Opening Minds through Art (OMA):

Scripps intergenerational art program for people with dementia (Part 2)

Elizabeth “Like” Lokon, PhD

()

Tel. 513-529-2648 - Office: Upham 206A

CONTENTS:

How do we facilitate the creative process of people who have dementia?

Symptoms of Alzheimer’s disease that affect communication[1]:

1.Memory impairment and confusion

  1. Increased anxiety, in some cases
  2. Shortened attention span
  3. Difficulty with language, both comprehension and production, oral and written
  4. Difficulty organizing thoughts and thinking logically
  5. Taking longer to process thoughts, conversations, and accomplish tasks

Therefore,

“As we become more emotional and less cognitive, it’s the way you talk to us, not what you say, that we will remember. We know the feeling, but don’t know the plot. Your smile, your laugh and your touch are what we will connect with. Empathy heals. Just love us as we are. We’re still here, in emotion and spirit. If only you could find us.” (Bryden, 2005, p. 138)[2]

(Recall the “emotional contagion” and amnesia studies from last week.)

Analyzing and discussing communicative strategies

Exercises

In the next series of exercises, please watch the video clips[3], then discuss in your groups the questions below. Be prepared to share a summary of your group’s discussion with the rest of the class.

Video Clips 2 & 3:

Asking question #2 & #3

Please compare the two video clips in terms of:

  1. The type of questions asked
  1. The way the two volunteers asked the questions
  1. The response of the artist to the two volunteers

Video Clip 4:

“Do it for me?”

Both staff members pleaded with the artist using variations of the phrase “Would you do it for me?” The strategy did not work. In your opinion, why didn’t it work?

Video Clips 5 & 6:

Making choices #1 & #2

The video clip showed two different situations of volunteers and staff offering choices to the artists. In both cases, the artists did make a choice.

What did you learn about ways to encourage autonomy (decision making, asserting preferences) from these situations?

Video Clips 7 & 8:

Assisting #1 & #2

Compare the two video clips in terms of:

  1. How the staff/volunteer assist the artist: how did the two volunteers differ in the way they assisted the artists?
  1. Which of the two ways of assisting better promote the creative expression of the artist and why?

Video Clip 9:

Assisting #3

Notice the ways that the staff/volunteer assisted the artist in this clip. What did you learn about ways to assist someone with relatively advanced stage of dementia from this video clip?

Putting it all together

Watch the video clip of a volunteer and a resident with dementia named Ed in one OMA session. Discuss what actions by the volunteer in the video promote the artist’s engagement, autonomy, dignity, and creativity and what actions and processes undermine these? Be prepared to share with the rest of the class.

Actions promoting well-being / Actions undermining well-being

Art talk

What are some tips for looking at art with someone with dementia at the end of the session? Practice doing “art talk” that would be appropriate for people living with dementia. Some art vocabulary and simple definitions/synonyms that might be helpful:

Color: Give examples, red, blue, yellow and point at the color you are talking about.

Contrast: Difference between light and dark

Texture: How something feels, rough, smooth, sharp, soft

Lines: Thick/thin, straight, broken, wavy, etc.

Shapes: Square, rectangle, circle, triangle

Symmetrical: The two halves are the same/similar or mirror image of each other

Asymmetrical: The two halves are not the same/similar.

Composition: How things are arranged on the page

The strongest part of the painting (if a particular segment stands out): Identify an area that you personally like best in the finished piece and explain to the artist your reasons in clear and simple terms.

Practicing art talk

Work in pairs and take turns to role-play art talk. Switch artwork with a different pair before you switch roles.

You just placed a mat around a finished piece of art by someone with dementia and here is what s/he says. How will you respond?

[talking about her own art work]: “This is a mess. I don’t see anything good in there!” OR [pointing at his own work that he did not remember creating]: “Who did that? It looks like someone in kindergarten did it!”

YOU:

Debriefing Art Talk

Artists reporting back:

Which strategies used by your volunteer were helpful in increasing your appreciation for the artwork you just created?

Scenarios

1. Please read the excerpt and discuss: What strategies did you see Elinor, the daughter, use with her mother who has Alzheimer’s disease in the conversation above?

