Erin Brumleve, MA, LPC, ATR
Population facts ……
The Alzheimer’s Association (2005) and National Institute on Aging
(2005) estimates the current direct and indirect costs of caring for the 4.5
million Americans with Alzheimer’s Disease (AD) are at least $100 billion
By 2030 the entire baby boom generation will be over 65; the number of
Americans with AD is expected to grow even larger. Research also indicates
the most successful treatment for the AD client is that which involves a
combination of pharmacological, psychodynamic, and structured person
centered care giving.
Therefore to a skilled nursing and memory care facilities who wish to serve the
AD population, the utilization of a multimodal treatment approach seems
optimal. Art therapy is a unique treatment modality within this spectrum.
What is art therapy? How does it benefit persons
with Alzheimer’s Disease?
Art therapy “the therapeutic use of art-making, within a professional
relationship by people who experience illness, trauma, or challenges in
living, and by people who seek personal development. Through
creating art and reflecting on the art products and processes, people
can increase awareness of self and others, cope with
symptoms, stress, and traumatic experiences, enhance cognitive
abilities and enjoy the life-affirming pleasures of making art”
(American Art Therapy Association, 2005).
With regard to AD, art therapy can be used to assist in diagnosis and
evaluation of cognitive status, serve as an avenue of non verbal
communication, provide a means to structure reminiscing, and
encourage sensory stimulation, with the art product serving as a
tangible result of the self-reflective process inherent in the process of
art-making (Kahn-Dennis, 1997).
Art therapy sessions with AD
clients may take in a group of
with an individual. Individual
art therapy sessions may be
useful for clients who remain
isolated within their rooms
either due to ambulatory
restriction or who are
intentionally withdrawn. Art
therapy sessions may be
composed of structured
directives, or “free choice”
depending of the client’s needs
and level of cognitive
functioning (Stewart, 2004).
Life Scrapbooks created
with collage or other
materials offer an
opportunity to integrate
feelings and consolidate a
sense of self while serving
to stimulate memories,
validate ones personal
history, and leave a legacy
for the person’s loved
Life Review Procedural Outline-eight sessions (Ravid-Horesh, 2004)
Session Theme Age/year Directives
Pre-assessment A lifeline Draw your life as a line.
Life image Draw an image of your life.
Childhood Birth - 6 Draw a significant memory.
School Age 6-18 Ditto.
Early adulthood 20-40 Ditto.
Middle adulthood 40-70 Ditto.
Late adulthood 70-80 Ditto.
Older Adulthood/future 80-89 Ditto.
Post-assessment A lifeline Draw your life as a line.
Life image Draw an image of your life.
Group art therapy can
promoting feelings of
n, and support when
used as a modality for
rehabilitation, or in an
activities based model
of AD care (Yaretzky
& Levinson, 1996).
The act of sublimation
may deter acting out
behaviors that occur
Art therapy has much
to offer the AD client,
such as: stimulating
feeling states the client
may be unable to
articulate with words.
Art therapy as a non verbal commutative modality is especially important in
working with AD clients who are clients with aphasic or who experience
difficulties expressing themselves words
Research compiled by Dr. Ellen Dissanayake and others (1992) have
demonstrated through experiments with commsurotomized (split brain)
patients that rich cognition can exist in the absence of language. When a
visual stimulus is exposed to their right hemisphere the persons are able to
draw what they see with their left hand (which is controlled by the right
brain), but unable to articulate what or why they drew because the speaking
part of their person, the left brain has not “seen” the stimulus. “Nonlinguistic
avenues of processing and expression, notably images, patterns, emotional
intonation, and emotion in general-are as much a part of human experience as
knowledge as language” (p.154).
Thus the artwork can offer a glimpse into the client’s inner experience while
serving as a record of cognitive processes.
Elders feel a tangible sense of accomplishment in finishing arts and craft pieces.
Recognition of the resident’s creative efforts helps to further boost esteem
and provide a reciprocal dialogue between themselves and the larger community of
loved ones and facility staff.
The goals of long-term art
therapy are varied, but
may include to calm
someone with anxiety,
relief from depression,
coping mechanisms for
grief and loss, increase
self-esteem, validate life
changes in behavior, and
Potential Research Avenues
There seems to be tremendous potential for future research and
exploration for art therapy as a treatment modality and assessment
method for person’s diagnosed with Alzheimer’s Disease. This
therapist’s research interests include utilizing face forms in therapeutic
art activities. The face seems to be one of the earliest recognizable
forms for the human infant. It plays a role in facilitating attachment
between infant and caregiver, the reciprocity of which is involved in
the development of the infant’s primary neurological processes.
Thus the face has a great deal of
emotional significance for
people. As such, I am
hypothesizing it may be able to
elicit a greater degree of
response from middle stage AD
clients than other therapeutic art
Art Therapy can be an integral component of a multimodal treatment
approach in serving the AD population.
Alzheimer’s Association. (2004a). Fact sheet: About Alzheimer’s Disease. Retrieved March 16,
2005 from http://www.alz.org.
American Art Therapy Association. (2005). Retrieved August 31, 2005 from www.arttherapy.org.
Dissanayake, E. (1992). Homo aestheticus: Where art comes from and why. New York: Free Press.
Goldman, L. (2004) Art therapy and Alzheimer’s Disease: My mother’s art. In Magniant, R. P.
(Ed). (2004). Art therapy with older adults: A sourcebook. Springfield, IL:Charles C.
Kahn-Denis, K. B. (1997). Art therapy with geriatric dementia clients. Art Therapy:
Journal of the American Art Therapy Association, 14 (3), 194-199.
Lev-Wiesel, R., & Hirshenzon-Sergev, E. (2003). Alzheimer’s disease as reflected in self-
figure drawings of diagnosed patients. Arts in Psychotherapy, 30 (2), 83-89.
National Institute on Aging (2005). Retrieved April 1, 2005 from http://www.nia.nih.gov/.
Ravid-Horesh, R.H. (2004). “A temporary guest”: the use of art therapy in life review with an
elderly woman. Arts in Psychotherapy, 31 (5), 303-319.
Stewart, E. G. (2004) Art therapy and neuroscience blend: Working with patients who
have dementia. Art Therapy: Journal of the American Art Therapy Association, 21
Yaretzky, A., & Levison, M. (1996). Clay as a therapeutic tool in group processing with the
Elderly. American Journal of Art Therapy, 34 (3), 75-83.