Creative arts and dementia

 

Whilst an array of organisations and practitioners currently use and develop creative therapies for people with dementia, they are rarely reported and are often not publicised. The Association for Dementia Studies has been laying the foundations for building research in this area.

Professor Dawn Brooker, Director of ADS, has a long-standing practice and research interest in creative activity and dementia. She worked in partnership with the ExtraCare Charitable Trust to develop the Enriched Opportunities Programme as a means of engaging people with dementia through activity and occupation (Brooker et al, 2007; 2011). This proved to significantly improve quality of life, decrease depression and decrease hospitalisations for people living with dementia.

Then, in early 2015, the Alzheimer’s Society funded eight Doctoral Training Centres in various aspects of dementia to help to increase research knowledge and capacity in this vital and TAnDem is the name of the Doctoral Training Centre (DTC) that has been funded to focus on studying The Arts and Dementia. This is a partnership between the Association for Dementia Studies at the University of Worcester and the Centre for Dementia, University of Nottingham and this topic was chosen because without greater knowledge and evidence about the arts and dementia, people living with dementia and their families cannot make informed choices. It is difficult for service providers and artists to help people with dementia and their carers to live well with dementia, as commissioners cannot justify expenditure on arts-as-interventions. The TAnDem PhD studentships are designed to remedy this gap in scientific knowledge and understanding. All of the proposed studentships will have a common focus on advancing knowledge about the impact of engagement with creative activities on people with all stages of dementia and on their family and professional carers. Please see the relevant webpages for details of students and topicssupervisors and management team. One unique aspect of TAnDem is that it offers the complementary resources of two universities to all the PhD candidates.

For details of other current and past research please go to the relevant tabs.

Other ADS staff engaged with this work are:

Please also see the TAnDem page for details on the The Arts and Dementia Doctoral Training Centre

 

Creative Ageing Programme

Concerned that arts projects need to be sustainable, The Courtyard is developing toolkits to "support continued delivery in care homes, and also the option of care homes" as well as looking at other methods towards sustaining arts projects for people who are older and/or living with dementia.

The Courtyard has been awarded funding to run their ‘Creative Ageing’ programme for a 3-year period, ending in August 2019, which comprises a wide range of activities. The Courtyard have commissioned the Association for Dementia Studies to carry out an evaluation of this programme over two years.

The evaluation will seek to capture the success of this project in addressing the following three outcomes as stated in the Creative Ageing project proposal:

  • Improve wellbeing for older people and their carers through participation in high quality creative experiences
  • Cultivate opportunities for older people to maintain wider social networks and reduce social isolation through participatory arts projects
  • Develop specialist skills in the local community to provide varied and sustainable age-appropriate activities in older people’s settings.

For more information about this project please contact Dr Simon Evans.

Namaste Care Intervention UK 

 

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Delivering excellent care every day for people living with advanced dementia.

The Association for Dementia Studies has been awarded an implementation grant from the Alzheimer’s Society to carry out a 3 year project from 1st October 2016 to help UK-based care homes to provide better care for people with advanced dementia by an evidence based intervention that provides a practical, systematic approach to meet the physical, sensory and emotional needs of people living with advanced dementia.

Namaste is a multi-component intervention developed in the USA shown to reduce distress behaviours, pain, use of antipsychotics, hypnotics and depressive symptoms and inappropriate hospitalisation in people living with advanced dementia.

In this project evidence from research and practice in the UK to date will be synthesised to establish the optimal intervention. The a series of six implementation studies utilising Kotter’s 8-step process for change management will be undertaken in care homes posing different challenges (e.g. size, training, skill-mix). This will establish effectiveness and acceptability, including feedback from care homes, staff and people living with dementia and their families in addition to preliminary costing model.

The outcome will be an in-depth description of the optimal intervention in the form of a guidance manual together with expert practitioners who can mentor new programmes. The optimal intervention will then be ready to roll out across care homes with information about how to implement it successful, costs, staffing and resource use.  This will include guidance on how to deal with common barriers e.g. competing priorities, lack of time, staff changes, engaging families and regulators. 

An on-line “Community of Namaste Practice” will be built to gather feedback from multiple sites throughout the research. This will also be a major vehicle for generating and maintaining interest in implementation for further roll-out.

What do we already know?

Palliative care addresses the needs of people who are in the later stages of a disease or are approaching the end of their lives. Without proper palliative care, people with advanced dementia may experience unnecessary discomfort or have untreated pain. This can lead to distress, depression and changes in behaviour.

The Namaste Care programme was developed in the USA and focuses on enhancing quality of life through a range of physical, sensory and emotional care practices.  These include improving pain management, ensuring proper nutrition, using music, aromatherapy and personalised nurturing communication with each individual. Early research indicates that this care programme could be beneficial for people who are in the advanced stages of dementia. It may help to alleviate symptoms such as agitation and reduce the use of medications such as antipsychotics.

What does this project involve?

The researchers aim to find out what aspects of the Namaste programme would be most effective for people with advanced dementia in care homes in the UK and how best to put the programme into practice. The research team will work with existing Namaste practitioners and 6 care homes implementing Namaste for the first time to find the best ways that the Namaste programme can be used successfully. This includes identifying things that help or hinder developing the programme in the care home and making sure that it is acceptable to people with dementia and their families.

How will this benefit people with dementia?

