How cultural experiences can improve health and wellbeing

Coffee Cake & Culture: An Arts for Health programme for older adults living with dementia

Wendy Gallagher, Whitworth Art Gallery & Manchester Museum, The University of Manchester wendy.gallagher@manchester.ac.uk

Andrea Winn, Manchester Museum, The University of Manchester andrea.winn@manchester.ac.uk

Coffee, Cake and Culture Event

Abstract

Arts for health programmes and initiatives are being rolled out in museums and galleries in a number of countries, with networks and partnerships developing between museums and galleries and the health care sector. As Museums and galleries continue to strive to improve access to their collections and provide programmes that promote wellbeing through engagement, evidence is beginning to emerge of the benefits to people’s health, wellbeing and quality of life with participation in cultural activities.

Coffee, Cake & Culture is devised and delivered by the Manchester Museum and Whitworth Art Gallery for people living with dementia and their carers.  It is a monthly programme of activities for older adults living in care homes, supported housing communities and participants in community support groups.  The programme provides a forum dialogue through museum’s exhibitions and collections and gallery artworks.

People with dementia need cognitive stimulation, along with opportunities to interact meaningfully with their physical and social environments on a regular basis.  Museum and gallery staff and artists, through a partnership with the Central Manchester University Hospitals NHS Foundation trust and the dementia and ageing research team at the University of Manchester, are working in collaboration with advanced nursing practitioner’s to pilot activities in the Museum and Gallery and in acute hospital settings as well as in community venues.


Keywords: Dementia, arts, health, museums, galleries

Introduction

Manchester Museum and the Whitworth Art Gallery Cultural Assets of the University of Manchester, offer programmes for people with dementia in clinical, community and museum settings.  Activities in all of these setting have shown to have positively influenced the wellbeing of patients and their social inclusion into society, but do so to a different degree.  The Museum and Gallery are working closely with our colleagues in the Dementia Ageing Research and Training Centre at the University of Manchester to look at the impact such programmes have on the quality of life and care for people with dementia.

With steadily rising life expectancy in developed countries such as the UK, prevalence of dementia increases and the illness becomes more relevant every year.  Not only medical research addressing early diagnosis and treatment but also research into the social aspects of the disease is moving into most governments focus.

Various museums and art galleries introduced programmes directed at older people in general or at dementia patients throughout the last decade (Robers, Camic, & Springham, 2011).  However, the focus of each programme is different and can range from singing projects to art based activities (e.g. Chatterjee, 2008).  The scientific evaluation of such programmes is still in its infancy, but a growing number of museums include different types of evaluation approaches in their programmes.

Dementia – an overview

Dementia, as an umbrella term, is used to describe the condition of a person suffering from severe progressive cognitive impairment.  There are multiple forms of dementia, the largest proportion and therefore the best-know being Alzheimers’s disease (society, A n.d).  Alzheimers is estimated to account for up to 70 percent of all dementia cases and is for this often falsely used interchangeably with dementia in general (Rosenberg, Parsa, Humble and McGee, 2009). The second most common type is vascular dementia followed by dementia with Lewy Bodies and Fronto-temporal dementia.  There are more forms of dementia and it also has to be emphasized that each individual disease can either entail a rather unique set of symptoms.  However, there is a range of symptoms that characterize all types but are facultative in the sense that a diagnosis can be made without each of them.  Memory loss as the best know hallmark of the disease shows most often in deficient retrieval of recently learned information.  Moreover, everyday life tasks and routines cannot be performed anymore, such as cooking or brushing the teeth.  A disturbance of language often manifests itself in uncommon descriptions for objects as substitutes for their actual name (e.g. ‘that thing for cutting’ for a knife). Reduced spatial orientation ability can show through disorientation and getting lost in familiar surroundings or through misplaced possessions.  Poor judgment not only makes patients more likely to be victims of deception but also often shows in inadequate everyday decisions, such as the choice of appropriate clothes for the current weather conditions, (Wallesch & FÖrst, 2005).  More hallmarks of the disease, which are often reported to be amongst the most disturbing ones by relatives, are sudden changes in mood and alternation of personality.  A general loss of initiative can be explained through reduced physical mobility and loss in cognitive abilities on the one hand.  On the other hand it is agreed that social factors and the stigmatization of patients suffering from the disease play an important role in the patient’s passivity.

