Chapter 7  

The Role of Art--Some common themes and emphases

in ongoing, successful programs   

By Bruce Darling

 

Introduction

Arts programs associated with improving the quality of life of may be classified broadly as active or passive, programs where people actually make something – taking a water color painting course or compiling a memory book- or where they attend a live concert performance or visit an art exhibition. Generally speaking, in retirement communities and nursing homes the arts frequently fall under the purview of an “activities director,” who may or may not have knowledge or interest in the arts. For such administrators the arts are considered merely as one of a group of activities to fill time. In such cases, professional artists, with additional training in working with older people, may take the leading roles in conducting the classes or projects.  Many fewer are the situations where the art programs are run by art therapists, professionally trained in both art and therapy. In such cases, it is often the arts that take precedence. The majority of older people seem open to making art, but do not want to be considered in need therapy. Third are those programs established and/or run by artists themselves, programs that focus on art for the sake of art. Museum programs, art centers, life long learning programs all have profession artists involved.  Finally, many of these art programs would not survive without the good will of volunteers, often retirees but also young people, contributing in various aspects of the programs—planning, fund raising, teaching, driving.

           This age perhaps should be called the ”era of rising expectations” for older people. In other words, older people are not only expecting a better old age, they are demanding one.  A person ‘s Quality of life, referred above, essentially depends upon how one feels about one’s situation, how one perceives it. A person making art is constantly engaged in making one’s own choices—say about color, form, subject, medium—such control is a crucial aspect of life satisfaction; a person participating in theatre and dance is able to express emotions otherwise repressed. In both cases, such creativity at its best is associated with a state of total absorption and thorough enjoyment known as “flow,” as discussed by Csikzentmihalyi.[1] Another aspect of achieving life satisfaction involves leaving something significant of yourself for the next generation. Erickson states that the most import task of one’s middle years is to achieve generativity; Csikzentmihalyi terms this passing on genes and memes; that is first leaving children and second passing down one’s ideas and values.[2]  This remains important in one’s later years as well. Older people often express a desire to leave such a legacy for the next generation. Making art is one way for them to do so.

Perhaps the majority of art programs introduced for older people, then, are to provide them with the opportunity to make art for the sake of making art, or to bring them into contact with authentic art experiences. Artistic experiences go to the core of our being—whether we are expressing deeply felt emotions or being touched to the core by the work of art we are seeing or hearing.  Getting in touch with our inner selves brings a balance to our lives that contributes to our being satisfied with our current state.

 

Art and Life-Long Education

Art history, studio art, music, drama and literature courses are regular components of adult education and life-long education programs. Often these are affiliated with colleges and universities. Museum education programs and local art leagues also offer opportunities to participate fully in the arts. Universities of the Third Age(U3A) (http://www.u3a.org.uk/ &http://www.u3aonline.org.au/), Institute for Learning in Retirement (ILR) (http://www.allshouse-associates.com/ilr_usa.htm), Elder Hostel (https://www.elderhostel.org/welcome/home.asp) web sites suggest the tremendous scope of such programs. Participants in courses keep their curiosity alive by continuing to learn. (In Japan, for example, adults flock to the various culture centers for courses covering a broad range of subjects from science to the arts.)  In the United States, noteworthy university-based programs include The Harvard Institute for Learning in Retirement, established in 1977 in the Division of Continuing Education, Harvard University, and the North Carolina Center for Creative Retirement (NCCCR), established in 1988 at the University of North Carolina at Asheville. These are both listed with their URLs in Chapter 5.  There is no question about the popularity of such programs. Testimonials to, or anecdotal evidence of, the benefits of art and cultural programs for the elderly is legion. Moreover, both quantitative and qualitative evidence is rapidly accumulating. This evidence is elaborated upon in chapter 8 and elsewhere in this report.

 

The Three Losses

Next, I would like to discuss the role the arts are playing as an intermediary for ameliorating several specific issues that strongly relate to the quality of life for older people. These may be termed the “three losses”: isolation from the community (including a lack of opportunities to contribute); reduction in personal contacts with others, especially with the younger generation; thinning of memory and, hence, of sense of self.