ELINOR: How are you mother?

LIL: Oh, in a fast muff, getting out of the wet ditches.

ELINOR: Wet ditches, well, that’s interesting.

LIL: Oh, I’m in a dedeford, they’re, they’re having a bedurz. I mean, they’re having a cressit. And would be considered hajardi. Would be picking dependent stuff. I mean they’re showing up prepays and other things.

ELINOR: That’s good!

LIL: We basent and had any consedery other than a bull, which we’re not getting. They’ve got the meat in the vettery, so they feel things aren’t by any means all wet.

ELINOR: I see. And do you have some friends there?

LIL: Oh, they have the thogs here with the wolfit beef. But they’re still rather concerned about the westerd stuff being westerd. They feel rather patz about that.

From: Fuchs, E. (2005). Making an exit: A mother daughter drama with Alzheimer’s, machine tools, and laughter. NY: Metropolitan Books.

Communicative strategies used above:

Imagine and complete the conversations below.

2. Pauline sits on her wheelchair by the door that faces out to the Memory Garden. Her expression does not seem to be distressed in any way. She points to the empty garden outside and says,

PAULINE: Look, look at all those children out there….. Can you see them? Tell them to come in.

YOU:

.

Guidelines for assisting OMA participants

Please review the list below before you start volunteering.

Communicating with participants:

  1. Approach the participant from the front and introduce yourself.
  1. Position yourself so that you are eye-to-eye with the participant.
  1. Use short and clear sentences, but not as though you are talking to a young child. Always show respect. Don’t argue/correct.
  1. Give multiple cues: say it, show it, and use as many senses as you can.
  1. Redirect inquiries for which you have no answers (e.g. If someone asks for his deceased mother, ask him to tell stories about his mother. There is no need to tell him that his mother has long ago passed away.) Then find out what it is that he wants/needs from his mother and try to address that need. In other words, respond to the “intent” of the communication, not necessarily the words. Investigate the intent or unmet needs that underlie their statements/questions. And address the intent/needs.
  1. Wait beyond your comfort zone for the participant’s response.

Assisting participants:

  1. Assist only with tasks that are physically impossible for him/her to do (e.g. cutting, gluing, and manipulating small objects).
  1. Encourage the participant to do the activity and make his/her own aesthetic decisions (e.g. colors, design, and composition).
  1. Allow the artist to take the project in any directions s/he is interested in going. The activity handout is there for you to redirect the artist if s/he seems lost or confused. However, when the artist is fully engaged, even when s/he is NOT following the process described in the handout, there is no need to correct or redirect the artist’s art making process.
  1. Feel free to adjust the activity to meet your partner’s need. You do not have to do all of the steps in the activity. And if your partner is taking the activity in a different direction than originally planned, go with his/her flow.
  1. Wait beyond your comfort zone for the participant to make his/her own aesthetic decisions.
  1. The most important outcome of the program is engagement and enjoyment in the process of making art, not the finished artwork
  1. Encourage those who are able to sign their finished work in pencil in the front. Prepare a sticky note with your partner’s name, title of the piece, site name, and date. Attach this to the back of the finished piece.

Resources

Local Resources

Council on Aging
of Southwestern Ohio
175 Tri County Parkway
Cincinnati, OH 45246
(513) 721-1025 or (800) 252-0155
/ Alzheimer’s Association – Greater Cincinnati
644 Linn Street, Suite 1026,
Cincinnati,OH45203
Phone (513) 721.4284
24/7 Helpline: (800) 272.3900

OMA Publications and Research Papers

Brief overview of OMA program:

Lokon, E. & Dana, C. (2014). Using Art to Overcome Cognitive Barriers. LeadingAge Magazine 4(1).

Boen, D. (2012). Colorful Friendships: Miami Students Help People with Dementia Express Themselves through Art. Miamian, 31(1).

Impact of OMA on elders with dementia:

Sauer, P. , Fopma-Loy, J., Kinney, J., & Lokon, E. (2014). “It makes me feel like myself”: Person-centered versus traditional visual arts activities for people with dementia. Dementia: The International Journal of Social Research and Practice.

