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P13. Art and dementia

Detailed programme and abstracts

P13. Art and dementia (Wednesday 2 Nov., 8.30 - 10.00)

P13.1. cARTrefu: creating artists in residents


cARTrefu is an exciting two year Wales-wide project that aims to create and increase opportunities for care home residents and staff to participate in the arts by providing eight-week art residencies in one of four art forms: Performing Arts (Dance/Drama), Music, Visual Arts, and Words (Poetry/Prose).

The project is being delivered by Age Cymru and is jointly funded by the Baring Foundation and Arts Council Wales. An independent evaluation is being led by the Dementia Services Development Centre Wales, Bangor University. The evaluation explores the impact of the art residencies on care home residents, care home staff, the artist practitioners, and the wider community.

As the largest project of its kind in Wales, this project will deliver 128 residencies with sixteen artist practitioners (four from each art form) delivering eight residencies each over two years. Evaluation methods include care staff from participating homes completing a pre- and post- residency questionnaire exploring their attitudes to dementia, previous experience of art, confidence in leading art sessions, and three top tips to running a successful art residency; residents completing the Smiley Faces Assessment Scale, a self-report rating scale using a response system of pictures of five faces ranging from very unhappy to very happy, before and after each session; and the Artist Practitioners writing a reflective journal after each session as well as contributing unique feedback from a creative and emotional sensibility.

This paper presents results from the first year of the project. As a pioneering project working at such a huge scale, we feel important implications have been learned for future projects. Along with the results of the evaluation, challenges and successes of this inspiring and significant project will be highlighted to enable the sharing of best-practice for large-scale art projects in care homes.

P13.2. Arts interventions in care homes: social return on investment (sroi) analysis

SCHNEIDER Justine, BOSCO Alessandro, BROOME Emma, DENING Tom

Background: Residents in 17 care homes in one city in central England were exposed to a diverse programme of arts interventions over 18 months. Two-thirds of the residents had dementia. The purpose was twofold: to explore the impact of professionally-led arts on residents, care home personnel, and activity co-ordinators; and to investigate what the artists learned from working in care home environments.

Methods: We used social return on investment (SROI), a novel method akin to cost-benefit analysis which ascribes monetary value to non-financial outcomes. SROI has been used in previous studies of arts interventions for people with dementia and their carers.  In the present study, data were gathered from monitoring documentation, interviews with stakeholders, and consultation with the programme leaders. The data were assembled in an ‘impact map’ which specifies the inputs, outputs and outcomes from the programme for a range of ‘stakeholders’. These stakeholders include the intended beneficiaries (residents, care home personnel and artists) together with care home providers and funders of the activities.

Results: We found that the arts programme achieved a positive ratio of return on investment and that this was highly sensitive to the assumptions made.  We will compare our results to those of two, similar SROI analyses. We will demonstrate how the SROI process offers a structure for decision-making and highlight some of the methodological issues it raises.

Conclusion: SROI can support funders and providers to capture the social value of complex programmes of activity.  However the ratio, distilled from a mass of information, can also be misused. By explaining its application in this instance we hope to enable researchers to weigh up the advantages and risks of the use of SROI.

P13.3. A Sensory garden in dementia care: From design to practice


Aims and objectives: Sensory gardens are supposed to be beneficial to improve mental well-being in vulnerable people. Our aim is to investigate how regularly attending a sensory garden can improve both quality of life and social interactions in elderly people with Alzheimer’s disease.

Background: A newly designed sensory garden in an elderly daytime health care center in Balerna in southern Switzerland is accessible almost all year long.

Design: Fifteen elderly individuals have been regularly attending the garden since September 2014 (Age: 69-87 yrs.; 4 males; 11 females).

Methods: Caregivers were assessed with the Caregiver Burden Scale before their family members entered the program. After three months experiencing the garden, all caregivers were administered a shorter version of the same questionnaire. This includes questions regarding specially designed features like a Dali sculpture representing a huge thorn clock, a water fountain and wooden ramps to assess how people with dementia react to art and design. Results: All subjects except one, a 73-years old man, felt calmer and relaxed after attending the garden for 90 days. Eleven subjects enjoyed the scents and fresh air. Twelve people, including the four men, enjoyed the most walking the ramps, which are “the way back home”. Nobody payed any attention to the sculpture as a piece of contemporary art but as “a broken clock” that raises a lot of conversation. Ten subjects enjoyed the fountain and flowing water.  All 15 drank the water, no urinary incontinence because of flowing water.

Conclusions: The garden is demonstrating to counterbalance aggressiveness and anxiety. It seems to fully satisfy one’s wandering more on the ramps than on the base circuit while sensory stimulation is a priority. Public health programs promoting such activity should be encouraged to avoid both excess of psychotropic medicines and improving socialization and mental stimulation.

P13.4. Dementia and Imagination: Qualitative research findings from a visual art and dementia study

HOWSON Teri, HEDD Jones Catrin, WINDLE Gill

Dementia and Imagination is a UK wide study looking at the role of visual arts activities for people living with dementia and those who support them. One aspect of the research has involved conducting a series of 12 week art groups led by professional artists in three settings: care homes in the North East of England, hospital units in Central England and community venues in North Wales. The aim was to understand the impact of viewing, discussing and making art on people living with dementia and to understand the contexts and mechanisms that create successful outcomes for visual arts activity programmes.