          Elderly when placed in nursing homes are often removed from the neighborhoods where they grew up; they are literally torn from their roots.  Even when older people are able to age in place, i.e. grow old at home, their mobility is reduced and as it is harder for them to get out, neighborhood contacts are reduced.  Moreover, many nursing homes do not open their doors to the immediate community, thus reinforcing the sense of distance from the surrounding neighborhood and its myriad activities. Outlets for older people’s contributions are hence further reduced. On the other hand, the extent of volunteer participation is a good measure of a facility’s openness.

As one grows older, one’s close friends begin to die off and one feels more and more alone. Furthermore, residents of nursing homes and in the U. S. of retirement communities often find restrictions placed on the presence of children, further limiting energizing intergenerational contact. Opportunities to take the role of the wise elder thereby are curtailed.

The thinning of memory among the elderly means a gradual loss of who one is. Sterile environments, lack of companions, reduced stimuli from the world at large tend to reinforce loss of memory and sense of self. Depression certainly is one outcome of this.  Removal from one’s intimate surroundings/neighborhood, reduction in personal contact with others, especially with the younger generation, reduction of intellectual stimulation—these all contribute to this. Clearly, these three losses are not isolated phenomena. Art programs provide a good way to counter such potential looses. Next I would like to discuss the intermediary role the arts are playing to ameliorate these three losses that so strongly impact the quality of life older people:

Art and Community          

Art and Intergenerational contacts 

Art and Reminiscence/Memory   

 

Art and Community    

Living History Theatre Festivals

Elders Share the Arts (ESTA), the New York-based NPO introduced in Chapter 5, has been working hard to generate community through its intergenerational art programs since being founded in 1979. The Living History Theatre Festivals, one of which was introduced in Chapter 5, represent one of ESTA’s successful programs that help to build community spirit by getting students and seniors together to work out differences in race, social status, age. 

(ESTA Programs URL: http://www.halsell.net/projects/ESTA/main.html)

For a discussion of a history of the Hodson Drama Group, see “A Stage for Memory: Living History Plays by Older Adults,” by Susan Perlstein.[3]

 

The Public Art Projects: Senator John Heinz Regional History Center Mural

Douglas Cooper, an artist at the School of Architecture, Carnegie Mellon University, has been working with seniors and others on large mural projects for community walls for the last several years.  Seniors are able to relive a sense of history through their vivid memories. The Heinz History Center Mural, created with seniors from a seniors activities center in the East Liberty district of Pittsburgh beginning in 1992-93, was his first such mural project.  Other such mural projects followed: the Philadelphia Courthouse Mural (1995); Kleinmarkthalle Mural Frankfurt am Main (die Kleinmarkthalle is Frankfurt's central food market )(1996). For more information, see Douglas Cooper: Civic Murals.  (url: http://www.andrew.cmu.edu/~dcooper/)

 

Story telling

           An innovative example of story telling is the “All My Somedays” project that brought together seniors at the Pierce County Library in Tacoma, Washington, to share stories and to write about their lives. Participants apparently gained in life satisfaction from this project.  Their individual stories could include photographs, pictures of various sorts, poetry, anything the individual wanted to include. Often these individual biographies would be related to the history of the surrounding community. Such “living histories” not only enabled participating individuals to relive their earlier lives, but also brought back to life stories about the community as it used to be.

           Ronald J. Manheimer, director of this project, made the following comments

to the Tacoma New Tribune (Sunday, February, 15, 1981):

People undervalue their own knowledge, oftentimes because they don’t have a frame for it. They can’t connect it to other experiences or larger meanings. But ordinary people are the characters of American history, not the famous. These are people that others can relate to.

I’m hoping that when people begin to reflect on their histories, they will find their place in public history and a sense of continuity in a meaningful way. My first interest is in sharing life stories and propagating the feeling that life has

meaning.[4]

 

Of course, telling stories also is an excellent way to bridge the gap between the younger and older generations and a means to review one’s life, to refresh one’s memory.  

