Creative arts for people with dementia
Dementia can have a devastating effect on people’s cognitive abilities. Interestingly, however, the creative, imaginative and emotional parts of a person often remain relatively strong.
People with dementia can also lose some inhibition and therefore might feel more free to express themselves creatively and spontaneously.
The frail old man in the corner becomes a King. Staff suddenly see the man in a different light!‘Ladder to the Moon’ actor
There have been some wonderful developments in creative work with people with dementia in the past decade – these have shown how important it is to celebrate a person’s potential rather than always focus on problems and deficits.
People with dementia as poets
Have you ever spent time really listening to the words of people who have dementia?
The words may be very muddled and it might be easy to switch off listening. But, if you take time to listen, there are often very important messages to be heard through the muddled words which can often have a quite symbolic or poetic quality.
Quite often the person is trying to communicate something very important about either their past life or their present situation or perhaps both.
The groundbreaking work of John Killick, who has spent many years listening to people with dementia and recording their words as poems, has helped open our eyes and ears to what people are trying to communicate.
Carry on singing!
A person with dementia often will remember the words of verses, songs and hymns when other parts of their memory are very damaged. Singing helps lift spirits, raise energy levels and feel connected with others! Many people with dementia do not always feel their voice is heard, so it provides an immediate sense of self-worth if they can sing and have others notice and respond.
When you are working with a person with dementia, it might help to suggest or start singing a song. You will be surprised how often a person with dementia will come to life and join in with great enjoyment.
One home care worker found that one of her clients with dementia hated having a wash, but when she incorporated singing a few favourite songs into the activity, her client was immediately more willing to go into the bathroom.
If you are not from the same cultural background of the person you are working with, you may need to find out about the types of music that they might respond to. You might even ask your manager to purchase some relevant song sheets so that you could help prompt a person by asking if they know a particular song. The fact that you don’t know the song doesn’t have to be a problem as you are then asking the person to share something they know with you! (For more on this, look at the section on ‘Getting to know the person with dementia’ and also the feature on ‘The person behind the dementia’ in the section on ‘Communicating well’.)
Most singing takes place informally throughout the day, but there are some groups who offer a more structured approach to singing in groups such as Singing for the Brain™, a service run by the Alzheimer’s Society.
Making the most of music
A very frail looking man with dementia suddenly took the drum and started to beat it with great energy and strength. Everyone else in the room turned around and looked at him. He had a huge smile on his face!Music group leader
When verbal communication is challenging, holding and playing an instrument, even if only for a few minutes, offers a person a chance to be ‘in control’, express something about themselves and their mood. Many people with dementia find new ways to communicate through music perhaps with their eyes, their arms or their feet.
Some music collections in homes or day centres can be very limited. Older people do not just like music from the 1930s and 1940s! ‘Rock and roll’ collections from the 1960s or classical collections might be more popular.
Find out about the backgrounds and interests of the people you are working with. If you are working with younger people with dementia, make sure that you have music that is appropriate to their age and interests.
One woman in our nursing home repeatedly called out ‘Nurse, nurse’ throughout the day from her bedroom. Her keyworker found out she loved Scottish country music and playing this for periods in the day helped lessen her loneliness and need to call out as often. She started to talk about her childhood in the Highlands of Scotland.Care home manager
Music for Life musicians use improvisation to draw out self-expression and communication, an approach that can be particularly helpful when working with people with advanced dementia.
Lost Chord runs interactive musical sessions in Yorkshire and Nottinghamshire using dance, song and instruments.
The Museum Association argues that these institutions can engage people who live with dementia and improve wellbeing. When people see, handle, make or discuss objects in a museum’s collection, it can trigger memories and stimulate conversation. Some museums have taken collections into the residential settings of people who live with dementia while others have encouraged people with dementia to come into the building and they’ve organised activities in which they can take part.
We had a small group of people together miming what they did for a job. We had lots of laughter and some of the residents became extremely animated. One woman who used to be a nurse did a brilliant mime of taking the blood pressure of everyone in the group!Care home manager
People with dementia will often enjoy being playful and spontaneous. Many people will have played charades when they were younger. However, sometimes care workers do not feel as confident. You might feel worried about looking silly. Using props or objects can help, for example bringing in different kinds of hats and seeing how people respond when they put a hat on. For drama-related activities it can help to choose a theme, for example ‘weddings’ or ‘schooldays’. You might be surprised at who suddenly becomes the ‘bride’ or the ‘strict school teacher’!
