Michael C. PattersonWe applaud Kavan Peterson’s Forget about Memory! Focus on Imagination article. We are inspired by with such an assertive stand advocating for new approaches to dementia and Alzheimer’s care — approaches that can improve quality of life without resorting to the use of anti-psychotic drugs. As Kavan says, the very least dementia care communities should do is introduce the Music and Memory Program. The use of the arts in dementia care is an exciting field that is just hitting its stride.
While our efforts to promote cognitive wellness tend to focus on healthy older adults, most of our recommendations pertain equally to people who are living with dementia and Alzheimer’s. As the title of Kavan’s blog suggests, loss of memory does not mean loss of mind and certainly does not mean loss of imagination. Nor does dementia signal the loss of the ability to find pleasure and fulfillment in music and other arts. There is growing evidence that the arts not only contribute to cognitive health, but just as important, contribute to overall wellness and satisfaction with life for people with all kinds of challenges.
At MINDRAMP Consulting we strive to translate cutting edge research into practical programs and strategies that promote cognitive wellness. This goal begs the question — just what do we mean by cognitive wellness? We have come to believe that there are two essential components of the wellness equation. One side of the equation focuses on brain health — on the attempt to limit structural damage and to manage diseases that undermine cognitive function. But, the other side of the equation is equally important. This second side focuses on the ability to find pleasure, meaning, purpose and fulfillment in life.
The term “flourishing” is frequently used as a shorthand term for all of these elements of wellness. Martin Seligman in his book Flourish, defines wellness as being composed of five core elements: positive emotions, meaning, engagement, accomplishment and positive social interactions.[i]
As I explained in a recent review of Seligman’s book posted on Amazon, I was quite taken by his point that mental wellness is not achieved by simply removing the causes of mental distress. The absence of pathology can still leave people feeling empty. The other side of the wellness coin is the cultivation of real happiness, meaning and fulfillment, which requires concerted effort. We need to learn how to release and nurture the positive aspects of our psychological makeup. Quality of life is not achieved when we languish; it is achieved by learning to flourish.
A healthy brain may make it easier to attain these positive conditions of wellness, but a growing body of evidence makes it clear that people who struggle with profound cognitive deficits can still flourish. And, it is frequently the arts that unlock the gates to this secret garden of subjective wellness.
Kavan asks for additional ideas on how to improve quality of care and quality of life and reduce the use of anti-psychotic drugs. I’d like to offer some ideas that center around the power of the arts to nurture wellness.
For starters, I want to whole-heartedly second the support for Ann Basting’s Timeslips program. It is a model program that sets the standard for approaches that promote quality of life for people living with dementia. The Modern Museum of Art’s art program for Alzheimer’s patients and John Zeisel’s work pioneered the approach captured by your title. Forget about memory; focus on the imagination.
Timeslips and the museum projects use the arts to interact with people in the here and now. They focus on feelings and thoughts that are happening in the present, not on the ability to recall facts and figures from the past. In so doing they reaffirm the dignity and worth of people who have lost their memory by engaging retained cognitive functions, like imagination, to discover meaning, fulfillment and joy in what is happening right now.
MINDRAMP has very close ties with the National Center for Creative Aging (NCCA). The mission of the NCCA is to foster an understanding of the vital relationship between creative expression and healthy aging, and to develop programs that build upon this understanding. Their membership includes the top teaching artist in the country. These working artists design, implement and test arts programs for older adults, both healthy adults and adults with dementia.
So, here you go, Kavan. Here are two ideas to consider:
1) I highly recommend that teaching artists, elder-living and care community leaders, and those interested in creativity and aging, become members of NCCA and take full advantage of their many services. We recommend that your readers learn more about NCCA at: http://www.creativeaging.org/about-ncca-0.
2) I also recommend attending the second annual Creative Aging Leadership Exchange that will be held at Arena Stage in Washington DC this May 19-20. Leaders from the field of creative aging will explore arts programs, the business of supporting arts programs for elders, and the scientific research that support the field. I will be moderating the opening research plenary panel.