There is a need to better understand how to care for someone in the advanced stages of dementia to avoid any unnecessary distress, discomfort or pain. This study will allow researchers to understand what works well and what doesn’t when encouraging care homes to adopt complex but potentially effective methods of palliative care. If successful, using the Namaste programme may help to increase comfort and quality of life for people in the later stages of dementia.

The Research Team

  • Professor Dawn Brooker PhD: Principal investigator:
  • Caroline Baker (Co-applicant): Director of Dementia Care at Barchester Healthcare. has extensive experience of change management in dementia care
  • Professor Darrin Baines (Co-applicant); Health economist who is well versed in modelling and statistical analysis, and economic evaluation.   
  • Roy and Ros Dibble (Co-applicants) are members of the Association for Dementia Studies LINK (Experts by Experience) group. Ros was a director of a large multi-national IT company based in the UK before contracting Alzheimers (Posterial Cortical Atrophy). Roy was Chief Executive of two government agencies.

University of Worcester research team

  • Isabelle Latham, Senior Lecturer at ADS University of Worcester. Research Project management and care home data collection. 
  • Faith Wray, Research Associate investigating the application of Namaste Care in care homes in the UK 
  • Jennifer Bray, Research Assistant at ADS, University of Worcester. Survey design, data support and management.
  • Mike Watts; Project Administration

Collaborators

In addition the following experts in the field have agreed to be involved

  • Joyce Simard Associate Professor, University of Western Sydney Australia:
  • Ladislav Volicer, MD, PhD, Professor, School of Aging Studies, University of South Florida;
  • Min Stacpoole RN, MSc, Clinical Nurse Specialist in palliative care for people with dementia at St Christopher’s Hospice;
  • John Killick, Director of Dementia Positive 

Briefing paper - Project overview

Namaste Care UK Project Overview

Launch of the Project

The project was formally launched at an event at the University of Worcester Arena on 9th November 2016

A copy of the PowerPoint presentation is here

Contact us

For more information please contact us via dementia@worc.ac.uk or 01905 542531.

Links to other organisations:

St Christopher's Hospice

Namaste Care

Dementia Positive  

Alzheimer's Society

An extract from the Alzheimer's Society Magazine - Living with Dementia - Feb 2015 on Namaste can be accessed here 

 

Making of Me - Mentoring Programme  

The Courtyard in Hereford has provided access to the arts for the older rural population since 2010. Their 'Making of Me' project was successfully piloted and evaluated by the Association for Dementia Studies (ADS) in 2014 (see Lillyman et al., 2014). During the pilot, a unique mentoring model was employed wherein a poet with considerable experience working with people who are living with dementia delivered training to four poets over several days. Following this training, the mentees shadowed the mentor during sessions in care home settings and received ongoing support. The evaluation showed that this model positively impacted on the mentees, and was well received by the residential recipients.

The second phase of the project was funded by The Baring Foundation, and ADS was commissioned to provide an independent evaluation. During this second phase 'Making of Me' extended the mentoring model to include three creative art forms - poetry, dance, and drama. Previous studies have shown that it is essential that creative arts specialists be trained to develop interpersonal skills in order to gain the confidence of older care home residents, in particular, residents living with dementia. It is also important that arts specialists are aware of potential barriers and communication issues common to this population (Dobson, 2000; Mottram, 2003; Coaten et al., 2013). A primary aim of this study was to provide a legacy of trained staff members towards who would be able to continue similar arts-based sessions within the participating care homes. While the evaluation confirmed the benefits for all involved in this model of mentoring, successful sustainability through training of care staff remains a difficult prospect.

For more information about this project, please contact Dr Claire Garabedian.

My Musical Memories

The Alzheimer's Society's ‘My Musical Memories Reminiscence Programme’ (MMMRP) aims to use music to create the opportunity for people with dementia, through facilitation and support, to recall their past history.

The MMMRP consists of a series of small group sessions for people with dementia and is loosely based on the theme of the BBC radio show, ‘Desert Island Discs’. Each session has a separate theme such as ‘work’ or ‘weddings’ and the music used is tailored to the preferences of the participants.

The Association for Dementia Studies has evaluated the design and impact of the MMMRP, and a project summary is available.

For further information about this project please contact Dr Claire Garabedian at c.garabedian@worc.ac.uk.

Sound Healing 

"The therapeutic application of sound frequencies to the body/mind of a person with the intention of bringing them into a state of harmony and health" (The College of Sound Healing)

Although there have been previous studies on the use of music therapy and therapeutic music intervention for people with dementia in care homes, there is limited information on the impact of sound separate from interaction with a therapist/facilitator and peers. Anecdotal evidence suggests that playing therapeutic sounds in the environment may have a calming influence on both residents and staff, and reduce levels of agitation.

Devised by Lenni Sykes alongside the Association for Dementia Studies, the ‘Therapeutic sound for care home residents with dementia’ project will explore the potential effects of therapeutic sound and how to measure them.

The project was initiated by Lenni following her positive experience of using therapeutic sound with her mother in a nursing home setting. She observed beneficial effects when using an instrument called the Freenotes Wing, and this experience has informed the focus of the project. During the project, Lenni will be the sound practitioner and ADS will evaluate the impact of the project and explore the effects of therapeutic/healing sound. It is hoped that the project will lead to a larger evaluation adopting an experimental methodology. 

For further information, please contact Dr Claire Garabedian at c.garabedian@worc.ac.uk