Mental Health-Dementia

January 11th, 2016

I was driving around today, wondering what to write about. An idea popped into my mind. My last field placement, as I completed the two-year graduate art therapy program, was on a locked dementia unit. I had worked with children, I enjoyed leading group sessions at Women's College Hospital with outpatients and I thought I would bring art therapy to older adults.

I spent time in two different long term care facilities. In one facility, I travelled with an art cart from the floor for active older adults, to the "low mobility" unit, doing art in their rooms. I also offered a few group sessions on the dementia unit's activity room. In the second facility, I mostly spent time going to resident's rooms on the dementia unit.

I wish someone had filmed my first month with patients diagnosed with dementia. I really wanted to connect with them, enrich their lives, bring some joy to the unit itself. However, I knew nothing about working with this population and they frightened me. I quickly learned never to lean over in front of a seemingly frail, confused man. Some instincts are alive and well and my back end was grabbed more times than I can count. Ditto for leaning forward while feeding a resident in a geriatric chair. The residents were all seated in a main area and some were non-verbal, others were too confused and couldn't tell me their name. I would introduce myself and ask their name. No response. I would look at the name on the door closest to where they were sitting. "Are you Mrs Boucher?" They would nod. The nurse who happened to walk by would inform me that Mrs Boucher was at bingo, this was Mrs Finnigan. The resident would respond with indifference, "What she said". I had to learn their names so I could document who I had visited. I made a note next to each name to recognize them next time as well as some warnings such as, bites, spits, yells, grabs etc. so I could keep myself safe.

I doubted my sanity for thinking I could do art therapy with this population. I am ashamed to admit that I pre-judged them. The first thing that caught my attention was the reaction of residents when I came to work. I had only been there a week or so when I walked onto the unit and headed for the nurse's station. I heard people getting up from the glider chairs and walkers being clinked together and wheels gliding on the carpet. The residents who normally sat in the main entrance, bored, an empty look in their eyes were walking over to me. They were asking me: "What are we doing today?" or "Were you looking for me?". Even the non-verbal lady came over, smiling and rubbed my back, waiting. I was moved by this response because it proved that they have an emotional memory. They may not remember my name, most of them called me "Hey, girl" but they recognized my face and remembered that they liked me, or at least, liked what they did with me. The residents have a very different response to staff who show up to bathe them. They hate baths.

I loved working with this population, once I learned how to communicate with them. They lose their inhibitions so you are less likely to hear them say: "Oh no, I'm not an artist". They have a great sense of humour and are very spontaneous. They love to be with other people and many of them crave colour. They love to party, to dance, sing and create. I took photos of them enjoying their life and posted them at the door to the dining room. That way, they had something to look at while they waited to get into the dining room and their loved ones could see these photos as well. They don't remember the fun they had but when they see themselves, they are excited, "Hey that's me" they'll say and laugh.

I engaged families to help us connect with their loved one. They shared loved stories about their parents for Valentine's Day. I posted each story next to the resident's door along with a photograph of them as a younger adult. This served as a reminder to anyone who entered the room that this person wasn't always this way. They were each individuals with a story, worthy of dignity. For non-verbal residents in geriatric chairs, creating placemats of photos with subtitles for their table-top provided a glimpse for staff into the resident's life, values, traditions. Instead of walking past them, they might stop and read the information and comment on what a lovely family they have. It also helped the residents feel less isolated because they could see photos of their loved ones.

I discovered a creative streak in one of the residents I visited weekly. She became non-verbal and I wondered if she was still interested in participating in our sessions. I used collage with her. She had been telling me about her life, she had suffered a great deal. As her language skills diminished, I brought magazines and clipped out images she could choose. I would then place them on piece of paper and ask her to move them to where she wanted them. Once they were all organized, I would glue them and she would paint colours around them, giving them a background. One day, she picked out a deer. She wrote: "Poor Dear" and filled the background with blue. The paint was dripping, it looked like tears. It was absolutely appropriate considering all she had been through. I know there was meaning to her art, it wasn't just a coincidence.

When I was hired to continue my work on this unit, I quickly became an advocate for my 40 residents. I was determined to take them to the art gallery for art workshops. I had volunteers and the art gallery was willing to work with my group but the facility would not let us use the bus. They feared that someone would get lost, residents might fall and injure themselves and they wouldn't remember it anyways. I was so angry. I contacted a local funeral parlour and they agreed to take 8 residents in their limousine. We signed a contract and the residents were able to take a sculpting class, a painting class, a drawing class and a photography class. Once we had attended these workshops, my contract with that company ended. I had made my point, they deserved to get out and enjoy life too.

If your loved one has been diagnosed with dementia, the best thing you can do is spend time with them, talk to them even if they don't respond, list all the things they once loved and plan something fun each time you see them: watch an old movie, listen to music, go for a walk, plant some herbs, eat a yummy treat, hold hands, share photographs, read poetry or a book they might like to your loved one, bring grandchildren and pets, carry on traditions, don't exclude them. What they taught me is no matter what they are saying or doing, they see you, they hear you and all they want is for you to hear and see them and, of course, love them.

Anne Walsh
www.artnsoul.org