Alzheimer’s disease causes loss of memory of recent experiences because the hypothalamus has been damaged and can no longer retain these experiences.  Older memories are retained in the brain until much later in the disease’s progression and so memories are available even in the later stages of the disease.  Because the area of the brain that stores memories long term is affected later in the disease, the affected person will know more about life when they were young than they know about what has happened this week.

Reminiscing activities involve reaching memories that are still residing in these viable parts of the brain.  There are many ways to encourage these memories through specifically focusing on provoking past memories of life experiences around touch, smell also provokes very powerful memories.  According to the Alzheimer’s Society, there are 80,000 people with dementia in the UK, and with an aging population these figures will double in the next 40 years.  There are 850,000 carers involved in caring for those with this illness (A prospectus for arts and health, 2007).

Coffee, Cake and Culture

Museums and art galleries are full of objects and artworks of historical, social and personal significance.  Coffee, Cake and Culture has been devised by the Manchester Museum and Whitworth Art Gallery to use the Museum and Gallery spaces and their collections to focus upon imagination, creativity and learning.  The programme of supported visits to the Museum and Gallery is aimed at groups with dementia, be they from a care home, hospital setting or supported housing community.  The aim is for the resident and carer to visit the museum and gallery and enjoy a social experience within the gallery spaces, with sensory based activities, fully supported and facilitated by Gallery and Museum Staff.

The programme developed from a pilot and feasibility study carried out over a six month period in 2012.  This in turn followed a programme of outreach and in-reach activities, to promote access to the collections and participation in cultural activities in a socially engaging way.  During the pilot study the Museum and Gallery worked with residents, with early on-set dementia, from a residential care setting and a supported housing venue.  The programme comprised of fully supported and facilitated monthly visits for the residents and their carers or family members.  The programme focused on creativity rather than reminiscence, memory or recall. The aim of the pilot study was to identify the potential impact of participation in cultural activities on the health and wellbeing of the residents.  The study also aimed to assess if there were benefits for the carers when engaging with the residents.  At total of 17 residents, 10 care staff and one family member attended the sessions.

The visits consist of several stages.  Visitors and carers were met on arrival at the door and welcomed to the Museum.  This was followed by a guided tour of an exhibition or gallery.  The third stage was a creative activity followed by refreshments and discussion.  Final stage was departure and farewell.  Each stage of the visit was considered important to support care staff and make all visitors feel welcomed and relaxed.  The needs of the visitors were accommodated, extra staff were available to support the groups movement around the building and additional seating was made available where required.

Benefits of participation

Professor Brenda Roe of The University of Manchester carried out a feasibility study of the Coffee, Cake and Culture pilot programme.  Prof. Roe concluded that the study demonstrated that the Coffee, Cake and Culture programme is feasible and facilitates older people from care homes and supported living communities to access public museums and galleries. The programme encouraged creative arts, cultural appreciation and social engagement which promote wellbeing, quality of life and social inclusion.  (Roe, McCormick, Lucas, Gallagher, Winn, Elkin 2014)

It was noted that the exhibits and activities did encourage visitors’ engagement with their personal and shared history.  The programmed prompted them to discuss their history and shared experiences as well as learning new information and participating in creative activities, making art works they could take home with them.  ‘They love it, getting out and being in normal society, being in hustle and bustle, seeing other people was good…The enjoyed the learning, all really listened and their attention increased over the weeks, as they knew what to expect.’ (Supported Housing Manger).  ‘I speak for all at the home…this has been the highlight of the last few months.’ (Residential Home Activity Coordinator).

