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The In the Flow Community Arts Project was developed by ACH Group through consultation with Country Arts SA, Rural City of Murray Bridge, local arts groups and local aged care providers in 2010, in response to a gap identified in community activities for people with dementia in the local area by the Murray Mallee Ageing Task Force.
The Project was awarded a Dementia Community Grant, through the Australian Government -Department of Health and Ageing, and a partnership between ACH Group, Rural City of Murray Bridge, lead artist Helen Crawford and the Murray Bridge Regional Arts Society was established.
The objectives of In the Flow Community Arts Project were to:
- meet identified gaps in services and to promote the goal of Good Lives for Older People (ACH Group);
- demonstrate the capacity of people living with dementia to contribute to their community through the creation of street banners in weekly arts workshops;
- bridge social gaps between indigenous people, students, people with dementia and artists to encourage their social participation and improve their confidence and well being;
- continue the arts focus in the region and promote Murray Bridge as a community which celebrates older people;
- develop community arts capacity with fellow artists, aged care providers and older people in the Murray Bridge area;
- create place making art works in Murray Bridge which celebrate the diverse cultures and environments of the area;
- promote the value of the arts by contributing to a local community project;
- involve local artists working together to learn from each other and to contribute skills; and
- demonstrate how arts practice can improve wellbeing and a sense of belonging.
Over a 12 month period, a group of 20 participants, including indigenous elders, participated in the weekly program.
Utilising community development principles, inviting contribution, consulting widely, providing a safe and respectful environment in which to work, a strong sense of belonging and involvement was created.
The commissioning of street banners for the Rural City of Murray Bridge focussed on the participants connection to the local area and their stories, providing a goal and a purpose for each week. The participants experimented with a variety of art forms with support from local artists and contributed to group designed banners based on the themes of farming, dairying, river boats, native birds, rowing, speedway, fruit growing, Italian migration, the train bridge, church life, and a Ngarrindjeri totem. The banners are displayed in the main street every October during Every Generation Festival and were launched with an exhibition of the art works in the Town Hall.
Tertiary students completed Measuring Engagement scales for 8 of the participants for periods varying from five and fifteen sessions. These scales were adapted from Cognitive Stimulation Therapy (Spector et al, 2006 in Making A difference- The manual for group leaders). The scales monitored the participation, interest, communication, enjoyment and mood of the participants during the art and reminiscence sessions. Any significant issues affecting participants were also noted on the individual record each week. The monitoring of these elements of engagement and issues gave an indication from week to week about the appeal of different activities for individual clients and their ability to participate in them. It allowed the volunteers to review the complexity of the activity and the clarity of communication and consider other health and environmental factors which might influence an individual’s level of engagement.
As expected, the overall trend of scores in these areas indicated an increase in engagement over the course of the project with minor fluctuations noted due the individual preferences, level of dementia, abilities and health issues, and changes in the environment. It was evident from this monitoring and observation that individuals became more engaged as they became more comfortable with the routines, environment and expectations of the sessions, realised their strengths, gained confidence and got to know the other participants.
Well-being and Ill-being profiles, from Bradford Dementia Group (Bruce, 2000) were also used to monitor outcomes for the participants people. The results from this sample study indicated an overall increase in well-being and decline in ill-being of the selected participants over 12 months. Minor fluctuations were attributed to ill health, the appeal or challenge of the activity and the overstimulation of the environment on occasions.
Interviews were also conducted with 10 of the older participants by a trained volunteer. Some highlights of the interviews were:
- The interview questions triggered reminiscence accounts from some of the participants, while others, due to their dementia, found it difficult to focus and respond to all the questions;
- The responses gathered highlighted the value of Reminiscence for older people and especially those with dementia;
- Several of the participants seized the opportunity to share accounts of their life and opinions of life today with the interviewer;
- Participants acknowledged the importance of the relationships they formed through the project with other participants and staff;
- Several expressed the sense of achievement and belonging they felt from working with the group on specific artworks in the project and their surprise at their achievement and the quality of the final product.
