Caring compassionately for the elderly with dementia or mental illness.

Elizabeth Simpson’s article in today’s Virginian Pilot pointed out the great need that exists in healthcare for the thousands of people who suffer from dementia or mental illness, combined with other diseases or conditions, and further complicated by advanced age.  I have been up to the 3West wing at Chesapeake General Hospital (mentioned in the article) and have seen the dismay and confusion on the faces of the patients who are there because they don’t have anywhere else to go.

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.

Neuroplasticity and the Aging Brain

We all know we need to exercise to keep our bodies healthy.  Some great research supports why it makes perfect sense that “use it or lose it” applies to our mental faculties, too.  And it’s exciting to come upon more and more research that shows how engaging in the arts stimulates many areas of the brain, as expressed in the August 14 article on Music and the Brain in Science News.  And how creative activity is good for the brain, impacting dendrites, nerve endings, and more.  I recently heard Dr. Paul Aravich, a researcher at EVMS’ Glennan Center for Geriatric Research, talk about the importance creating a stimulating environment in long-term care.  Here is where the great opportunity for the community arts programs, like those provided by Tidewater Arts Outreach, comes in.  As we age, we lose the ability to do stimulating things that, at one time, gave us challenges, pleasures, and opportunities for development, like engaging in team sports or physical activities, business pursuits, serious hobbies, intellectual pastimes, etc.  It’s vital to continued health and vitality that we replace those things that can no longer be done with appropriate, stimulating and satisfying activities.

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.

The value of vocalises (vocal exercises) for singing seniors

We are asking singers and musicians to engage in vocal warm-ups with their participants as they set up equipment and prepare to present their program of music.  There are a number of reasons why these simple, lyrical exercises are effective with people who have experienced a loss of vocal power, or the faculty of speech, due to stroke, dementia, Parkinson’s and other ailments.  The simple vowel sounds that range up and down four or five notes (ah-ah-ah, etc), or vowel/consonant blends (e-me-me-me-me-me-me) and you-you-you-you-you-you-you drew laughs recently) are achievable for folks who might not feel competent in singing along to songs with lyrics, providing them with an important opportunity to participate.  I’ve found that when I present vocalises before a singalong, senior participants seem to participate more spontaneously and with greater enthusiasm during the main program, leading to more stimulation, greater enjoyment, and more physical benefits, such as posture and breathing.

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.

Art in a suitcase

…this is great for art students, art teachers, art scholars and art lovers who’ve taken the time and interest in studying artistic styles, periods, and the masters.

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.

 

 

 

What are our societal values re: our oldest members?

We are looking for people in the community (graduate students, study centers, professionals, etc.) who might be in a position to partner with us in a pilot research project that quantifies the value of regular, quality arts programs for seniors in long-term care. What we’re finding is the medical students, art therapists, students in social work, nursing, etc., are putting their energies toward exploring and relating to the condition of humanity at nearly every other stage of life but at the later years. I just have to question, ‘why?’ Why is it that our culture is so far behind other countries when it comes to showing an interest in the quality of long-term care? Clearly, through our music and arts outreach at TAO, we are in a field where there is great need, but far less understanding or acceptance in our society of that need. Unless there is change, this segment of society will continue to be marginalized and under-served. And there will be lots more of us in that boat in the coming 20-30 years.

Drum Circles for Seniors

Sentara Adult Day Program came alive with the sounds of percussion in a drum workshop led by Anthony Hailey and Chris Koroshetz, two area musicians of note.  We gathered some participants into a circle so that they could play the nine djembes together.  The other 50+ participants were seated throughout the room at tables, which we ladened with woodblocks, guiros, shakers, various bells, chimes, zills, tambourines, etc.

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

How the arts enhance the bottom line in LTC

I’m looking for research that supports the value of arts programming in long term care settings.  The surveys we receive from residents and staff are incredibly positive.  Everyone is telling us how much our (music, dance drama and visual) arts programs are appreciated.  Our artists go to nearly 70 locations in Hampton Roads…not all are nursing homes and assisted living facilities, but we see enough of these places to know that people are frustrated, lonely, and marginalized.  Staffs are burdened with caregiving, medications, safety, behaviors, paperwork and much more.  They can’t do it all and we as a community should not expect them to.  None of us ever wants to be that resident who sits in a wheelchair by the nurse’s station all day.  The community, in general, doesn’t know how to come in and engage with frail, elderly, depressed and/or medicated seniors.  But at TAO, we feel that in this environment in these long-term care facilities, the arts shine and can be the convener.  The arts build community.  They help us celebrate our uniqueness, our humanity, and our lives, no matter our age, shape, or condition. With the right approach and accommodations, people can be brought into the experience and can benefit in many ways.

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.