The stories of two old residents of a nursing home in the northeast United States is told in Tracy Kidder’s book entitled Old Friends  (Boston & New York: Houghton Mifflin Company, 1993).

 

Art and Intergenerational Contacts

 The Center for Intergenerational Learning, Temple University

Temple University

Center for Intergenerational Learning

1601 North Broad Street, Room 206

Philadelphia, PA 19122

(215) 204-6970 phone

(215) 204-3195 fax

 url:  http://www.temple.edu/cil/ (accessed 2 July 2003)

          

The Center for Intergenerational Learning, Temple University, was established in 1979 to bring older adults and children of various ages together for the mutual benefit of both old and young and of their communities. Creating opportunities for participation, encouraging partnerships among groups and organizations, serving as an information center—these are some of the functions of the Center.  The Center provides free training and ongoing support for all programs. Publications and videos are also available to support the introduction of intergenerational programs in other communities.  Volunteers play a crucial role in the various programs; young people and seniors alike receive small stipends from some of the programs, thus acknowledging their importance to the success of those program. Notice the emphasis on life-long education, health concerns, and personal and social problem intervention.

                     

Program Descriptions (quoted from the CIL Program Descriptions Web page)

Across Ages

A national drug prevention program in which older adults mentor high-risk

middle school students.

 

Experience Corps

A national literacy program in which older adults tutor elementary school

students in reading and writing skills.

 

Family Friends

A national program in which older adults provide in home support to families

of children with special needs.

 

Full Circle Theater

An intergenerational ensemble of actors that uses improvisational theater to

address social issues at schools, senior centers, community groups, conferences

and corporations.

 

Grandma's Kids

An after-school program for children being raised by grandparents or other

alternative caregivers aimed at preventing violence and substance abuse.

 

Homefriends

A child-neglect prevention program in which older adults mentor families who

are at risk or have been reported for child abuse and neglect.

 

Project SHINE

A national program in which college students provide language, literacy, and

citizenship tutoring for elderly immigrants and refugees.

 

Time Out

A program in which college students provide in-home respite to families caring

for frail elders.

CIL also provides information on intergenerational programs outside of the United States For examples from the UK, France, Singapore, The Bahamas, Tanzania, Japan, see the Spring 1999 issue of Interchange, published by CIL.

Art and Memory   

      Memory is used in its general sense of remembering, retaining and recalling

past experience.[5] Older people suffer various problems with memory difficulties. Loss of memory means loss of one’s self. This is one of the greatest fears of growing old.  Reminiscence therapy and Life Review are two approaches to help old people retain their memory. Certainly the arts have a most important role to play in such cases.

      Memory plays such a crucial role in all aspects of our lives that it is no wonder that the theme runs throughout the Community and Intergenerational projects outlined above:  the Public Art Projects of Douglas Cooper (for example the Kleinmarkthalle Mural in Frankfurt's central food market); the Story telling project “All My Somedays” at the Pierce County Library in Tacoma, Washington; the Full Circle Theater projects of the Temple University Center for Intergenerational Learning. Below are several of the many additional noteworthy programs concerned with memory and art.

ESTA’s Legacy Works Program

ESTA’s Legacy Works is a visual arts program in which teenagers

work with older people to create art works. ESTA artists first train the teens to interview the older people about their lives and then instruct them in the art of collage. Then the teens go in pairs to visit individual elders once a week for 30 weeks.  The teens may visit as many as four individual elders each week. Many frail elders are housebound and so the weekly visits of the teens brought them new support with their community.  The teens learned about the history of their community and about respect for older people; the elders also discovered they could still be useful to their community. After the interviews the teens begin collecting memory-filled materials from the elders; the elder and the teens together create either a Life Book or collage. More than just an activity to keep older people busy, each elder and teen team created a significant work of art that could be passed on to the family members and friends, a legacy.

