How the Arts are Positively Transforming Dementia Care

Using all forms of art to connect with those with dementia has become increasingly popular.

Anne Basting is an artist who has taken her passion and transformed the care given to some of those suffering from dementia and alzheimers. She has done this by infusing the arts into traditional elder care, through song, dance, and theater. These activities can help even the most negatively affected patients communicate with each other and with their loved ones. Basting’s ideas and methods have spread to care centers across the nation, and art therapy is now an increasingly common treatment.

This treatment is referred to as “creative care.” The treatment centers around letting imagination and expression run free with no rules, restrictions, or expectations. This allows patients to come out of their diagnoses and daily struggles and use their imaginations to create feelings of connection with others.

What is Creative Care?

                                                       Creative care in action.  Image courtesy of Parc Provence 

So what is creative care? Bastings describes it as the act of inviting other people into your personal expression and meaning-making. Her role as the facilitator is to listen her patients’ expressions and stories in real, concrete life. By giving and encouraging non-judgemental listening and collaboration, she is inviting them to create community and connection with her and others. These feelings of connection are essential to building a space where those with dementia or Alzheimers can find joy.  

Furthermore, these spaces allow patients to focus on their growth rather than what they’ve lost. Shifting the focus from memory to new stories has the power to pull people out of the disconnection with the world that comes with these diseases.

Why emphasis on memory is the wrong approach. 

                                            A basket of photographs pictured above to suggest memory. 

When Bastings first attempted to bring art therapy to Alzheimer and dementia patients, she was unsuccessful. She thinks that this is because she was too focused on memory and on getting the patients to remember as the basis for their art and expression.

In a subsequent session, she decided to introduce the patients to the art of improvisation. She instructed the group to simply come up with a story with no rules or limitations She wrote down everything they came up with and helped them add to it with her skills in theater and improvisation.

The change this activity provided to the patients was, in her words, “a miracle.” The group, with this new assignment, was able to interact and sing and dance and laugh and let their imaginations run wild together, fostering a feeling of connection with others. The patients began coming out of the disconnection they had fallen into as a result of their diseases.

When you base care on discussions and interactions with both memories and current events, you are setting up these patients for failure. As a result, patients focus on what they’ve lost, rather than their ability to create. Letting go of the expectation for memory and comprehension opens up a whole world of possibilities living in the human imagination.

The possibilities that come with imagination based care

                                                          A dementia patient uses art to trigger imagination and joy. Image courtesy of Arts Professional.

When you base patient care and conversation around memory, asking things like “do you remember me?” or “do you remember that trip we took together in 1985?” the possibilities are very limited. It’s either a yes or a no, and either answer elicits emotion and the reminder of disease and old age. Bastings prefers to use open ended questions and statements that open even the oldest and sickest of minds to thousands of possibilities, and also teaches them to be confident in their creativity.

Bastings believes that care and imagination based therapy is resisted in our society because of how important memory is in Western culture. She says that there is this idea in Western society that memory is imperative to identity, and when you lose memories, you are losing aspects of your identity. It is common for caregivers to be influenced by this Western attachment to memory-- pushing patients to try to remember things, rebuild their identities and get rid of their sense of loss.

This does not really work, as usually, when people lose their memories, they are not able to get them back, and dwelling on that loss creates a sense of failure and despair for patients. Instead, Bastings believes that taking a creative care approach, where the focus is on what patients are able to create and dream up, rather than focusing on what they’ve lost, is more conducive to fostering feelings of connection and happiness. People with Alzheimers and dementia are suffering, and allowing them to play and create together and off of each other allows them to feel pride in what they are still capable of, rather than forcing them to dwell on what they can no longer do.

The key to creative and imaginative care for dementia and Alzheimers patients is to emphasize that there are no rules, no wrong answers, no restrictions. If they can think it, it is possible. This can manifest through acting, especially improvisation. It can come through music, whether it’s listening to music and paying attention to the sounds, lyrics, or voices that bring joy and trying to recreate them, or singing or dancing along to a beautiful song. It can come through visual art, playing with colors, shapes, and brush strokes that inspire, and encouraging patients to have pride in what they are able to create.

The arts have immense power. Anyone can be an artist, if they tune into their imagination. Although we see this with young children already, we are beginning to see this with the elderly in creative care.

Edited by Cara Jernigan on January 30, 2021.

Macie Gelb
Macie Gelb is a writer based in Pittsburgh, PA.
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