The arts in dementia care - A Critical Review of cultural and arts practices in dementia care in the UK

It is generally accepted that the 'arts' improve the lives of those who live with a dementia. Consequently there has been a proliferation of arts based activities for people with dementia. However, there has been little or no critical evaluation of these initiatives. Similarly there has been little work exploring the views of people with a dementia who participate in arts activities. This lack of research has resulted in an uncertainty regarding the approaches that may be most effective. The proposed review will provide a corrective to this lack of clarity. The work will supply an analytical overview of the existing arts and cultural interventions that are used in dementia care. It will map some of the approaches being used and the gaps in research and knowledge concerning the use of the arts for dementia care. Above all, it will seek the views of people living with a dementia and integrate these in the final report.

The major outputs arising from the review will include a critical report on current arts based approaches to dementia care that will contribute towards a new critical paradigm for the assessment of arts and culture based approaches to dementia care. In addition, the review will articulate the perceptions of people living with a dementia concerning the value of arts and cultural interventions to their well-being and health and these views will be central to the re-appraisal of prevalent assumptions about the benefits of arts and culture in the lives of those living with a dementia. An additional major output from the 6 month project will be the development of a dedicated website that disseminates findings in accessible language and therefore reaches beyond academic boundaries to people living with a dementia, their carers and the dementia care workforce.

The project will benefit from a uniquely qualified inter-disciplinary team comprising: the PI - Dr. Hannah Zeilig (a research fellow at both the University of the Arts, London and the University of East Anglia) who has over two decades of experience as a gerontologist and has used numerous arts based approaches with people living with a dementia; Chris Fox who will provide clinical/research guidance and is a leading international dementia researcher and consultant old age psychiatrist and the input of the innovator and pioneer of arts based approaches to dementia care: John Killick.

Impact Objectives:
The long-term aim of this initially small-scale critical review is to fill a significant gap in the current knowledge base concerning the role of arts and culture in the lives of people living with a dementia. The critical review will therefore have a significant and far reaching potential impact because it will draw together existing knowledge on the role of the arts and culture in dementia care and also investigate the views of some of those participants living with a dementia who take part in arts and cultural activities.

Who will benefit from this research?
It is unlikely that the critical review will immediately lead to the establishment of a fully-formed critical paradigm. However, by addressing a range of key questions concerning the role that arts and culture play in the lives of people living with a dementia and through involving interdisciplinary and cross-sectoral discussants and those who live with dementia; it is expected that critical dialogue will be stimulated between lay, provider and specialist participants. In particular:
i) Diverse UK charities would benefit directly from this review (including: Ladder to the Moon, Arts 4 Dementia, Dementia Care Matters, Arts & Dementia network).
ii) Those engaged in creating 'dementia friendly communities' would learn from this work as would those who are developing 'dementia friends and champions' (including the Alzheimer's Society).
iii) People living with a dementia and their carers would benefit.
iv) Museums, art galleries and theatres that promote arts and culture for those with a dementia would gain from a critical understanding concerning the impact of the arts on people living with a dementia,
v) Professional artists and performers who have been working with people living with a dementia would gain from an enhanced consciousness of the views of people living with a dementia about arts based interventions.
vi) Medical and health professionals will benefit from an enhanced reflexivity and critical awareness of the role of arts and culture in dementia care.
vii) Policy makers who are planning the development of services for and communities amenable to people with a dementia will be able to take the fruits of this research into account.

There will be further specific benefits to this research. One objective of the critical review is to contribute to a framework for identifying, defining and evaluating some of the components of cultural value. This 6 month project will pinpoint some of the central advantages and disadvantages of arts and culture based approaches to dementia care. The development of a website for the project will ensure a source of open-access information and a forum for dialogue that is directly available to policy-makers within international, national, local government and voluntary sector bodies. The dedicated website will draw together and place in dialogue a broad range of people who are involved in various ways with arts and culture in dementia care and will be designed to reach beyond academic boundaries. It is expected that the critical review will contribute to improving social welfare and public services by enhancing knowledge and improving understanding about the arts based approaches that are most effective for people living with a dementia. The benefits of arts and cultural activities for mental health, including conditions like dementia, are not as well understood as in other areas (such as in secondary health care). The critical review would therefore address this lacuna in knowledge by adding to the evidence base in this area.

It is expected that the impact of the review would be long-term and disseminated by the publication of peer-reviewed articles (in Dementia, Ageing and Society, International Journal of Ageing and Later Life, The Medical Humanities) and conference papers (including at British Society of Gerontology annual conference and Royal College of Psychiatry).