The Glasshouse Cares - Art and Dementia Programs

When you first take a glance at Australia's newest and arguably most spectacular regional arts and entertainment centre the thought of aged and community care does not immediately spring to mind but the Access for All program, developed and promoted by Port Macquarie's Glasshouse, provides inspirational insight into how a combination of imagination and love for the community can help to provide variety for both residential and community aged care programs.

It all began in 2010 when the National Gallery of Australia first made contact to explain how they were operating a program for dementia sufferers and carers that was based on a $500,000 program being successfully run by the Museum of Modern Art in New York. ('Meet Me At The MoMA' Alzheimer's project)

Following the initial contact, staff from the National Gallery visited Port Macquarie to run workshops on how to deliver art programs for the sufferers of dementia, and their carers. The response to the workshops from both the Glasshouse management and people involved in running local community and residential aged care programs was overwhelming. From this beginning the Access for All Programme was established.

The Access for All Program provides support for a range of groups in the community including: sufferers of Alzheimer's and other related disorders (dementia); depression and mental health; and, intellectual disability both adult and youth. This article focuses on the specific program for the sufferers of dementia, and their carers.

The first people to be trained for the program were Gallery Manager, Sharni Lloyd and Public Programs and Audience Development manager Skye Frost. The training program involved:

• familiarisation of the issues associated with dementia;
• bringing dementia suffers and carers into a public environment safely;
• identification, reassurance and management of emotional and behavioural issues;
• art guiding for people with dementia.

"Appreciating art and helping the sufferers of dementia to express their feelings helps the residents to ease their frustration." Alison Sherrac, Emmaus Community Aged Care

The overall focus of the training program was to enhance interaction and participation whilst at the same time minimise agitation, particularly in the first few visits.

The program involves choosing three artworks for each session (approximately one hour in duration) and spending 15-20 minutes 'appreciating' each of the three artworks. Choosing the right artwork is important. It has been found, for instance, that large and complex artworks can create confusion and resultant agitation. Typically, the program will choose artworks such as landscapes, small abstracts and sculptures. Carers are asked to sit behind their partners or friends and the program leader will prompt discussion and reaction to the art from the people with dementia. The group will be asked questions such as: "what do they see?"; "what does the art remind them of?"; "does the art trigger memories?" It is a typical experience to see the first session start off quietly, but over time confidence and trust grows, and the level of interaction increases dramatically. No one is pushed into a response, but the program leaders are experts at the sort of light hearted and warm banter that soon puts a smile on the faces of everyone.

One of the issues faced by the program leaders is the temptation by carers to answer questions for the dementia participants, a protective behaviour that has understandably been developed over time. For this reason the carers are seated in the second row during the sessions. They are not excluded from comment but they are informed and educated to let their loved ones have full opportunity to express their own feelings and thoughts. Over time, the carers feel more and more comfortable with their role and in fact one of the many positive aspects of the program is that the carers feel that they have been given great respite from the need to feel in control of the situation.

As the program has developed, Sharni and Skye have found it necessary to train other staff as program leaders. When the program first started the number of participating dementia sufferers in each group was three, but it has been found that groups of 4-6 tend to work better, particularly if for any reason one of the group cannot make it on the day. The sessions are always run in the morning and it is noted that by the end of the session some of the participants show signs of being tired, but always still smiling.

Evaluation of the pilot program was critical to the future of the initiative. This process was assisted by a psychologist and included the impact on both the dementia sufferers and their carers. It was also noted that the evaluation surveys and tools also helped to educate and reinforce the role of the carers and RAO's in the program.

Several QPS Benchmarking clients have included this program into their activity program routine. Residents are accompanied by either their carer or the facility's Recreational Activity Officer. In assessing the full value of the program one has to keep in mind the fact that whilst the program lasts for just one hour the value of the session is enhanced by the fact that sufferers and carers will dress up for the occasion, and add shopping or a meal out to the process. All in all, it is a day out at an extraordinarily beautiful place. Totally inspired, one day care group even goes back to their facility and paints!

One of the QPS Benchmarking residential aged care facilities that participate in this program is Emmaus Community Aged Care in Port Macquarie. The volunteer lifestyle coordinator, Alison Sherracc, is impressed with the impact the Glasshouse program has on the residents she supports. Since coming to Emmaus one of the residents has taken up painting in an effort to express his feelings and emotions. He loves the Glasshouse program and has explained to Alison that "the discussions at the Glasshouse have helped me to better understand and express my own feelings on canvas and helped me deal with the frustration of the early stages of dementia".

Program volunteer at the Glasshouse, Chris Filipek, is a former GP Practice Manager and just loves her new role. Chris says "there is nothing more rewarding than to see a face with a blank expression explode into life. We may not understand fully what they are thinking but it is obvious that they are feeling joyous..... smiles and laughter are a universal language".

In a somewhat humble but endearing way Gallery Manager, Sharni Lloyd, reflects on the program by commenting that the Glasshouse staff often say that the Access for All program "has made them ambassadors for the Alzheimer's cause and makes them feel effective in bettering the participants life style and sense of worth".