Learn more about the conference at: http://www.creativeaging.org/www.conference.creativeaging.org.
[i] Seligman, Martin. (2011) Flourish: A Visionary New Understanding of Happiness and Well-Being. New York. Free Press.
Hi, I am an AGNG 200 student at the Erickson School of Aging. I strongly agree with your post, I think it is very important for us to “promote cognitive wellness.” I agree that we should try to focus on present feelings in order to help reduce stress. I also think it is very important to help elders, especially ones with dementia or alzheimer’s, to focus on the present and “engage retained cognitive functions.” In my aging class, we talked about how when people move through different stages of aging, they often experience a feeling of “role-loss,” the feeling of no longer having a place in life. With your methods of focusing on being in the present, this helps people find a purpose and meaning for life again.
Christina,
You make a number of good points. In our book Strong Brains, Sharp Minds, https://www.smashwords.com/books/view/503385, we discuss how stress is a risk factor for cognitive decline and the “role-loss” you mentioned is a significant stressor for older adults. There is fascinating research that levels of stress are closely tied to our perceived status in society. Often, the transition from adulthood to elderhood is (incorrectly) perceived as a loss of status. Loss of status increases chronic stress levels unless we can find ways to cope with the change and have the confidence to allow the meaning and significance of elderhood to emerge.
Hi, I’d like to read the book mentioned in this article. Then I will see if I can afford this conference. Not working now, but way too young to be retired. So, I now am helping my 90yr old mom-in-law to live her life to the fullest! This site is wonderful!
Thanks, Cathy Hall R.T. (R) (M)
How fortunate that you can have this deep and meaningful relationship with your mom-in-law. You are never too young to start working to strengthen and nurture your cognitive wellness. The sooner the better.
As a stroke survivor who has found a life worth living I could not agree with you more. I wrote about the 2nd component of wellness in my post about finding meaning. http://homeafterstroke.blogspot.com/2011/07/the-power-of-personal-anchors.html
You blog makes an important connection between goals and desires. Meaning is very closely connected with motivation. We are much more willing to work on goals when we see how they help us achieve our desires. When we work with people to develop personalized brain health strategies, motivation is always the first step. We also recognize that people’s initial motivation may be largely extrinsic – they are doing it because someone encouraged them to do the work, or because they know it will be good for themselves in the long run. But it is always important to figure out how to move the motivation from external sources (extrinsic) to more internal drivers (intrinsic). The behaviors and lifestyle changes that promote brain health and flourishing are much easier to sustain when they stop being chores and become sources of inherent pleasure and fulfillment.
I Agree with the above comments and would add that any activity that promotes relationship building and a sense of interdependence is also important. Caregivers should not be in the role of the “doer for”. Rather, they should work from the underlying assumption that elders have as much to contribute to the relationship as the caregivers. I believe this is best accomplished in the institutional setting when time is allotted for activities that are unstructured and spontaneous, rooted in genuine interests and caring for fellow human beings.
Very nice. The best relationships are those that enable us to give and receive in equal portions.
The pattern I’ve noticed is that anything that puts a person squarely “in the moment” reduces stress – like dancing, holding their hand, singing a familiar song, reciting a memorized quote (a known bible verse, or the “Pledge of Allegiance”), Add to that, anything that contributes to a person being aware that they are safe and loved will reduce stress – friendly eye contact, warm, friendly gentle touch hand-to-hand, verbalizing “you are safe and loved here”.
I’ve come to believe that we all would benefit from living “in the moment” with awareness of being safe and loved.
I heartily agree with your perception about living in the moment. So much of our stress is related to ruminations about past events and to anxiety about what might happen in the future. Many of the stress management techniques seem effective because they enable us to do safe and pleasurable activities “in the moment.” The focus on the present blocks out thoughts of the past or the future. To a certain extent, activities like exercise and challenging creative activities engage a benign stress response that captures our attention and keeps it locked into the here and now.