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P5. Care approaches: Art and dementia

Detailed programme and abstracts

P5.1. Implementing a theatre-based communication method for people with dementia living in nursing homes

BOERSMA Petra1, VAN WEERT Julia2, VAN MEIJEL Berno1, DRÖES Rose-Marie1

1 VU University Medical Center, Amsterdam, Netherlands, 2University of Amsterdam, Amsterdam, Netherlands

People with dementia living in nursing homes benefit from person-centered communication methods. Studies examining the effect of these methods often fail to report about the implementation of these methods. A recently developed person-centered communication method is the Veder Contact Method (VCM). With theatrical, poetic and musical tools, VCM stimulates the communication between caregivers and residents. Our study aimed to describe and test the implementation of VCM in daily nursing home care. 

Caregivers (n=136) and residents (n=141) participated in a one-year quasi-experimental study. Foundation Theater Veder implemented VCM on six experimental wards and rated quality level of implementation. Six control wards delivered care-as-usual. Before and after implementation, caregivers’ behaviour was assessed during observations using the Veder-observation checklist and the Quality of Caregivers’ Behaviour scale. Their attitude towards residents was rated with the Approaches to Dementia Questionnaire. Quality of life, behaviour and mood of the residents were measured with QUALIDEM, INTERACT and FACE. Care Plans were assessed on person-centered background information.

Significant improvements in caregivers’ communicative behaviour (i.e. ability to apply VCM effectively and establishing positive interactions) were found in favour of the experimental wards with a high implementation score, as compared to the experimental wards with a low implementation score and the control wards. In addition, some changes in the behaviour and quality of life (positive affect, social relations) of the residents were found. No significant differences between the groups were found in caregivers’ attitudes towards dementia, the residents’ Care Plans and mood.

The positive changes in caregivers’ behaviour and wellbeing of the residents in the experimental wards with a high implementation score partly confirm the successfulness of the implementation of VCM. Finally, caregivers reported that application of VCM during their daily caring tasks contributed to facilitation of the care (dealing with difficult behaviour), cheering up residents (when depressed) and teambuilding.

P5.2. cARTrefu: creating artists in residents. A national art in care homes participatory and mentoring programme


1Bangor University, Bangor, United Kingdom, 2Age Cymru, Cardiff, United Kingdom

Background: cARTrefu is an exciting Wales-wide project aiming to create and increase opportunities for care home residents and staff to participate in the arts. Thought to be the largest project of its kind in Europe, the project is being delivered by Age Cymru.  cARTrefu was originally funded for two years by the Baring Foundation and Arts Council Wales and an independent evaluation was led by the Dementia Services Development Centre Wales, Bangor University.

Objectives: The evaluation explored the impact of the art residencies on care home residents, care home staff, the artist practitioners, and the wider community.

Methods: A variety of quantitative and qualitative tools were used including the Smiley Faces Rating Scale to show whether cARTrefu sessions changed how residents felt, the Approaches to Dementia Questionnaire (ADQ) to explore whether cARTrefu changed how staff viewed care home residents, especially those with dementia, and reflective journals to capture what happened in sessions and the experiences of residents, staff and artist practitioners.

Results: 1952 hours of free arts were delivered in 20% of the care homes in Wales between 2015 and 2017. 793 care home residents and 272 care staff took part in the evaluation. Participating in the cARTrefu programme was found to significantly improve the well-being of care home residents and attitudes of staff towards residents, especially those living with dementia. Staff also gained the confidence to lead creative activities themselves.  Following the huge success of cARTrefu, a second phase, cARTrefu II, has been funded until 2019.

Conclusion: cARTrefu has left a huge legacy on care homes residents and staff across Wales and has paved the way for the future with cARTrefu II which aims to push the boundaries of arts in care homes even further.

P5.3. ART MAKES VISIBLE - Experiencing the possibilities of art therapy in dementia care at the Luxembourg Alzheimer’s Association


Association Luxembourg Alzheimer, Luxembourg, Luxembourg

Living with dementia means coping with situations in which the person is confronted with deficits in her everyday life. A person with dementia has to handle situations in which she “does something wrong” or is losing her abilities.

Art therapy gives people with dementia the opportunity to express themselves in a new and powerful way. The artistic expression allows everything! There is no “right” or “wrong”. By experiencing “artistic freedom”, the person can take pride in herself again. Art therapy focuses on the person and not on the dementia.

The Luxembourg Alzheimer’s Association debuted the artistic project “ARTstudio” in 2014. It uses art therapy specifically in the accompaniment of people with dementia.

At the “ARTstudio”, residents of the association’s care home "Beim Goldknapp" and guests of the daycare center “Dominique Marth” are expressing their creativity either individually or in a group under the guidance of an occupational therapist with a training in art therapy.

The “ARTstudio” encourages the person with dementia to discover new ways of expression by being creative. There is no pressure for the artists. It is not important to create a “beautiful” painting. The aim is to enjoy being creative and trying new things without the fear of failure. At the “ARTstudio” everything is possible - there are no limitations!

The resulting artworks open up new ways of understanding people with dementia! They provide an insight into their emotional world and form a bridge to their soul.

That's why the “ARTstudio” has chosen Paul Klee's quote as its guiding principle:

“ART does not reproduce the visible but MAKES VISIBLE”.

