Art as therapy in aged care: what you need to know

“Every child is an artist. The problem is how to remain an artist once we grow up.” - Pablo Picasso

Here we explore the role of artistic pursuits in residential aged care, particularly for those living with dementia, and look at some of the ways the aged care sector can embrace creativity to improve the lives of their residents.

Art as Therapy

Art and creativity can be therapeutic without needing to be formal arts therapy.

Residential aged care centres don’t provide arts therapy, which integrates art and clinical psychology. According to the Australian, New Zealand and Asian Creative Arts Therapies Association, arts therapists employ different creative methods to help clients explore their feelings, improve self-awareness and reduce anxiety. As such, an arts therapy session is very different from an art class or other creative activity.

However, that doesn’t mean artistic pursuits aren’t therapeutic in their own right. Creative and arts-based activities can have very positive impacts on physical and mental wellbeing.

Most residential aged care centres, including IRT’s, offer various activities for their residents, which can include arts and crafts, music, dance, writing, cooking and gardening.

Creative arts and dementia

According to the UK’s Mental Health Foundation, a review of 31 global studies found participatory art can help improve cognitive functioning, communication, self-esteem, musical skills, pleasure, enjoyment of life, memory and creative thinking in older people with dementia. Dr Louisa Smith, a research fellow at the University of Wollongong’s Australian Health Services Research Institute, has a particular interest in the value of creative pursuits for people living with dementia in residential aged care.

She leads the Care Connections stream of the Connections for Life with Dementia project, which is part of UOW’s Global Challenges Program.

Dr Smith urges the aged care sector to consider five things as they embrace artistic activities for their residents living with dementia:

1. Think about arts more broadly

Creativity can involve much more than painting and drawing and other conventional forms of art. Dr Smith views artistic activities as multi-modal forms of engagement that foster connection.

“The interim report of the current Royal Commission into Aged Care Quality and Safety is called Neglect – I think the opposite to neglecting is connecting, and creativity and arts give us a capacity to connect,” she says.

Across the globe there’s a growing creative ageing movement that embraces a whole range of artistic activities, including making something.

“It has involved reinvigorating men’s sheds, sewing circles, knitting circles – activities that people have done their whole lives and are still included in art-making,” Dr Smith explains.

She cites one example of a residential aged care centre that arranged for a tapestry to be created in a public space, over a long period of time.

“Family members, community members and people in the facility all contributed to the tapestry. They could do it whenever they wanted to, and engage with it whenever they chose.

“It became an incredible way of people relating and connecting to one another and that is one of the most powerful things about art and creativity – it is an avenue for connecting.”

That connection is often mediated by something familiar, something historic that people have done for a long time. Dr Smith says there are powerful examples of people with dementia being able to recall their historic creativity through engaging with an activity in the present. She tells the story of a woman living in a dementia unit who was disengaged with Dr Smith’s activity, which involved interacting with individualised sensory scarves.

 “Then one day my colleague was wearing a tweed scarf. The woman said ‘I made that’, so I asked her what she meant. She said ‘I wove that tweed fabric’,” Dr Smith recounts.

It turned out the woman had worked in woollen mills for 20 years so Dr Smith gave her a tweed scarf and that was how she made a connection with her.

“For an hour she told us the whole history of working in the woollen mills. She wasn’t interested in engaging in craft-based activities but she loved talking about her profession.

“We all histories of making something, particularly in the Illawarra region where men and women worked in the steelworks and mines and used industrial skills in their homes.

“So many people have a rich creative history. We really need to support older people to enliven that history in the present.”

2. Tailor programs to individuals

Dr Smith says arts activities in residential aged care are usually designed by the aged care centre and offered to the residents as group-based activities.

“It might be water colours, collage or scrapbooking. Some people in that centre might be interested in those activities, but they don’t suit everyone.

“The reality is these activities work best when they’re based on the interests and passions of residents themselves and when they have a say in how they evolve.”

This approach aligns with the new Australian Aged Care Quality Standards, which highlight the importance of residents being able to make their own choices and for them be engaged in meaningful activities that are satisfying to them.

However, it is a departure from the way things have traditionally been done, so Dr Smith says there has to be top-down support for the change in approach.She acknowledges it can be challenging to design appropriate activities for people with dementia.

“You need to think about the activities that make them feel really comfortable within themselves and connected, and work out what supports they need to do those things.

“For someone it might be mowing the lawn; for someone else it might be knitting. For someone with dementia, if it is not in front of them and placed in their hands they’re probably not going to do it, but it doesn’t mean they don’t want to.”

She recommends creating a whole range of offerings, which she calls provocations.

“In a Montessori-based approach, a lot of things are placed around the person’s space which allows them to interact when they think it is appropriate, rather than at a set time.”

In this way the environment itself becomes a creative space because it holds a series of options. This challenges existing thinking because the space around people living with dementia is often cleared to protect them.

“We need to have some reverence for the capacity of the people with dementia to engage with rich environments.

 “An environmentally impoverished space that doesn’t hold a lot of stimulus is more likely to lead to negative behaviours.”