This paper considers responses to open ended questions collected as part of the research, as a way of understanding the main query of the impact of the art group on participants. Broadly, these questions considered previous involvement with art and other leisure activities, barriers and facilitators to participation, and the participant’s feelings about taking part in the art group. 

Over 120 people living with dementia took part in the research and the opinions of their formal and informal carers were also gathered. Where the person with dementia lacked capacity, a proxy response was sought. Data were collected at three time points: prior to beginning the art group and at one and three months after the art group.

Initially, responses were open coded to look for emerging themes, before discrete analyses were conducted to enhance the understanding of quantitative data that were also collected for the research. For the purpose of validity, the analysis was conducted independently by two researchers using the software package Atlas.ti. This paper will present the preliminary qualitative findings and discuss the implications for the future creation and delivery of visual arts activities for people living with dementia, and the communities that support them.

P13.5. The development and preliminary evaluation of CHORD (CHOrus Research in Dementia) Manual

MCDERMOTT Orii, ORRELL Martin, RIDDER, Hanne Mette

Introduction: Community-based singing groups are valued by both people with dementia and their carers in the UK. However, written guidance on evidence-based, replicable singing interventions is not available. Music therapy is a clinical intervention delivered by trained music therapists but some of the music therapeutic techniques are transferrable to facilitators of music activities without formal training. This study aimed to identify these skills and develop a standardised singing manual.

Methods: The study followed the four-stage process of the MRC Guidance on Complex Intervention.

Development Literature review on group singing for people with dementia was conducted. Ongoing discussions with clinicians and researchers in the UK, Denmark and Australia contributed to a draft framework for the manual. Expert consultations took place to articulate the transferable skills. CHORD manual version 1 was developed. Following further expert consultations, manual version 2 was produced. Ethics approval was obtained.

Feasibility study Service users and their family members were recruited from the Memory Service in London and were invited to attend ten weekly singing group sessions. The facilitator followed the CHORD manual version 2.

Evaluation Post-intervention focus group was held to obtain the participants’ views on the CHORD intervention and to identify the areas requires further development. Further expert consultations with dementia care specialists were held to refine the manual.

Implementation Copies of the final version of the CHORD manual were produced. Further evaluation of the CHORD intervention is being conducted by a PhD student.

Results: Successful completion of the CHORD feasibility study indicates it is possible to produce a written guidance on clinically effective singing intervention. The participants with dementia initiated their own ideas and actively supported fellow participants. Singing group encourages people with dementia to use their abilities and offers a space for self-expression and to connect with others.

P13.6. A violin in hand: an unusual music therapy project for people with dementia

RAGNI Silvia, BRUTTI Edoardo, LEVI Stephanie, VANACORE Nicola, BARTORELLI Luisa

Introduction: The use of the creative arts in reactivation for people with dementia is now deemed to be very important.  In particular, music therapy is considered one of the most significant activities for people with cognitive disorders, as demonstrated through neuroimaging, both when listening as well as playing music. Furthermore, when music is played in a group setting, it also takes on an additional value of socialization, significant for persons who are at risk of isolation.

Material and Method: At the Alzheimer Day Center of the FRS, we have conducted a group experiment using an innovative methodology: placing a violin, for the first time in the hands of people with dementia. The violin is the perfect object: an old traditional Italian instrument, made of wood, a living material, and with a pleasing shape. 10 people with mild to moderate dementia, divided into two groups, took part in a program of 12 weeks, meeting twice a week for 45 minutes. It was led by a multidisciplinary team including a professional violinist and coordinated by a psychologist-music therapist. The main objective is to evaluate the capacity to learn, both at a cognitive and a motorial level and to assess the coordination of gestures and balance in posture and the effect on mood and personal relations. Secondary objectives are to evaluate unexpressed and dormant abilities through the verbal and non-verbal stimulation of the music. Besides the MMSE, NPI, Cornell-Scale, ADL, Tinetti, PPT, Test dei pioli, Matrici attentive, Verbal Fluency which are administered at the start and end of the project, a music therapy questionnaire is also given to the participant and the caregiver, to evaluate musical skills. Also a qualitative assessment is done with an observation chart compiled by the health-care workers and caregivers.

Results: The preliminary results for learning and mood are encouraging and the full results will be presented together with a video. The findings show that the experience of playing in a group with professional violinists producing “real music” promotes a sense of self-esteem and motivation. The project promotes the integration of cognitive functioning with fine motor skills and verbal fluency on a narrative and autobiographical level.  Ultimately the violin can indeed be considered an appropriate tool for music therapy for people with mild to moderate dementia and mild apraxia.



Last Updated: Tuesday 10 January 2017


  • Acknowledgements

    The 26th AE Conference in Copenhagen received funding under an operating grant from the European Union’s Health Programme (2014-2020). Alzheimer Europe and Alzheimerforeningen gratefully acknowledge the support of all conference sponsors.
  • European Union
  • Roche