Here are some continuous quality improvement ideas, to help you on your journey to providing the best arts experiences possible:

• 80% of our clients are seniors, and statistics show that approximately 50% of seniors in long-term care suffer from Alzheimer’s or related dementias. Often, we see adults reverting to what we consider to be childlike behavior. It is a symptom of their disease and we must show our respect in everything we say and do. Even though a client has messy hair, food on their shirt, cannot speak, etc., they are still adults and need to be treated as such. If you can’t understand what someone is saying, apologize for your limitation, not theirs, and either move on with a smile or engage staff assistance, as appropriate.
• Place yourself at eye level with a participant when speaking to him/her. If someone is experiencing hearing loss, they may be able hear better when your voice is projected from eye level. Standing above them while speaking may also unintentionally communicate dominance.
• Acknowledge the feelings you observe, provide reassurance, and try to engage in an activity that will provide comfort, e.g. storytelling, singing, and movement.
• Use age-appropriate song, story, workshop and project content. There are many beautiful songs and stories that are simple, but profound and adult-oriented. Check TAO’s website for examples.
• Be patient. You need to allow time for participants to absorb, understand and think about what you have said or what you propose to do in your program. They need to be given time to respond in a manner that suits their capabilities.
• Restate your message if it is not understood the first time. Rephrase your statement, if necessary, and ask for acknowledgement and feedback. Aim for concise, straight-forward sentences.  Speak clearly and distinctly, using eye contact as often as you can.
• Pay attention to body language. Most of our communication with one another is unspoken. For example, if you are too close to someone they may lean back or turn their head. Eye contact and a smile go a long way!

The first step to engaging people we serve is effective communication. For more tips, please visit our website, and THANK YOU for all you do.

Program volunteer Ally Cassorla

For those who want to visit with folks living in nursing homes and other long-term care settings, but are not sure how to go about it, or what to do once you get there, consider linking with TAO programs as a Program Host.  This volunteer position is a flexible, fun and creative approach that allows participants to be a part of the artistic experience and to connecting meaningfully with this deserving, yet under-served, group of community members.

Program hosts decide when, where and how often they work with TAO.  Our hosts regularly check our online calendar of programs to decide where to link in.  When they find a program they want to attend, they contact us (TAOvolunteers@gmail.com) to make arrangements.  We send them confirmation, program information, directions and contact info.  Once at a location, they work with the TAO artists and facility staff to assist in any way they are comfortable.  That might mean:

• finding cups and water for musicians
• going to the nurse’s station to be directed in wheeling residents to and from the day room or dining room where the TAO program is taking place
• passing out songbooks, percussion instruments, or art supplies
• greeting and conversing with residents
• taking part in the arts experience, at whatever level of involvement is comfortable
• encouraging participants to take part in the arts experience, often looking to the activities director for cues on who/when/where and how to best approach individuals
• sincerely encouraging, listening to and appreciating the residents
• thanking the artists on behalf of Tidewater Arts Outreach

It looks like a lot, but they are natural acts that evolve throughout the course of the hour spent in program.  The time always passes quickly.

The real beauty of the project is that it is creative and spontaneous in nature.  Artists are reacting to the cues received from participants, and programs evolve based on the participants’ reactions and inputs.  Our best programs are client-centered in every aspect.  We utilize the talents of our artists to facilitate arts experiences that result in creative responses (singing, dancing, drumming, storytelling, painting, etc) from those we serve.

It is a great way to participate in the lives of these special needs residents.  It’s fun and very rewarding.  It also is meaningful to TAO and our outreach.  We rely on the goodness of community members to be a part of the community life at these long term care locations, and we use the arts to build community and create common ground.

Further, the arts in healthcare settings:

• Help patients feel safe, comfortable and welcomed
• Reduce anxiety and the experience of pain
• People feel connected, heard and appreciated
• Help people be seen and understood as individuals, not as patients, numbers, or by their job descriptions or diseases
• Help to enhance the facility’s community relations and express its values
• Reduce staff stress; improves morale
• Enhance a sense of connection with the community
• Has the potential to help reduce staff turnover & attract quality staff
• Replace activities that can no longer be accomplished with meaningful activities that are appropriate and achievable
• Help staff connect culturally with patients, families and other staff members from diverse cultures
• Specific arts activities can ensure that people leave a legacy, and create a lasting expression
• While the arts cannot cure, they can help heal
• Provide additional, profound communications opportunities for verbal and non-verbal participants

Music has been shown to preserve cognitive skills in clients with dementia. Jazz dance has been shown to have positive effects on cognition, mood and balance in older adults. Study after study shows there are far-reaching benefits to having regular, stimulating programs and social experiences in long-term care, and that the arts are an important tool to help people with special needs engage and thrive.
“I Remember Better When I Paint” is a beautiful video depicting the benefits of engaging in visual arts experiences for persons with Alzheimer’s.