P5.4. The CHORD manual for singing group facilitators working with people with dementia


University of Nottingham, Nottingham, United Kingdom

Introduction: Singing groups for people with dementia and their carers facilitated by community-musicians and volunteers are very popular. However, these groups tend to rely on the individual facilitators’ musical and interpersonal skills. There was a need to develop guidance on how to optimise the therapeutic aspects of group singing. We conducted the CHORD study to develop a manual for singing group facilitators incorporating music therapeutic skills.

Methods: Stage 1.The development of the CHORD manual followed the four-stage process of the MRC Guidance on Complex Intervention. A draft manual was developed from the literature review and extensive consultations with music therapy clinicians and researchers in the UK, Denmark and Australia. The draft manual was piloted with a singing group of Memory Service users in London. Feedback from the participants and the group facilitator was incorporated into the refinement of the manual. The preliminary study outcome was presented in the Alzheimer Europe conference in 2016.Stage 2.A PhD study incorporating the evaluation of the CHORD manual, conducted a ten-week feasibility study with 16 people with dementia or memory problems and their carers. The researcher evaluated adherence to the manual and interviewed the facilitator and group members. Further expert consultations were conducted to finalise the CHORD manual. Hard copies were produced to make the manual more widely available.

Conclusion: The development and evaluation of the CHORD manual demonstrates it is possible to produce an easy-to-use clinically relevant manual. The use of the manual allows replicability of effective facilitation of singing groups. Music therapy is an intervention to be provided by qualified music therapists. However, the CHORD study suggests that it is possible to skill-share some music therapeutic skills to support non-therapists working with people with dementia. 

P5.5. The impact of care staff on outcomes from arts interventions for people with dementia: a dual case study


University of Nottingham, Nottingham, United Kingdom

Background: Arts interventions are increasingly being implemented in residential care settings to improve the quality of life for residents, including those living with dementia.  Creative activity that involves and engages care personnel can lead to improved care strategies and the validation of personhood in persons with dementia.  The aim of this study was to explore empirically how care personnel influence arts interventions in two residential care homes in the United Kingdom.

Method: A dual case study was conducted; the arts intervention was observed over 6-weeks using non-participant observation. Follow up interviews were conducted with participants.  Monitoring narrative reports and reflective diaries were collected from the programme coordinator.  Data were analysed using a qualitative realist approach utilising a context, mechanism, and outcome framework.

Results: Contextual factors influencing staff participation presented in two ways: i) the focus on task based care ii) the perception and reception of creative activities within the setting.  Inclusion, fun and celebration were identified as person-centred mechanisms facilitated by staff during the intervention.  Outcomes of staff participation included improved resident engagement and staff development.

Conclusion: Findings demonstrate that there are potential benefits when care personnel are involved in arts interventions; particularly with regard to the sustainability of external creative and cultural programmes. However there are still barriers to integrating arts into care practice; care personnel, including management and budget holders, need an understanding and awareness of the benefits of integrating creative and cultural provision into care settings so that the potential of arts based activities can be fully realised. This research advances knowledge about the impact and implementation of arts interventions in care homes.  It has the potential to help shape the development and delivery of creative practice within the social care sector for the benefit of those who live and work within these settings.

P5.6. “pARTEcipo anch’io” (Here we are too)

BARTORELLI Luisa1, RAGNI Silvia1, PIGLIAUTILE Martina2, LONGO Annalisa2, MECOCCI Patrizia3

1FSR - AU, Roma, Italy, 2Alzheimer Uniti Italy, Perugia, Italy, 3PG - University, Perugia, Italy

Background: pARTEcipo anch'io is a biennal research project funded by Fondazione Sanità e Ricerca in Roma and Perugia. Azheimer Uniti Onlus Association, A.M.A.T.A. Umbria (Associazione Malattia e Telefono Alzheimer Umbria) and Section of Gerontology and Geriatric, Department of Medicine of the University of Perugia were involved. People with dementia were invited to a program of cognitive, motor and social stimulation activities relized by means of museum visitis and artistic workshops.

Aim: to evaluate the effects of a museum stimulation program for people with dementia.

Method: 23 and 28 persons with different levels of dementia (from mild dementia to moderate dementia) were enrolled respectively in the first and in the second year of experimentation. Quantitative and qualitative data were collected. The health state was monitored and the effects of the program was evaluated by: 1) visual-analog scales concerning wellbeing; 2) the Observed Emotion Rating Scale; 3) a quality of life scale; 4)ad hoc interviews to people with dementia and their caregivers.

Results: an increase in self-reported wellbeing during museum visits was found. During the museum visits the participants signs of pleasure and interest was reported both in mild than moderate dementia. From the interviews the importance that the museum visit is carried out by specially trained personnel was emerged. People with moderate dementia required a simpler visual scale.

Conclusions: the museum stimulation program for people with dementia is a low-cost psychosocial intervention useful into stimulate cognitive functions and increase the well-being. Caregivers and experts and moved their attitudes to the care.  



Last Updated: Monday 27 August 2018


  • Acknowledgements

    The 28th AE Conference in Barcelona received funding under an operating grant from the European Union’s Health Programme (2014-2020). Alzheimer Europe, CEAFA and Fundación Alzheimer España gratefully acknowledge the support of all conference sponsors.
  • European Union
  • Roche