- Participants identified the experience, challenge and satisfaction of trying something new. There was also awe at the nature of the materials used to create the artworks.
- Even though a couple of the participants had little memory of their involvement in the Art activities they took pleasure in the outcomes and reported feeling comfortable and welcome in the group.
Focus groups were held with artists, volunteers and aged care service providers to seek feedback at the 6 month and 12 month project mark.
Training session evaluations from 17 artists, volunteers and students were used to identify learning and areas for improvement. All were very positive that the training improved their understanding of dementia and was relevant to the project.
The public launch by the Mayor of the street banners and exhibition brought together a diverse range of community members and built bridges between social groups. Aboriginal elders, their families and friends celebrated the inclusion of themes from their culture; Italian migrants enjoyed seeing the representation of their culture on display and the images of farming, dairy and local environment resonated well with the local community. Over 200 people visited the exhibitions and see the colourful street banners each October. This positive approach lifted spirits in the community and brought a sense of pride to many.
The program evaluation clearly showed improvement in the participants’ health and wellbeing. This is significant considering that dementia is a progressive condition of cognitive and functional decline which impacts on the health and well being of the person with dementia and their carers.
For participants the key outcomes included:
- the ability to share stories acknowledged the life roles of older people;
- improved confidence as participants challenged themselves to learn new skills and were rewarded for their efforts;
- the social aspects of the project created a sense of belonging and over-came isolation for people with dementia and their family carers.
I’m pleased and proud: I’ll see it up in the street and I’ll think I did that. Participant
… it gave me quite a bit of knowledge. It’s been very very good. They are so clever the way they make it so easy. Participant
Feedback from participants family members:
- unanimous in their pleasure in seeing their relative engaged, enjoying themselves and achieving something despite the diagnosis of dementia;
- the art program provided a reprieve for them and their family member from the symptoms of dementia;
- noted behavioural changes, more appropriate participation and a sense of purpose; and
- found a sense of hope and stress reduction as a result of the program.
For local tertiary students, volunteers and staff from aged care providers the key outcome was the opportunity to work with local artists, indigenous elders, people with dementia and family carers to learn innovative ways to support people with dementia and community development strategies.
I think the last 12mths has been an eye opener … it was incredibly important to hear what they had to share … pure enjoyment. Volunteer
Feedback from the artists:
It is meaningful, bonding and will produce a great result for the larger community to enjoy as well. Artist
..this is a very meaningful project in which art and reminiscence are used for the well-being of elderly people and at the same time contribute to awareness of the important role our older community members still have in the wider community. Artist
For the ACH Group key outcomes included:
- provided a strong profile as a service partner and promoter of good lives for older people;
- developed the ability to work with community artists and knowledge as to how to contribute the local service network;
- proving that older people and people with dementia can contribute to their community and that arts programs can challenge the perception of older people.
Continuing the Flow
An ongoing program Continuing the Flow has been supported by ACH Group, the local council and other aged care providers and local artists to enable people with dementia and their family carers to continue to enjoy making art, contributing their creative talents and providing an effective health intervention for people with dementia and their family carers.
ACH Group has, in addition, developed an arts strategy across the organisation to promote the involvement of older people in the arts both for enjoyment and for health benefits. They have developed choirs, dance groups, art groups, and writing programs for older people, which engage local artists for their expertise and are based on community art principles. They similarly have shown improved health and wellbeing for the older people involved, despite chronic conditions, grief and dementia.
The partnership between Helen Crawford & Murray Bridge Regional Arts Society and ACH Group & Rural City of Murray Bridge was awarded the 2013 SA/NT State Creative Partnerships Arts and Health Award and was one of six finalists for the National Award presented in November 2013. The Institute for Creative Health is proud to partner with Creative Partnerships Australia in the development and delivery of this Award.
Lenore de la Perrelle
Manager Dementia Learning and Development Unit