On 10th December a group of interested parties gathered at The Hive in Worcester for an event hosted by the TAnDem (The Arts and Dementia) PhD students to share their research from the TAnDem Doctoral Training Centre. Following a welcome by Professor Dawn Brooker and PhD student Karen Gray, we had an elephant-based ice-breaking exercise with the premise being to consider how difficult it is to eat an elephant. By dividing an elephant into a few key areas – health, care, arts, education, research and advocacy – and getting us all to consider where our individual skills fit, we quickly discovered that we were a very diverse group covering all areas. Hopefully this indicated that if we all work together eating an elephant isn’t quite as daunting a task as it would initially seem.
We then heard how the University of Worcester offers several dementia and/or arts-related courses which could be applicable to the wider group. A quick overview was given about our new Postgraduate Certificate in Dementia Studies (by Chris Russell), the BSc Occupational Therapy (Dr Yvonne Thomas), the BA Fine Art with Psychology (Maureen Gamble), and the BA Drama with Psychology (Alison Reeves). There’s a lot of interesting education available, and great to see how the connections between art and dementia are already starting to be made.
The rest of the day was split into three themes, with a similar format being followed for each theme: short presentations by the TAnDem students about their PhDs relating to the theme followed by an open group discussion facilitated by Professor Tracey Williamson to consider how the findings could be put into practice and what needs to happen to enable this.
Theme 1 – Arts in dementia care settings
Dr Emma Broome’s PhD had considered the role of care staff in influencing access and experience of participating in creative activity in care homes. She found that care staff are well-positioned to contribute as they know their residents and care homes in terms of their skills, preferences, access needs, and space available, all of which are useful for arts practitioner to know in order to get most out of session for residents. She also found that the interaction between residents and staff during creativity sessions is beneficial as it goes beyond the ‘care’ relationship. Additionally, upskilling activity coordinators can help sustainability as activities are less likely to end once an artist is no longer coming to a care home to deliver sessions.
Professor Dawn Brooker shared emerging findings on behalf of Amy Veale whose PhD focuses on how arts practitioners engage people living with dementia in the care home setting. The findings covered how to create clear and compelling opportunities to encourage residents to engage in activities, which relates to how the idea of attending activities is presented to residents. Flexibility is also key, with practitioners having to think on their feet; practitioners may have aspirations for a session, but have to adapt to what actually happens at the time. An all-embracing approach is also important, with all forms of engagement being welcomed and valued equally. Amy also found that practitioners need to keep an open mind and not make assumptions about residents in terms of what they can do and their preferences.
Good discussion followed these two presentations, confirming that these findings resonated with everyone in the room. Some of the challenges faced when running activities in care homes were also raised and explored.
Theme 2 – Music in dementia contexts
Becky Dowson presented one strand of her PhD, considering skill-sharing in music therapy and dementia. She found that by therapists skilling-up carers, more people can be enabled to access music outside of dedicated sessions run by a therapist. It also empowers the carers and improves their confidence. However, it can potentially be an extra burden for therapists and carers, and some therapists may feel threatened as essentially giving someone else the skills to do their job. Becky also gave us an example of skill-sharing through the CHORD manual which was used by an inexperienced facilitator to set up and run singing sessions.
Ruby Swift’s PhD focuses on sharing music at home by exploring how music can be shared and supported within the caring relationships of people living with dementia at home. Using the experiences of three dyads, Ruby illustrated how sharing music can support engagement and interaction as part of a wider sensory activity. Music forms the foundation for activity, which is beneficial for both person with dementia and carer. It enables people to relate to each other in a new or different way and offers the opportunity for new shared experiences.
Subsequent discussion considered the need to share and be aware of what is available locally, not just so that the public knows about it but also so that other artists and practitioners are aware and can potentially collaborate with each other.
Theme 3 – The challenges of evaluation
In the final session, Karen Gray presented her initial findings on what is it about arts and dementia that makes it so hard to evaluate? She raised that one of the issues relates to outcomes being intangible, e.g. how the atmosphere in a room can change, which can be difficult to measure. Difficulties encountered when trying to evaluate arts activities and get evidence to show that they work include the funding of any evaluation, small group sizes, short-term activities, ensuring appropriate use of appropriate tools, involving people with dementia, and interpreting findings. Karen also talked about the skills needed by artists and evaluators, both in terms of how to do research, but also how to communicate the importance and the need for evaluation as well as the findings. She suggested that the focus should not just be on outcomes but also on the process and implementation, and collaboration across disciplines and sectors should be encouraged.
This led to interesting discussions about who is responsible for guiding what is evaluated and indeed whether the right things are actually being evaluated. Are we so focused on the impact of activities for people with dementia that we are ignoring the wider impact on carers?
Professor Tracey Williamson brought the event to a close, before everyone had the chance to network over lunch. Thanks to everyone involved in organising and attending the event, it’s generated plenty of ideas for the TAnDem students to take forward.