Academic journal article Generations

Arts in Dementia Care: 'This Is Not the End. It's the End of This Chapter'

Academic journal article Generations

Arts in Dementia Care: 'This Is Not the End. It's the End of This Chapter'

Article excerpt

Using art to reconnect with others-and oneself.

I'd been visiting Martha for weeks, hut nothing much had come of it. I talked; she stared out the window. She didn't seem upset, but I didn't think she was really listening. I thought she was simply enjoying the sound of my voice. So I started to ramble. I talked about whatever came into my head. One day, I mentioned something about Christmas. She pulled her head away from the window and looked directly at me. I asked her, "What did you do for Christmas when you were young?" To my great surprise, Martha began to sing in what I later learned was Swedish. She sang a song that had been a family tradition, three complete verses, with the chorus in between. Her face appeared lit from within.

Over the past decade while working in the arts with people who have dementia, I've witnessed several such miracles, as I consider diem to be. People who have edited themselves into silence for fear of saying the wrong thing, or shut themselves clown to avoid contact they cannot understand, can use the arts to reconnect with themselves and the people who care for them. And perhaps most important, the arts offer a chance for people with dementia to connect with the people who have forgotten themtheir communities at large. The arts offer great value to people with dementia and warrant tremendous hope for the future.

'THE ARTS' AND 'DEMENTIA' DEFINED

I would like to define these two broad concepts before I remark on their mutual benefits. First, by the term the arts, I mean any medium used for creative expression, including not just paint (visual arts) and costumes (dramatic arts), but words (poetry, storytelling), plants (gardening), food (cooking), fabric (weaving, fiber arts), clay (pottery), and the human body (dance). If it can be used to convey meaning, it is a tool for creative self-expression.

Second, by the term dementia, I refer to the umbrella category of deteriorated mentality that includes Alzheimer's disease, multi-infarct dementia, Pick's disease, Parkinson's disease, and vascular dementia. The latest figures suggest that these conditions affect up to 75 percent of older adults living in skilled nursing facilities and up to 50 percent of all people 85 years of age and older. We are also now learning more about dementia as it affects younger people, including those with multiple sclerosis, Down's syndrome, or AIDS. People with dementia can use creative expression, no matter the cause of the dementia and no matter where they live-at home with a home health aide or family members or in communal living arrangements such as assisted living centers and skilled nursing facilities.

WHAT THE ARTS BRING

To people with dementia, the arts bring tools that enable them to express themselves and their vision of the world and are particularly powerful tor this group because the arts operate on an emotional level. One needn't have control of rational language to write a poem, create a dance, or take a photograph. Where rational language and tactual memory have failed people with dementia, the arts offer an avenue for communication and connection with caregivcrs, loved ones, and the greater world.

More specifically, researchers have tried to understand exactly how the arts benefit people with dementia, focusing mainly on quality of life, particularly by reading the faces of people with dementia to assess their interest, engagement, and pleasure, and by observing any reductions in what are called "problem behaviors" such as wandering, verbal outbursts, or aggressiveness. While such studies have found the arts to be effective, the numbers of people studied (sample sizes) are too small for the studies to be conclusive. In general, there are very few control studies of the effect of the arts on people with dementia in which arts programs are compared with other types of activities.

'MEDICAL' vs 'SOCIAL' ARTS PROGRAMS

Two basic and overlapping modes of arts programs are being used for people with dementia-medical and social programs. …

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