Prof. Roe noted further research is warranted to establish the ongoing benefits of such programmes, involving project teams comprised of researchers, arts for health managers and curators, artists, care staff and older people as partners and participants. Such research could identify the benefits for older people not only during the visits but also between sessions in terms of their behaviour, mood, communication and social interaction when they return to the care home. (Roe, McCormick, Lucas, Gallagher, Winn, Elkin 2014)

Health and Culture Programme

Coffee, Cake and Culture is now part of the wider Health and Culture progamme at the Manchester Museum and Whitworth Art Gallery. It was originally designed to target older adults with dementia in care settings, but has now extended to include any group that require additional support to visit the museum and gallery.

The Museum and Gallery have been working in close partnership with Manchester hospitals and health professionals since 2008 often with impressive results, whether for patients or healthcare professionals themselves. The Museum and Whitworth won two awards from The Royal Society of Public Health for innovative and outstanding contributions to arts and health research and practice.

Engaging patients with dementia is an important strand of our hospital partnership work. Artists visit hospital wards on weekly basis, taking with them a box full of cultural goodies, inviting patients with dementia to participate in montessori based activities. With these resources we hope to reduce the number of Deprivation of Liberty Safeguards issued to patients with challenging behavior.

We share our arts and health work with the wider hospital community through an annual week long Culture Shots advocacy event at Central Manchester University Hospitals NHS Foundation Trust.   Culture Shots events offer health professionals a chance to find out why culture works and how they can use the expertise within Manchester’s museums and galleries to improve their professional practice as well as their patient’s health and wellbeing   Museums and galleries from across Manchester, led by the Whitworth Art Gallery and Manchester Museum, take over Central Manchester, Trafford, Altrincham and Stretford Hospitals.   We target staff and offer a taste of what we do from object handling to performances. The aims of Culture Shots are (i) to promote the proven contribution to health and wellbeing that engagement with museums can bring about.  (ii) To enhance the wellbeing and satisfaction of hospital staff through informative and enjoyable activities. (iii) To promote the work of museums and galleries in Greater Manchester to staff, patients and visitors. (iv) to identify further opportunities for collaborative work between the hospital and museums and galleries throughout Greater Manchester’.

Conclusion

Both the Manchester Museum and Whitworth Art Gallery has a long and successful history of working with hospitals, local communities, such as community centres in surrounding wards, older people in residential and care homes, and adults with mental health problems. We believe we have an important role to play in establishing the conditions that support people’s general wellbeing, especially mental health. Much of this work has arisen out of a better understanding of our context, including aligning ourselves with Greater Manchester’s JSNA (Joint Strategic Needs Assessments) and conversations with local community leaders, charities, council and NHS staff.

Making partnerships work effectively is one of the toughest challenges facing public sector managers. Partnership working can also be costly, and partnerships can be justified only when their achievements outweigh the resources that they consume. Many fail to achieve their full objectives, or are partnerships in name only.

Strong partnerships are at the heart of our learning and engagement work. They take time and effort, however, there is a huge collaborative advantage in joining together. Our top three tips for successful partnership working would be to ensure all partners are actively involved, to agree on priorities for action and to respect each others area of expertise.

Bibliography

Arts Council England. (2007a). The Arts, Health and Wellbeing. London: Arts Council England

Chatterjee, H. J. (2008).  Touch in Museums: Policy and Practice in Object Handling (English Ed.). BERG.

Roberts, S., Camic, P.M., & Springham, N. (2011).  New roles for art galleries: Art-viewing as community intervention for family carers of people with mental health problems.  Arts & Health, 3(2), 146-159.

Roe B, McCormick S, Lucas T, Gallagher W, Winn A, Elkin S, (2014)

Wallesch, C.-W., & FÖrstl, H. (2005). Demenzen (1.,. 85 Abbildungen, 108 Tabellen.). Thieme Georg Verlag.