Arts unlock those with dementia


A photo taken by one of ADA's clients in the photography part of the Arts & Dementia Programme.

There is much evidence that the arts help to stimulate those with dementia. Dr Donald Yeo, a clinical neuropsychologist at KALL Psychological & Counselling Services with a special interest in the psychological aspects of ageing and dementia, spoke about one such project called the Arts & Dementia Programme by the Alzheimer’s Disease Association (ADA) at the RehabTech Asia conference in March. He is also a volunteer at ADA.

Ageless Voice finds out more:

So how does arts work with those who have dementia?

With dementia, the thinking part of brain deteriorates and this affects language skills. One is not able to communicate verbally, however, arts get around this in a non-verbal manner by activating the brain’s emotional part and bypassing the limitations.

Can you share about the ADA’s Arts & Dementia Programme?

In 2012, ADA collaborated with the National Arts Council (NAC) and got two projects dealing with the museum and photography funded. Before the start of each project, volunteers collected information on the seniors’ life histories so we could use them to individualise the interactions with them.

Each group had no more than eight people with dementia, and also included their caregivers. We have since done a second year on these projects. (According to ADA, from March 2013 to July 2015, 123 clients (persons with dementia) from the New Horizon Centres participated in the Arts & Dementia Programme. The programme also had 58 volunteers.)

In the museum project, we help the seniors have a wonderful day out without focusing on their disabilities. We make them feel that it is a normal day; that they are doing normal things like eating out as we provide them with lunch. We do this by telling the Peranakan Museum docents these seniors are sharing their experiences with them rather than the museum is teaching them about the artefacts. The museum guides/docents might then pick up on something interesting from the life histories (which also details their interests) we gave them, and they then ask the seniors to tell their stories.

For example, there was a Peranakan senior who used to sew beaded shoes. The museum guide saw that information and brought a beaded shoe from the museum collection and the two became like old friends, even though it was their first meeting. It created that connection, so preparation is key. The volunteers collected their life histories two weeks before the project started, and that really is the secret to person-centred care. Without that, people just show up at the museum and it would be hard to then create an experience. We also grouped the seniors according to their spoken language.

What have been some challenges doing this?

The challenge is many eldercare centres have limited resources to organise outings that involve a small group of people and that require intensive life history-taking. We got around this through the help of volunteers so manpower was not further stretched. One staff usually comes along to the museum. Bringing the seniors out of the centre is a good thing for everyone. ADA received a programme grant from NAC (amount unable to be disclosed), which allowed us to create a model that is easy to do, inexpensive and doesn’t require staff time. It is easy to replicate as it uses community resources.

What about the photography project?

A professional photographer leads a photography class. The idea here is not to teach the seniors’ skills but to teach them how to use the camera. It is yet another opportunity to get them out. Volunteers helped to prompt and focus, and created conversations with them. The seniors were brought to places that they could connect with, such as Chinatown or Botanic Gardens, which were decided by them.

On the first session of the project, the photographer shot portraits of each of them and asked them to bring an item that had a special connection to them. For instance, there was a man who used to be a packer at Sheng Siong (supermarket). He came with two cans of sardines. Another woman was a makeup artist. The photographer asked ADA to put together makeup kits so she could use her talent to makeup her other friends. She was invited to contribute and it made her happy. Though she only did some makeup, it was a sense of identity. That is person-centred care – we know the person; we magnify their details to make them feel recognised.

The photography project was eight sessions which culminated in an individualised coffee-table book, where the seniors put the photos they took, with the cover being their portrait shot. There was a man who showed his book to his geriatrician and told him he took the pictures inside. The book is part of a public education where people can see a different view of those with dementia. The photographer even went to the extent of labelling their photos to show that they took them.

Also during the museum project, there were three sessions on art making where the seniors used their history to incorporate into clay-making items that would go into a Peranakan tingkat (a tiered Chinese lunchbox). A woman normally who is quiet was making ang ku kueh (oval Chinese pastry) and she started to tell us that we shouldn’t put water to make it but to use oil. She thought she was making it for real! Opposite her was a man who used to make curry puffs when younger so they ended up conversing and sharing old memories.

We also did a session where the seniors painted Peranakan designs onto plates and cups, which they could bring home. It became a tangible item and a souvenir that reminded them about their experiences.

(According to ADA, it will be submitting its proposal for funding for NAC in October this year to see if the project can be carried on. ADA said it hopes to incorporate it as an ongoing activity at its New Horizon Centres. In September 2015, there will be an exhibition of the Arts & Dementia Programme – displaying the photographic and artistic works of its clients at Jurong Regional Library. This is being organised in conjunction with World Alzheimer’s Month and the Silver Arts Festival.)

Final artwork of clients connecting their memories as part of the Peranakan Museum tour.

This is all great but how does all this translate back into the home?

We hope there is a cascade effect where family caregivers in seeing the results can be encouraged to try some of these activities at home. There was a woman in a wheelchair whose daughter got to see her mother come alive, which she never experienced before. When the woman was engaged with the museum docents, she talked about artefacts that were in her own life.

We also reached out to ADA’s centre staff to attend so they too could witness the experiences, and could have a changed mindset and see a different sight of the seniors. The centre staff could even go on to develop ideas on how to better engage their clients.

It is really about going beyond just the normal origami and colouring for kids that is being used on those with dementia. We use real-life normal experiences like going to the park and art galleries, and having a nice meal. We are using public spaces to create outings for them rather than expect them to do something alien to them. Actually, a lot of senior centres use colouring images, which are not age-appropriate. However, in Europe, they use famous paintings of the likes of Van Gogh, and seniors fill in the colours of those paintings rather than cartoons, and they even talk about them.

Are there interesting approaches to arts around the world?

Around the world, there already are projects for those with dementia. Harvard’s Peabody Museum of Archaeology and Ethnology in Boston holds regular structured programmes for those with dementia. Eldercare centres would drop off the seniors, and family members also join in the group tours. The facilitators are well-trained and provide supportive comments without making the seniors feel inadequate or confused. (A US organisation called I’m Still Here Foundation has an initiative called ARTZ: Artists for Alzheimer’s where it creates and facilitates regularly occurring arts and culture events for those affected by dementia – www.imstillhere.org.)

This idea of using arts with those who have dementia was originally muted when staff of eldercare centres in the US went to The Museum of Modern Art (MOMA) in New York (www.moma.org/meetme/index) to see if they could do something. The museum agreed and has been opening their facilities up on their off-days. In the Singapore museum project, the museum is not fully closed and it happens during a less busy time.

There is also a museum dementia awareness training programme in the UK called House of Memories developed and delivered by the National Museums Liverpool where they get seniors talking about clothes in the different time periods and even get them to do catwalks and incorporate drama (www.liverpoolmuseums.org.uk/learning/projects/house-of-memories/resources.aspx).

With the caregiver taking care of someone with dementia, it can be highly stressful. What advice can you give to caregivers?

Don’t be limited by what you see, as there are so many remaining abilities that are not obvious because the seniors have not been given the opportunity. When you provide that opportunity, you will be amazed at what the seniors can do. Bring them to a new place and show them a painting, you will be amazed at what comes out. The seniors appreciate beauty and art, as that is when creativity can be tapped. Those with frontotemporal dementia (a rare disorder related to Alzheimer’s disease) can produce great works of art even though they weren’t previously involved in the arts.

(** Special thanks to Theresa Lee, executive director of ADA for her inputs in this story.)

 


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