Living with dementia, March 2009

Art, dignity and dementia

Helen Bate is the founder of Pictures to Share Community Interest Company*. Here, she writes about helping people with dementia to get the most out of art.

The 2008 report On Our Own Terms by Help the Aged looked at the challenge of providing and measuring dignity in care. One of the criteria used for measuring dignity in care is whether the cultural, recreational and social needs of people in care are met, and whether people have choices in the activities available.

For the majority of people with dementia and the associated problems of isolation and depression, the provision of suitable resources and activities is crucial to their mental and emotional well-being.

Of particular importance in the case of people with dementia is the need for activities to be meaningful and relevant to their personalities and life experiences.

One activity shown to be valuable for many people with dementia is the appreciation of the visual arts. Like the majority of the population, people with dementia know what they like. A recent study (Halpern, A et al. Brain & Cognition) looked at the art preferences of people with and without dementia.

The study found that people with dementia were as able as people who did not have dementia to express a preference for particular pictures, and that these preferences remained consistent over time.

The Museum of Modern Art in New York provides interactive tours of its collection of modern art for people in the early and middle stages of dementia, along with their family members and carers.

Specially trained staff engage participants in lively dialogue by looking at iconic art from the collection, including works by artists such as Henri Matisse, Pablo Picasso, Jackson Pollock and Andy Warhol. This ongoing and successful project illustrates how the act of looking at art together can be a rich and satisfying experience for people with dementia and their carers.

Testing responses over the past two years, a small UK social enterprise called Innovations in Dementia has been carrying out research among people with middle to later stage dementia. Researchers investigated people's responses to a wide range of images including painting and photography, colour and black and white images, and representational and abstract images.

They discovered that while the age or style of an image does not preclude people with dementia from enjoying it, its complexity or content could create confusion or distress in the viewer. While a bold, semi-abstract painting of a landscape may tap into a person's emotions, that same person that same person may be distressed if they were unable to interpret a photograph depicting an unfamiliar scenario such as a group of children waiting at an ice cream van.

The work carried out by the Museum of Modern Art in New York, the Halpern study and the research by Innovations in Dementia has shown that there is no simple formula for what people with dementia like to look at in terms of art and pictures. Appreciation of art depends very much on their own aesthetic preferences and the cognitive limitations imposed by dementia.

Offering more old photographs are often used in reminiscence work and can be helpful in prompting memory.

Photographs cut from magazines can provide a tool to prompt discussion about a particular topic. But people with dementia are able to appreciate so much more in the way of art and visual imagery. To deny them that possibility is surely to deny them the dignity of choice, and the potential enjoyment and benefits that can be gained.

Care homes are often decorated with corporate style decorative prints that are more suited to a hotel or office. But carefully selected reproductions of old or modern art can offer so much more in terms of enjoyment and communication, particularly if they are chosen based on the residents' preferences.

People with dementia deserve the freedom to look at a wide selection of high quality art and photographic images in a format that is easy to use.

Purpose designed art and photography books can enable relatives and carers to engage in a meaningful way with people with dementia. They may also, just as importantly, help people with dementia to keep in touch with an aesthetic, emotional and spiritual part of their life; an important element that can often be ignored or neglected by people responsible for their day-to-day care.

*Pictures to Share is a social enterprise which provides appropriate media for people with dementia. There are currently seven illustrated books in the Pictures to Share range. The books, which have featured in this magazine, have been compiled following extensive research into the responses of people with dementia to a wide range of images.

For further information or to order books, visit www.picturestoshare.co.uk or call 01829 770024.

References: Please contact rdoeg@alzheimers.org.uk or call 020 7423 3676 if you would like references for the studies.