Interactive theatre in care homes
Have you ever organised a visiting entertainer or theatre group to come to the care home and found that many of your residents have not really engaged at all with the experience?
Ladder to the Moon is an organisation providing workforce and organisational development using creative arts that involves people with dementia in taking on roles in their shows so that they are not just audience members. This can provide people with dementia the chance to be a ‘star’, sometimes only for a few seconds and sometimes for an entire performance.
The frail old man in the corner who rarely says a word becomes a King who gives commands to others. Staff members suddenly see the man in a different light!Ladder to the Moon actor
Children and older people working together
Care homes and day centres sometimes report that it can be awkward for children visiting a lounge full of older people as they are not always confident about how to approach the older people.
By planning an art or drama activity, this can help prevent awkwardness and provide a focus for the two generations to be together.
The children prepared a simple drama sketch of the ‘nit nurse’ visiting the classroom, examining each child’s head and then sending one poor child out of the classroom! The older adults immediately started talking about. Nitty Nora’ (the name given to the nit nurse) and one of the women got up and joined in the sketch.
Intergenerational project worker
If the activities (for example creating decorated name badges or making an autumn collage) are set up for groups working around tables, the children and adults can immediately have something to do together.
If the children are more able to do some of the tasks than the adults, the older people will still feel involved with watching or picking up some of the art materials. Young and older people alike can enjoy singing songs such as ‘Wind the bobbin’ up’ with associated actions.
Magic Me, an organisation with extensive experience in intergenerational work, publishes helpful resources and guidance on this.
Access and download additional resources
Further reading and resources Open
Andersen-Warren, M. (1999) Creative groupwork with elderly people – drama, Milton Keynes: Speechmark.
Cotter, A., Fraser, F., Langford, S., Rose, L and Ruddock, V. (2001) Getting everybody included, London: Magic Me.
Craig, C. (2005) Focusing on the person: exploring the benefits of photography for people with dementia, Dementia Services Development Centre, University of Stirling.
Craig, C. (2003) Meaningful making: a practice guide for occupational therapy staff, Dementia Services Development Centre, University of Stirling.
Craig, C. (2001) Celebrating the person: activity pack, Dementia Services Development Centre, University of Stirling.
Craig, C. (2001) Celebrating the person: a practical approach to art activities, Dementia Services Development Centre, University of Stirling.
Innes, A. and Hatfield, K. (eds) (2001) Healing arts therapies and person-centred dementia care, London: Jessica Kingsley Publishers.
Killick, J. (2008) Dementia diary: poems and prose, London: Hawker.
Killick, J. (2000) Openings: dementia poems and photographs, London: Hawker.
Killick, J. (1997) You are words: dementia poems, London: Hawker.
Killick, J and Allan, K. (1999) The arts in dementia care: touching the human spirit, Journal of Dementia Care, vol 7, no 5, pp 33-37
Langford, S. and Mayo, S. (2001) Sharing the experience: how to set up and run arts projects linking young and older people, London: Magic Me.
Speechmark (2000) ‘Let’s mime’. Milton Keynes: Speechmark. A simple charades game for two or more people of any age.
Useful links Open
The Alzheimer’s Society produces over 80 factsheets on all sorts of topics related to dementia, including Staying involved and active (505), Exercise and physical activity (529), and Mobility strategies. The Society’s website also includes Dementia Connect, a webpage for searching for information about local services and support groups for people with dementia and carers.
Arts 4 Dementia
This charity works with arts organisations around the UK to develop opportunities for people with dementia and their carers to participate in a wide range of arts activities. Arts 4 Dementia offers training for arts facilitators, advice, online resources and seminars.
As easy as ABC: Care UK’s top 100 hints and tips for activity-based care
Care UK’s activity teams share what they have found to be helpful when supporting people with dementia in everyday activities, arts and crafts, maintaining independence, special occasions, health and wellbeing, and reminiscence.
Living well through activity in care homes
This free online resource from the College of Occupational Therapists sets out a wide range of practical ideas on how to support care home residents to continue day-to-day activities that are important to them. The resource includes free training materials and audit tools to review and evidence aspects of care such as personalisation and choice.
Using technology to support people with dementia
Technology has so much to offer people living with dementia and their carers; access to information, advice and entertainment as well as reassurance for a carer who does not live near a loved one. Used sensitively and thoughtfully, technology enhances rather than replaces human relationships and interactions.
Related pages from this section Open