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Art Therapy & Alzheimer’s Disease

Art is a lot of different things to different people. For some, it’s a means of escape. For others, it’s a way to express themselves. And, for others still, it’s a pleasant pastime. Yaacov Agam, an Israeli sculptor and experimental artist best known for his contributions to optical and kinetic art stated, “There are two distinct languages. There is the verbal, which separates people … and there is the visual that is understood by everybody.” The second is perhaps one of art’s greatest capabilities when it comes to using it for therapy with people who have dementia. For this population of people, art can provide a very real means of expression when words fail. It can touch them in places they may have forgotten existed. And, it provides a pleasant method of escape from a world that makes less and less sense, and one that is filled with more and more fear and doubt. As Thomas Merton, an American Trappist monk who was also a theologian, mystic, writer, poet, scholar of comparative religion and social activist, said, “Art enables us to lose ourselves and find ourselves at the same time.”

People with Alzheimer’s disease and other forms of dementia experience symptoms that increasingly diminish their quality of life. In a report published by the US National Library of Medicine National Institutes of Health, it was reported that “case studies and small trials suggest that art therapy engages attention, provides pleasure, and improves neuropsychiatric symptoms, social behavior and self-esteem.” The report further states, “With the appropriate structure, patients with dementia can produce and appreciate visual art.”

What is Art Therapy?

According to the American Art Therapy Association (AATA), art therapy is a mental health profession, facilitated by the art therapist, in which clients use art media, the creative process and the resulting artwork to explore their feelings, reconcile emotional conflicts, foster self-awareness, manage behavior and addictions, develop social skills, improve reality orientation, reduce anxiety and increase self-esteem. The goal of art therapy is to improve or restore a person’s functioning and his or her sense of personal well-being. During an art therapy session, a therapist uses a person’s artistic self-expression and their innate ability to create art to enrich and increase their physical, mental and emotional well-being.

History of Art Therapy for Use with Dementia

Art therapy was first used in the 1940s to enhance the well-being of tuberculosis patients during their treatment for the disease. It was not until 1969, however, when the AATA was established, that the role of art therapy became widely recognized.

Between the years of 1980 and 1990, art therapy was applied in the care of patients with dementia. The artwork created by those with dementia “featured repetitious, broken, split and twisted patterns and confused perspective angles, short and broken lines and missing details.” At this time the FEATS (Formal Elements Art Therapy Scale) was developed and used to track the progression of dementia based on different pattern characteristics created by patients as they moved through the stages of dementia. In the late 1990s, it was confirmed that art therapy was effective for use with dementia, enhancing memories, improving mood, decreasing behavioral and psychological symptoms and improving verbal skills.

In the twenty-first century, the use of art therapy in the intervention and assessment (Face Stimulus Assessment) of dementia has slowly increased. The use of art in therapy with dementia patients has moved beyond the traditional art forms, expanding to innovative interventions, including art appreciation programs, visual art activities and creation through recollection.

Organizations like the I’m Still Here Foundation, The Society for the Arts in Dementia Care and the Cognitive Dynamics Foundation continue to develop and evaluate innovative and non-pharmacological approaches to improve quality of life for those with cognitive impairment, such as Alzheimer’s disease and dementia, and to improve the lives of the people who love and care for them. As Dr. Daniel Potts, founder of Cognitive Dynamics, states, “They can lose themselves in the moment as they create … Roadblocks to verbal communication laid by dementia are bypassed through the artistic process, and individuals can express themselves through the art. Concentration and attention improve and patients are often easier to care for even when the therapy is over.”

Art Therapy and Dementia

Why is art therapy so beneficial for the dementia patient?

It is becoming more and more evident that individuals with Alzheimer’s disease and other dementias who become involved in creative activities obtain surprising results. Using the process of creating art as therapy may be possible because Alzheimer’s disease generally spares, to a large extent, the areas of the brain associated with creativity, emotions and creative expression.

Having impaired language capabilities or being unable to verbalize thoughts, emotions or feelings, while still retaining basic motor and visual skills, allows a person with Alzheimer’s and dementia to express themselves and find comfort through art appreciation and creative activities. As the disease progresses and patients become less able to express themselves, art therapy provides a means of venting negative emotions, thereby, helping with behavioral and psychological symptoms such as depression and anxiety, and a better quality of life.

Additionally, the creation of art increases activity within the parietal lobe, responsible for spatial relationships and fine motor skills of the hands, and the temporal lobe which is responsible for object recognition and accurate language expression.

Art therapy helps regulate mood through its effect on the right cerebral hemisphere, the part of the brain responsible for emotions. As dementia progresses, 70 to 90% of dementia patients exhibit various behavioral and psychological symptoms such as sadness, anxiety, depression, anger and restlessness, reducing their quality of life and generating an increased burden for their caregivers.

