The arts and dementia: Emerging directions for theory,research and practice

The beneficial role of the arts for older people in general is increasingly accepted. Some notable examples include the Finnish Ministry of Education and Culture’s programme to better understand the role of culture and the arts in well-being (Finnish Government, 2014), which has resulted in national recommendations for health policy, whilst in 2013, Australia became the first nation to adopt an arts and health framework (Australian Government, 2013). The United Kingdom’s National Institute for Clinical Excellence (NICE, 2015) issued guidelines for older adult health and social care that included the arts for the first time, whilst in 2016, Public Health England (published its first framework for evaluating arts and health programmes and in 2017, the All Party Parliamentary Group on Arts, Health and Wellbing (published its report, Creative Health, All Party Parliamentary Group on Arts, Health and Wellbing detailing the benefits of arts and culture from birth to the end of life, including people with a dementia. The National Endowment for the Arts (2016) in the US has begun a rigorous programme of research funding and policy seminars to better understand the role of arts and culture for individuals and communities.

In the absence of cures or effective pharmacological treatments for the dementias, the inherent possibilities of the arts for transforming the lived experience of dementia and even their therapeutic potential for addressing these complex conditions are gaining widespread recognition. The arts have been shown to be effective for supporting the health, well-being and cognition of people living with a dementia (Camic, Hulbert, & Kimmel, 2017, Young, Camic, & Tischler, 2016), for aiding communication (Gjengedal, Lykkeslet, S⊘rb⊘, & Sæther, 2013), for stimulating the residual creativity of those with a dementia (Palmiero et al., 2012), as a means of educating carers (Kontos, Mitchell, Mistry, & Ballon, 2010; Zeilig, Poland, Fox, & Killick, 2015) and also for challenging public perceptions and prejudice about the dementias (Gregory & Windle, 2013; Hughes, 2014). There has been an essential growth in interest in the role of the arts for those living with advanced dementias (Crutch, Isaacs, & Rossor, 2001) and also a recognition of the need to privilege the perspectives of people living with a dementia (McFadden, Frank, & Dyset, 2008; Zeilig, Killick, & Fox, 2014).

In the last five years, there have been a number of new and important international initiatives providing further evidence concerning the positive influence of the arts for those with a dementia. This special issue of Dementia contributes to this emerging body of innovative research and practice. It comprises a collection of 10 papers that encompass a range of pioneering scholarly work on the arts and dementia from both Europe and the US.

Nine of these papers emerged from the first International Arts and Dementia Research Conference in March 2017, sponsored by the Royal Society for Public Health (2017).

This special issue includes papers that are empirical, theoretical and review-based, exploring the visual arts, music, theatre and the spoken word. A variety of cultural contexts and settings are covered (including a UK hospital, a US long-term care facility, closed wards in a Dutch nursing home and a German Museum). A systematic review by Curtis et al. sets the tone for this collection by providing high-level evidence about the effectiveness of a range of arts for health activities on the health, well-being and quality of life for older people in care homes.

Music in dementia care has predominantly been considered in community settings and amongst groups of people with mild to moderate dementia. A unique international overview of the most current research into the impacts of music in healthy ageing for people living with strokes and also with a dementia is given by Särkämö, and Daykin et al.’s original study contributes to understanding about how live, participatory music sessions can ameliorate hospital-based care for those with dementia.

The importance of confronting the theoretical basis of visual art programmes is tackled by Windle et al., and the study by Schall et al. contributes to the growing evidence base concerning the value of museum-based projects for people with a dementia. There is also a more personal, reflective account by Harrison exploring the transformative effects on an artists’ practice of working with people with a dementia. In a similarly reflective vein, Basting outlines the development of ‘The Penelope Project’ and explores how a creative, community building approach can engage people living with dementias as equals in culture-making projects. Using one of Bastings’ innovations, Swinnen and de Medeiros, in their study, demonstrate the ways in which spoken word projects can support the linguistic agency of people with a dementia in long-term care settings.

The methodological challenges confronting researchers and evaluators of arts-based activities for people living with a dementia are investigated by Gray, who prompts us to think about the alternative questions we might be asking when we assess these projects. Finally, Whitehouse et al. explore the role and influence of the arts and humanities for public health policy in the US and the UK, with a specific focus on dementia care and practice.

We would like to thank John Keady and Penny Harris, the Dementia journal’s editors for inviting us to compile this special issue on the arts and dementia; it has been our privilege to do so. Viewed together, the papers help clarify the intrinsic value of the arts for people living with dementias and demonstrate how the field is increasingly characterised by reflectivity and rigorous research, theory and practice.