And we have seen frustration and loneliness in nursing homes.  Workloads are great and staff can not do it all.  I would love to see more community involvement with these seniors.  As Dr. Yetter said in this piece, “Why are we not taking care of our own?”

There are simple and very effective tools to use when working with people with dementia, and with five million people living with this debilitating and deadly disease in the US today, I think we owe it to ourselves to make training more widespread. We also need to be willing to learn the tactics.

One of the most common and effective tactics is redirection.  In at least one instance mentioned in the article, redirecting or refocusing the patients could have resulted in cooperation instead of argument.  Here’s how it works, simply:

If someone says, ‘I want to go home,’ an appropriate redirecting response is, ‘Tell me about your home.”  Keep acknowledging and asking questions to move the person from thoughts of leaving and to other ideas, like dinner or an activity.

Similarly, if someone says, ‘I miss my wife,’ the appropriate response is, ‘would you like to tell me about her?’   It’s fine to acknowledge the missing that person feels, but it’s also good  to acknowledge the love that they shared or that they feel when they think of this person.

Googling ‘redirecting Alheimer’s patients’ results in lots of good material.  I recommend our (TAO) artists and volunteers take a look, to increase their understanding of those we serve.  Half the nursing home residents today suffer from Alzheimer’s and/or related dementia.  These people still have joy, purpose, personality and so much more.  They deserve our involvement.  Thankfully, the arts present an impactful, effective and very beneficial way to connect with these individuals.

There is great room for improvement in many long-term care facilities.  We can’t expect that staff can meet all the needs of their residents.  Just as ‘it takes a village’ to support young families and their children, I believe ‘it takes a community’ to remain involved in the lives of our eldest neighbors, family members and friends.  And the arts are a fantastic bridge that allows meaningful, stimulating, respectful, appropriate, and engaging involvement to occur.

For more information about the benefits of the arts in healthcare and long-term care, visit the Tidewater Arts Outreach resources page.

Therapists are using vocalises and singing as ways to help some people regain speech after a stroke, or if Parkinson’s or dementia are robbing clients of the ability to speak.  Speech is confined to a small area of our brain, but singing spans several areas, making it more readily accessible to us.  All great reasons to sing more with seniors, and, when building program content, to thing about creating  mood, tempo, content and pitch that encourages vocal participation.

Pack a suitcase or portfolio with 3-12 of your favorite prints.  Have conversant knowledge on the period, the artist, the style and the subject matter – the more, the better.  Take all this to a nursing home or assisted living facility, and present the artwork as a discussion or workshop.  Seat folks close to you and be ready to get the art into their hands, so they can really see the picture (You may have people who have low vision or are blind; be ready to talk about color, shape, texture, etc in detail.)

Since approximately half of seniors aged 85 and older live with some form of dementia, indicating you will probably have varied levels of ability among your participants, consider the following:

-Speak slowly and directly, but in a conversational, adult-to-adult tone

- Initially, keep comments short and solicit feedback, to help you know how to structure your presentation.

- When asking questions, allow participants ample time to respond to you.

- Locate the caregiver and ask for their attendance throughout your presentation.

- Simply stated, open-ended questions about the subject matter, period, or style can elicit great discussions.  “What kind of person do you think he/she is?”  “How does this painting make you feel?”  “What jumps out at you in this picture?”  all are good starting points.

Art creates a wonderful bridge to unlock memories and stories, and open doors to communication.  Much more program information is available on the Tidewater Arts Outreach website.

Anthony started with a simple heartbeat.  It was easy for folks to join into this.  Once everyone was engaged, he and Chris took turns mixing it up a bit, adding other beats to accentuate.  A full twenty minutes later, still working off that same beat, eyes and smiles were wide and folks were delighted with what was being created.  The hour passed quickly.  The most effective part of this program was the use of two wonderful musicians, who not only played well, but related with such excellence to this group, and the use of one or two volunteers who went around the room assisting with instruments.

We have all the drums and instruments at TAO and we are working to put these into the hands of more seniors, through more senior drum circle.s

Tidewater Arts Outreach has grown quickly to answer unmet needs.  It seems like the artists and much of the community is on board with our mission and work.   If we can point to research that supports financial reasons to increase arts programming, we can increase person-centered arts opportunities in long term care.  If you were 90 and in a wheelchair in a nursing home, don’t you think an hour spent painting with a group of children would be appropriate and enjoyable?  We’re working to sustain TAO and these types of opportunities.  If anyone can point to studies that support this premise, I would be obliged.