Impact of OMA on student volunteers:

Lokon, E., Kinney, J. M, & Kunkel, S. (2012). Building Bridges across Age and Cognitive Barriers through Art: College Students’ Reflections on an Intergenerational Program with Elders who Have Dementia. Journal of Intergenerational Relationships, 10(4), pp. 337-354. DOI: 10.1080/15350770.2012.724318.

Yamashita, T., Kinney, J. M., & Lokon, E. J. (2013). The Impact of a Gerontology Course and a Service Learning Program on College Students' Attitudes Toward People With Dementia. Journal of Applied Gerontology, 32(2), pp. 139-163. Doi: 10.1177/0733464811405198.

References cited:

Basting, A. D. & Killick, J. (2003). The arts and dementia care: A resource guide. Brooklyn, NY: The National Center for Creative Aging, pp. 27-8

Legacy Health System Family Support Services (1995). I can Create! Arts programming for people with Alzheimer’s disease and related disorders. Portland, OR: author.

Csikszentmihalyi, M. (2008). Flow: The psychology of optimal experience. New York: Harper Perennial.

Feinstein, J. S., Duff, M. C., Tranel, D. S. (2010). Sustained experience of emotion after loss of memory in patients with amnesia.Proceedings of the National Academy of Sciences of the United States of America, 107(17), 7674-7679.

Kitwood, T. (1997). Dementia reconsidered: The person comes first. Buckingham, U.K.: Open University Press.

Ronch, J. L. (2003). Caring for people with Alzheimer’s disease and related dementias: Strengths-based approaches. In J. Ronch & J. Goldstein (Eds.) Mental Wellness in Aging (pp. 315-341). Baltimore: Health Professions Press.

Seligman, M. E. P. (2011). Flourish: A visionary new understanding of happiness and well-being. New York: Free Press.

Sturm,V. E., Yokoyama,J. S., Seeley, W. W., Kramer, J. H., Miller, B. L., Rankin, K. P. (2013). Heightened emotional contagion in mild cognitive impairment and Alzheimer’s disease is associated with temporal lobe degeneration. Proceedings of the National Academy of Sciences of the United States of America,110(24)9944-9949. doi:10.1073/pnas.1301119110

Internet Sources

  • What is Alzheimer’s Disease?

(David Shenk)

  • Alzheimer’s Association (
  • Alzheimer’s Association Brain Tour(
  • The Pioneer Network(
  • TimeSlips Creative Storytelling (

Books (non-fiction)

  1. Basting, A. D. (2009). Forget Memory: Creating better lives for people with dementia. Baltimore: Johns Hopkins University Press.
  2. Bryden, C. (2005). Dancing with dementia: My story of living positively with dementia. London: Jessica Kingsley Publishers.
  3. Fuchs, E. (2005). Making an exit: A mother-daughter drama with Alzheimer’s, machine tools, and laughter. New York, NY: Metropolitan Books.
  4. Kitwood, T. (1997). Dementia reconsidered: The person comes first. Philadelphia, PA: Open University Press.
  5. Mace, N.L. & Rabins, P.V. (2006).The 36-hour day. Baltimore, MD: Johns Hopkins University Press.
  6. Seligman, M. E. P. (2011). Flourish: A visionary new understanding of happiness and well-being. New York: Free Press.
  7. Shulman, A. K. (2009). To love what is: A marriage transformed. New York: Farrar, Straus and Giroux
  8. Snowdon, D. (2002). Aging with grace: What the nun study teaches us about leading longer, healthier, and more meaningful lives. New York: Bantam.
  9. Taylor, R. (2007). Alzheimer’s from the inside out. Baltimore: Health Professions Press.
  10. Zeisel, J. (2009). I’m still here: A new philosophy of Alzheimer’s care. N.Y.: Avery Publishing.

1

© E. Lokon

[1] Retrieved from:

[2] Cited in Brooker, D. (2007). Person-centered Dementia Care: Making Services Better. London: Jessica Kingsley Publishers, p. 96.

[3]All video clips in this training module are created and edited by Elizabeth Lokon; camera work by Kelina Basnyat.