LeadingAge Magazine · January/February 2014 • Volume 04 • Number 01

Using Art to Overcome Cognitive Barriers

January 04, 2014 | by Elizabeth Lokon and Carol Dana

This intergenerational art program pairs seniors living with dementia with specially trained volunteers to draw out the “vital person within.”

At a small table in the special-care wing at Berkeley Square Retirement Community in Hamilton, OH, 90-year-old Mary Jane sits shoulder-to-shoulder with Chris Satcher, a 21-year-old Miami University senior, intensely engaged in an activity that might seem unusual for a resident like Mary Jane, who has dementia.

Over the last half hour, Chris has helped his partner use an ancient Japanese process called suminagashi to create a half dozen sheets of paper covered with beautifully-marbled designs that look like the decorative end papers from rare, antique books.

But Chris and Mary Jane aren't done yet. “Would you like to add some extra color?” Chris asks gently, holding out small bottles of colored dye for his partner's consideration. After a moment's hesitation, she points to the red. Chris squeezes a few drops into a shallow cup, then hands her a fan-shaped brush, which she uses to add final feathery accents.

“I like the swirls,” Chris says, holding up the finished product and using a gesture that mimics the paintings' lines. “What do you like?”

“I like the color,” Mary Jane replies after a pause, then turns to smile into Chris's eyes.

Chris and Mary Jane are participants in an intergenerational art program for people with dementia called Opening Minds through Art (OMA), developed at the Scripps Gerontology Center at Ohio's Miami University. In addition to Berkeley Square, OMA operates programs at eight other locations in southwestern Ohio, including long-term-care communities and adult-day centers serving about 125 elders and 200 volunteers a year in small-group sessions that take place weekly during the academic year.

OMA’s approach uses a supportive relationship, combined with engaging art projects, to draw out the vital person that still remains despite the ravages of Alzheimer’s disease or other forms of dementia. What OMA is demonstrating is that “yes, you can connect” with people with dementia, says Jeff Thurman, president and CEO of Community First Solutions, the parent company of Berkeley Square, as well as Westover, another retirement community in Hamilton. Searching for the word that describes what OMA brings to those environments, he says: “maybe it is hope.”

Because the arts can tap into parts of the brain that tend to be less affected by dementia, there has been a growing interest in recent years in exploring the ways the arts can be used to help reach and engage people with cognitive loss. A number of innovative dementia-arts programs have emerged around the country, employing such art forms as music, theater, storytelling, movement or dance. Opening Minds through Art, which earned a best practice award from LeadingAge Ohio in 2011, is pioneering a way to use visual art with people with memory loss.

Grounded in person-centered philosophies and strengths-based approaches, OMA focuses on the skills and abilities that people with dementia still possess. Because people with cognitive impairment often retain social graces and the ability to form relationships, OMA makes intergenerational partnerships one of the cornerstones of its program, pairing each elder with a volunteer, often a college student, who has received training in how to communicate with individuals with dementia. The partner provides guidance and support during the art-making process, but does not make any aesthetic decisions for the elder. And as that relationship grows and trust develops over the course of the semester-long program, the partnership helps the elder gain the confidence to try new things and take more creative risks.

Another hallmark of OMA is that its projects are geared to adults. OMA avoids the childlike cut-and-paste or coloring-book activities that have been a staple of activity programs aimed at people with dementia. Instead, OMA has developed a series of painting, collage and printmaking projects that involve abstract or non-representational art. In addition to suminagashi, elders have made paintings based on the works of Russian abstract painter Wassily Kandinsky and the American abstract expressionist artist Jasper Johns. OMA projects also typically involve unusual tools or materials and enticing accents, like special textures or glitters. Participants have created landscapes from torn tissue paper and made “deep sea” collages using watercolor backgrounds overlaid with lacy nettings that resemble underwater plants and animals. At OMA’s program at the Cedar Village Retirement Community in Mason, OH, residents even glazed ceramic tiles, thanks to a partnership with the Cincinnati-based Rookwood Pottery company. To ensure that its projects can be successfully completed by people with dementia, OMA thoroughly pre-tests each activity, breaking each one down into a series of small steps and providing opportunities for the elders to make aesthetic choices at every juncture.

As a result, each person's work is unique, expressing their individual preferences and their own sense of what is beautiful. And while OMA's primary goal isn't to create gorgeous pieces of artwork, the results can be breathtaking.

“I'm amazed at what my mother does,” says Shelley Rice, whose 99-year-old mother Anna is a regular participant in OMA's weekly class at the Westover Retirement Community. “Anything that keeps her alert and cognitively challenged is so important,” Rice says.

The residents' artworks also give caregiving staff a fuller appreciation for the people they work with every day. “OMA brings out a different side that we don't usually see during the rest of the day,” says Mandy Marcum, an LPN at Westover. “It lets us see how much they’re capable of,” adds Rachel Duerksen, activities specialist at Berkeley Square.

“When you think about the fact that some of the art comes from individuals who are severely limited, who may no longer communicate or even recognize their loved ones, it's staggering,” says Carol Silver Elliott, CEO and president of Cedar Village. “I believe OMA allows us to reach a place deep within these individuals, giving that person one more chance to shine their light for all of us to see,” she says.

The elder artists often express pride in their artistic achievements, making comments like “I surprised myself,” “I didn’t know I was an artist” or, as Frances, a Cedar Village resident put it: “Pretty good for someone who doesn’t know what they’re doing!”

Rita, a former nurse who participates in the OMA program at Westover, says OMA helps residents “get their own idea of what they can do and feel good about themselves.” Plus, by helping residents take their minds off their worries, she adds that OMA “is very good therapy.”

Empirical evidence is backing up those kinds of reactions. As part of a study now in progress, a team of Scripps researchers analyzed video data of people with dementia in the OMA program. Participants showed greater engagement, social interest and pleasure—and less disengagement, fewer negative emotions, less sadness and confusion—when participating in OMA than in traditional arts-and-crafts activities.

A separate study by a different team of Scripps researchers looked at how OMA impacts the student-volunteers. In that study, published in The Journal of Intergenerational Relationships in 2012, researchers analyzed student journals and found that the program helped students develop more positive attitudes toward aging and people with dementia, and stronger skills interacting with that population. At Westover, Alexandria Predota, a 20-year-old Miami University junior, was paired with Charles, a man with fairly advanced dementia who often didn’t remember from week to week that the two had worked together. Yet, from sharing conversations about his life and from seeing the art he created, she says she “recognized that people with dementia still have the capacity to be creative and to think and interact with people. Sometimes it comes out a little rough, but they still have plenty to offer.”

The OMA website includes several videos of the program in action, including this one by Noah Applebaum:

For some students, one of the most unexpected outcomes of the program comes in the recognition that the person they had come to “help” actually turned out to be a mentor, teaching them valuable lessons about life. Students say they've learned something about perseverance and determination by watching their partners press forward to create art, despite fading memories, aching joints or blurry vision. Ashley Gordon, a Miami University junior who volunteers at The Knolls of Oxford, says her partner taught her about the joy to be found in everyday situations, noting that during the art-making sessions, her partner Dave “often paints my fingers and begins laughing.”

For his part, Chris Satcher, the volunteer at Berkeley Square, says that his partner Mary Jane has taught him “a lot about love and being happy.”

“She's the highlight of my week,” Chris added, turning to Mary Jane with a smile.

“Same thing,” Mary Jane replied, leaning her head toward Chris. “Lots of love. He's a good, good friend.”