates in words. A toddler, a non-native speaker, or a shy introvert might reveal more through gestures or play.

2. Keep it simple, but meaningful

The dementia lesson
Complexity overwhelms. Music therapy works because it’s built on simplicity: rhythm, repetition, familiarity. A caregiver doesn’t ask Margaret to analyze a song—she invites her to clap, sway, or sing along.

The bigger picture
Good design strips away clutter and leans into intuition.

• Try this: Replace jargon with metaphors. Designing a budgeting app? Frame it as “organizing a pantry”—shelves for essentials, jars for savings.
• Why it works: A farmer in rural India and a CEO in New York both understand pantries. Simplicity bridges gaps.

3. Bend, don’t break

The dementia lesson
Margaret’s good days and bad days demand flexibility. On tough days, her therapist might swap guitar strumming for gentle drumming. The goal isn’t rigidity—it’s adaptation.

The bigger picture
Participatory design isn’t a straight line. It’s a dance.

• Try this: Let users choose how they contribute. In a workshop, offer markers for doodlers, sticky notes for writers, and LEGO for builders.
• Why it works: A teen with ADHD might sketch a wild idea they’d never explain aloud. Flexibility uncovers hidden gems.

4. Anchor to what’s familiar

The dementia lesson
Margaret’s favorite song, Blue Moon, isn’t just a tune—it’s a time machine. Familiarity grounds her when the present feels confusing.

The bigger picture
People trust what they recognize. Use that.

• Try this: Start design sessions with a ritual—a shared snack, a quick game, or a song. It builds comfort.
• Why it works: A teacher designing a classroom tool might draw inspiration from her morning coffee routine. Familiarity breeds creativity.

5. Celebrate the unspoken

The dementia lesson
Margaret’s smile during Blue Moon says more than a survey ever could. In dementia care, success is measured in moments of connection, not checkboxes.

The bigger picture
Not all feedback needs a microphone.

• Try this: Watch body language. Did a user lean forward excitedly? Did they sigh and slump? That’s data.
• Why it works: A developer once noticed kids yawned while testing an educational app. The fix? They added a silly “monster sneeze” animation to reset engagement.

The takeaway: design as a conversation

Designing for Margaret teaches us that participation isn’t about fixing “flaws”—it’s about starting a conversation. One where everyone’s voice matters, even if it’s not spoken.

Think of participatory design like jazz improvisation. You don’t stick rigidly to the sheet music. You listen, adapt, and build on the rhythm others create. A child’s doodle, a farmer’s metaphor, or Margaret’s hummed melody—they’re all part of the symphony.

So next time you design, ask yourself: Am I listening to the silence between the words? The answer might just be the key to something extraordinary.