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  • Thank you for this. I am very interested in a future working with our elders in this way. Art therapy expresses what cannot be expressed in words, for all of us.
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  1. 1. Art Therapy Counseling with Persons who have Alzheimer’s Disease Erin Brumleve, MA, LPC, ATR
  2. 2. 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 annually. 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.
  3. 3. 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).
  4. 4. 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useful for clients who remain isolated within their rooms either due to ambulatory restriction or who are intentionally withdrawn.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).
  5. 5. 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 ones (Ravid-Horesh, 2004).
  6. 6. 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.
  7. 7. Group art therapy can  further facilitate socialization, by promoting feelings of fellowship, cooperatio n, and support when used as a modality for geriatric rehabilitation, or in an activities based model of AD care (Yaretzky & Levinson, 1996).
  8. 8. The act of sublimation  through art-making may deter acting out behaviors that occur with sundowning (Goldman, 2004).
  9. 9. Art therapy has much  to offer the AD client, such as: stimulating spontaneity, encouraging playfulness, and externalizing internal feeling states the client may be unable to articulate with words.
  10. 10. 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.
  11. 11. Elders feel a tangible sense of accomplishment in finishing arts and craft pieces.
  12. 12. 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.
  13. 13. 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 experiences, assess changes in behavior, and encourage social interaction (Goldman, 2004).
  14. 14. 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.
  15. 15. 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 directives.
  16. 16. Art Therapy can be an integral component of a multimodal treatment approach in serving the AD population.
  17. 17. References Alzheimer’s Association. (2004a). Fact sheet: About Alzheimer’s Disease. Retrieved March 16,  2005 from American Art Therapy Association. (2005). Retrieved August 31, 2005 from  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. Thomas. 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  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 (3), 148-155. 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.