Q.  During the week, I drop my husband off at an adult day care center and they offer regular art classes and art therapy groups. What are the differences between regular art classes and art therapy groups for people with cognitive impairments?

A.  Regular art classes focus on the individual’s interaction with the art media and the finished art product. Art therapy groups are aimed to activate the language center of the brain. The implementation of using art therapeutically includes several goals which include facilitating language expression, memory retrieval and socialization.

Q.  My father is unable to initiate conversation anymore, and his ability to verbalize has declined dramatically during the past year. I can tell this really bothers him a lot. Is there a way I can use art therapeutically to facilitate communicate between us?

A.  Yes, definitely! What I do to help facilitate language expression is to first see there are no other distractions in the room. I provide a quiet environment and begin by having several pre-cut images from magazines that depict several things such as food, animals, sports, facial expressions, objects, etc. for the person to view. I tell the individual I’m going to show them pictures and I ask them to choose images that they like. I usually have the person choose no more than four. I have a large piece of paper and ask them where on the paper they would like the pictures glued. I proceed by asking them what it is about the images they like, or what is happening in the picture. Through this activity, conversations surface. At this point, I usually try to guess the words they may be trying to convey.
 
I worked with a man that chose an image of a basketball player trying to get a basketball into a hoop. When I asked the man about the picture, he said the picture was about the basketball player’s ‘worries’ of not being able to get the ball into the hoop. At this point, I began to ask him about his ‘worries’ about not doing things. Apparently this hit home because he shared his concerns about not being able to do the things he use to do, such as being able to express himself verbally and being independent. The man felt relieved being able to share what was enormously difficult to express.

Q.  How does art therapy work for individuals with dementia?

A.  Art therapy works by actively engaging both sides of the brain. The brain has two hemispheres which work in conjunction: left and right. The right side receives information while the left side finds the words to describe the sensory information. Because there are vascular changes in persons with dementia, language areas become less functional. The therapeutic use of art accesses the language areas (the left side) by prompting the other side (right side) of the brain. Older individuals that have lost the ability to communicate feel isolated and self-conscious. Using art therapeutically provides a non-threatening activity which makes it easier for individuals to access and express language.

Q.  What is art therapy and what are the educational requirements to become an art therapist?

A.   Art therapy is the therapeutic use of art, within a professional relationship, by people who experience illness, trauma, or challenges in living, and by people who seek personal development. Art therapists are professionals trained both in therapy and in art. In the state of California, entry into the profession is at the Master’s level. The American Art Therapy Association sets the curriculum and educational standards to qualify as an art therapist. 

Q.  My husband has lost all ability to communicate. are there any activities i can do to communicate with him?

A.  Yes, I recommend engaging in activities that involve eye contact. Eye to eye contact is the most direct way to communicate to your husband that he is not alone and he is cared for. The eye ‘gaze’ goes back to the way infants attach to their main caregivers, and the same is true about the way adults attach to each other.
 
When I work in a group, I often use a beach ball and roll it to three or four adults sitting at a table. All the adults give and receive eye contact with each other, and engage in physical activity that requires coordination. I also will give the person a stuffed animal or doll that has very wide eyes and a pleasant smile to hold. Unless the adult objects, the eye to eye contact has a calming effect. As a caregiver, when you get tired, a doll or stuffed animal can serve as a substitute.

Q.  As an art therapist, what are your common goals when working with people who have cognitive impairments?

A.  Common goals are to maintain collateral brain pathways and preserve what is currently working. Basic brain pathways are set through the individual’s senses (sight, smell, touch, and hearing). The senses in general are set down early in life, and stay intact as a person ages. My job as an art therapist is to find which sense is operable and use it to stimulate the brain. Because individuals think in ‘images’ (visually), showing images helps prompt language, builds rapport and fosters social interactions with others.

Q.  Do you ever use art to educate people about their dementia?

A.  Yes, I do. Adults that are highly cognitive and recently diagnosed are very interested in knowing about what vascular changes are going on what can be done. I usually draw a picture of the brain on a large piece of paper and the changes taking place. I also make sure to write out on the paper itself the importance of maintaining brain health.

Q. What do you like about working at an adult day care center?

A.  I enjoy being with older people in general. Our culture does not value, nor represent elders the way they should. I enjoy the center where I work because they provide art therapy and support groups for these individuals and their caregivers.

Diane Alvy is a board certified registered art therapist with a Master's in Psychology. She is a Marriage and Family Therapy Intern at Opica Adult Day Care Center for people with dementia. During the past three years, she has used art therapy with adults with substance abuse challenges, adults with HIV and AIDS, and with children in the Los Angeles and Santa Monica School Districts.

 Subscribe to our weekly e-newsletter