          A final exhibition brought the creations of all the participants together for a gala show.  The program introduced above took place in 1996 at the Union Settlement House, located in East Harlem, that provides services for Latino and African –Americans.[6] 

The TR-Bio (Therapeutic/Restorative Biography)

      The TR-Bio (Therapeutic/Restorative Biography) is a A Creativity Discovery Corps project developed by Gene Cohen.  According to Cohen, “…the TR-Bio project is aimed at preserving, restoring, and celebrating memories of the patient, and the family for the benefit of the patient, family, staff, volunteers, and significant others…” (Cohen, p. 195).  Cohen developed this project in response to fathers’ Alzheimer’s disease. Patient, family and friends join together to create biographical stories about the patient and his or her family in either a yearbook or video format. The stories and memorabilia serve as a substitute for the increasing lack of memory recall of the patient by having immediate family and friends help the patient to tell is own story. The patient, too, can appreciate the small windows that open on his past and respond, perhaps with a smile. Everyone can join in and bring along their special skills, drawing or paintings, photography, music, computer graphics, writing.  The arts can bring color and immediacy to the project. The result will be a high quality biography that all will be proud of.

           Cohen also suggests how the TR-Bios programs can be established. As a community and intergeneration project, for example, high school students could be trained and supervised to conduct such programs. In nursing homes for Alzheimer’s and other patients activities directors could be trained to supervise the inclusion of TR-Bios along with other activities.  TR-Bios do not require large start up budgets.  Here we also see the role of narrative that is therapeutic, that enhances the patient’s quality of life.[7]

 

Memory enhancing environments

           How we think about memory reflects on our approach to dealing with the problem of memory loss. A person’s memory should not be considered to be located only in his brain or mind or physical being. A person’s memory is also to be located, in part, in his or her immediate environment, in his treasured possessions.  A person invests him or herself in his intimate surroundings. Taking these away means discarding part of one’s self, one’s memory.  All over the world today architects and interior designers are striving to create healthcare facilities, residences for older people, and even communities that contribute positively to people’s health and well being. For older people who can no longer live independently at home, this means moving into some of kind of elderly facility where the necessary amount of care is provided.  More and more such facilities are being designed to give residents a home-like environment. An important issue in our rapidly aging societies is how to help older people maintain their sense of well being and self through the structure and design of buildings and their interiors. And in specific reference to this discussion, what creative approaches can we find to reinforce memories that appear to dim with aging?  The following is a selection of several approaches to this problem.

 

Memory rooms

           One family requested a Seattle-based architectural firm to design a breakfast room addition that was inspired by the client’s childhood home. The room was intended to assist an older woman (whom I presume was a mother of one of the home’s owners) suffering from Alzheimer’ disease to recall her life. The window walls provided an abundance of light, while the small panes of which it was composed recalled the client’s childhood home. The room itself was filled objects and treasured items to provoke recollection. Favorite paintings adorned the walls; the wall behind the couch had a built-in set of shelves for displaying some favorite small sculptures, ceramic dishes, photographs.,  including one of the client’s childhood home. An elegant and thoughful approach to helping to maintain an older person’s memory.[8] 

           While the above example is literally called a memory room, another example of this kind of setting would be a space given a retro design such the art deco style ice cream parlor at the Miami Jewish Home and Hospital for the Aged.

 

Memory walls

           Residences for Elderly people often have at least one wall where they display photographs, paintings and other memorabilia about the history of the facility, the neighbor, and the residents. Sometimes, niches or even small rooms are filled with displays recalling the history that the current residents lived through. The Sweat Shop

recreated at the Riverdale Jewish Home for the Aged is an example of this.  A resident may also create his or her own memory wall by hanging a selection of old photographs and paintings in his own room. This is by no means an unusual. [9]

 

 

Memory interiors/furnishings

           When old people have to move into an elderly facility they want to bring with them some of their own furniture to help decorate their new living quarters to remind them of home and of themselves. For public areas in such facilities we also find older furnishing that the staff has found to help make the environment more familiar and homey for residents. Sometimes elderly facilities might cooperate with a local museum to borrow authentic items from the museum’s collection for use and display in the elderly facility.  This is happening in Japan as well as overseas.[10]