The activities used in art therapy are often determined by the person with dementia’s personal preferences, cultural background and the severity of their dementia. Since art therapy is a multi-dimensional, complex and vital intervention, it can effectively improve various cognitive functions such as attention, orientation and verbal skills and may impede and/or delay further deterioration, with varying outcomes for overall cognitive improvement. As assessment tools and methods improve, so will the effectiveness of art therapy.

Advantages of Art Therapy and Dementia

Since the 2009 documentary, “I Remember Better When I Paint,” excitement about art therapy has increased, and, with good reason. The power of art is reaching people with dementia in a myriad of ways which include:

  • Provides an alternative means of communication, especially beneficial to those with impaired language
  • Reduces depression, anxiety and other negative emotions
  • Improves mood by providing a means of releasing negative emotions
  • Provides a means of self-expression
  • Helps develop and maintain fine motor skills and coordination
  • Provides a way to gauge the status of the individual with dementia by analyzing the color, content and line of a painting project
  • Provides satisfaction and a sense of accomplishment
  • Provides a sense of empowerment by giving them the means to control some aspect of their life
  • Improves social skills, deepens connections with others and provides a sense of belonging when used in a group setting
  • Can ease the burden of caregivers
  • Can be a distraction, helping those who take part forget about their aches and pains, which in turn reduces agitation
  • May improve the flexibility of hands and increase hand-eye coordination when soft and easy to hold art materials are used
  • Familiar art topics and activities may increase verbalization regarding those topics, further promoting self-expression and social skills.

Although more direction may be required and the materials used carefully selected in the later stages of Alzheimer’s disease and other dementias, art therapy can easily be used in all stages of the disease.

Some studies have shown that art therapy can:

  • Decrease wandering
  • Decrease calling out for no reason
  • Increase average sleep times from four and a half hours to nearly eight hours

But any gains were often temporary, returning to previous norms or worse, when art therapy ceased. This indicates that art therapy is most beneficial when used as a consistent part of daily leisure activities.

Disadvantages of Art Therapy and Dementia

Even the best of programs will have disadvantages and art therapy is no different. Some disadvantages include:

  • More difficult for individuals who have no previous art skills which can make it difficult to maintain interest in or complete a project
  • Requires some hand function
  • Requires the ability to accomplish simple tasks
  • Has had mixed outcomes for the improvement of cognitive abilities
  • There are large variations regarding the duration, frequency and period of time required to receive the desired outcome
  • Scales used to measure progress need improvement

Although art therapy doesn’t provide a cure and the benefits may not be lasting, Sam Gandy of Mount Sinai School of Medicine in New York shares,

“Art may improve quality of life for patients and caregivers, even if temporarily. Anything that brings respite and joy into their lives is worth a shot while we are chasing down the science [for a cure].”

How to Find an Art Therapist

You can utilize Find-a-Therapist or the AATAs Therapist Locator to find a credentialed art therapist who meets the qualifications of the AATA. Credentials and education can be verified through the Art Therapy Credentials Board. Your local chapter of the Alzheimer’s Association may be able to provide a list of art therapy resources available in your area. You can also ask for assistance through Eldercare Locator, a public service of the U.S. Administration on Aging that helps locate services related to eldercare or contact your Area Agency on Aging. Additionally, adult day care centers, Alzheimer’s caregiver support groups and Alzheimer’s disease centers at academic institutions may have art therapy programs or be able to recommend other organizations that do.

It’s even possible for caregivers to learn how to use art therapy techniques for themselves. Cognitive Connections, a dignity-promoting arts training initiative for caregivers, was developed in collaboration with Angel Duncan, MA-MFT, ATR, the Executive Arts Director at Cognitive Dynamics.

Another alternative, especially if you have a tight budget or there just aren’t art therapy resources where you live, is to purchase the book, Memories in the Making. The book, based on a program developed by the Alzheimer’s Association of Orange County and over twenty years of experience, can help you implement a small-scale but effective art therapy program to harness the healing properties of art.

Dementia Care at Tessera of Brandon

Although more studies need to be done in the area of art therapy and scales to measure progress perfected, art therapy can be used to improve the lives of those with dementia and those who care for them. As Ernest Boyer, past President of the Carnegie Foundation for the Advancement of Teaching and Chancellor of the State University of New York, states, “Art helps us see connections and brings a more coherent meaning to our world.” Those with dementia can certainly benefit from both.

Art therapy is just one of the many programs offered in our secure Valeo memory care neighborhood in Brandon, FL. The word Valeo is derived from the Latin meaning for “to thrive” so it should come as no surprise that our programming is adapted to specifically assist residents with memory impairments, fostering social, intellectual, spiritual and physical well-being. In fact, Valeo is integrated into every aspect of care and service in our memory care community ensuring that all residents thrive and have meaningful interactions with others and the world around them.

Contact us today to learn more about everything Tessera of Brandon has to offer at our premier assisted living and memory care community.

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