 

Memory Buildings/Memory neighborhoods

           I associate the recent increased interest here in Japan with historical preservation with the rapidly aging society. Hence we find old finely constructed buildings that would have been quickly destroyed and replaced by some boring modern structures a few years ago now being the objects of intense movements by citizens (often living near by) to prevent the destruction and to restore and make use of the buildings as, for example, a kind of community center.  Creating familiar surroundings also helps with Alzheimer’s patients. Such treatment is referred to as “environmental therapy.” If patients are placed in familiar settings they will be more readily able to orient themselves to carry on their daily activities. The Village-Waveny Care Center is an environmental therapy assisted living facility located in New Canaan, Connecticut. The main living areas of the Village are designed to look like a Main Street in a small town dating to the 1950s, a time when residents would have been in their prime. Memory enhancers include such buildings as the general store or barber shop with its striped barber pole. [11]

 

Loss of memory that so often accompanies aging is of great concern to all of us searching for ways to improve the quality of life of the elderly. Memory support programs are being implemented in more and more retirement communities and nursing homes.  Such programs call for the introduction of the arts into the architectural and interior design of the residences as well into various creative activities for the residents.

The above is but the briefest introduction.  The Center for Health Design web site includes useful information on the relationship between health and design in general (URL: http://www.healthdesign.org/index.html ) and Alzheimer’s and design in particular. (URL: http://www.healthdesign.org/brawley.html)

 



[1] See Mihaly Csikzentmihalyi, Creativity : Flow and the Psychology of Discovery and Invention  (New Y ork: HarperCollins (paper), 1991),  pp. 110-113 for defintion.  Also check Mihaly Csikzentmihalyi, Flow : The Psychology of Optimal Experience (New York: Harperperennial (paper), 1996), p. 243-notes, p. 10ff.

[2] Csikzentmihalyi, Creativity : Flow and the Psychology of Discovery and Invention,

p. 199-201.

[3] Susan Perlstein, “A Stage for Memory: Living History Plays by Older Adults.” In  Marc Kaminsky, editor, The Uses of Reminiscence: New Ways of Working with Older Adults. New York: The Haworth Press, 1984. (Originally published in Journal of Gerontological Social Work, Volume 7, Numbers 1/2,  March 1984) pp. 37-51.

[4] This is quoted from Mary Baird Carlsen, Creative Aging: A Meaning-Making Perspective (New York: W W Norton & Company; 1991), p.165; see also p. 159.

Carlsen includes this discussion in her Chapter 9, “Narrative and Meaning-Making”

where she discusses “Narrative and the Therapeutic Process” and “Life Review.”

[5] An interesting source for the relationship between memory and the arts is

Daniel L. Schacter,  Searching for Memory: the brain, the mind, and the past,

New York: Basic Books, 1996

[6] See Susan Perstein,  “Really Caring: Why a Comprehensive Healthcare System Includes the Arts,” (originally appeared in High Performance #74, Winter 1996; online at http://www.communityarts.net/readingroom/archive/perlstein74.php.

[7] See Gene Cohen, The Creative Age,  New York: Avon Books, 2000.

Part II: Special Projects The TR-Bio (Therapeutic/Restorative Biography)

pp. 283-290.

[8] See Ojeda, Oscar Riera, ed. “Cuarto del recuerdo/ Memory Room , by Olsen Sundberg,” Casas Internacional, v. 59, Dec. 1998, pp. 48-51.

[9] Elizabeth C. Brawley,  Designing for Alzhemer’s Disease.  New York: John Wiley & Sons, 1997. See Figures 12-5 and 12-6.

[10]See Yomiuri Shimbun  2002 June 29, p. 25, article on recreating living places from the old days in conjunction with care for elders suffering from dementia.

[11] See CNN .com article “Familiar surroundings help Alzheiner’s patients” url: www.cnn.com/2002/HEALTH/conditions/02/07/alzheimers.facility/index.html.