Arts and Culture, the new partner of Care. Applying Dutch Creative Thinking to the Australian Situation. Door Susan Tredenick

In de afgelopen twee jaar schreef de Australische wijkverpleegkundige en publiciste Susan Tredenick een reeks gastblogs voor HAendeKunsten. Naast de inspirerende observaties en inzichten die ze met ons deelde was Susan in november ook in de gelegenheid haar kennismaking met de kunst & ouderenprojecten uit ons netwerk te delen op de Annual International Arts in Health Conference, dinsdag 13 oktober 2017 Sydney, Australia. In haar laatste blog (na de zomer vertrekt Susan weer, terug naar Australië) is een samenvatting van die presentatie, de observaties van een verpleegkundige in de ouderenzorg en wat zij uit de praktijk van healthy ageing & de kunsten heeft opgepikt om mee naar huis te nemen.

For my last blog I wanted to share with you some of that presentation and the lessons that I learnt from your innovative work and how if we can continue to share knowledge around the globe all aged people may have the opportunity to benefit from having Arts and Culture integrated into their lives and their healthcare. For myself being able to observe, participate and write about the projects here has really touched me not only personally to see the positive effects on all participants and organisers but as a health professional to gain a better understanding of the benefits of the Arts in Aged Care and has made me more determined to bring this into my own practice and that of my organisation in Australia. The projects have bought a tear to my eye, had me cheering from the sidelines and made me remember not to look past the person who is my patient but to engage with them and celebrate who they are. The organisers who believed passionately in their projects and all of the participants who allowed me to engage with them and bring me into their lives has reminded me of my initial reasons to become involved in healthcare.

For the Annual Arts in Healthy Conference I selected four of the ten projects I visited over the past two years, to share some of the valuable lessons that I learnt while visiting the north of the Netherlands.

Music and Dementia: Improvisation is really the key!!

For Music to my ears, I witnessed the Prince Clause Conservatorium master module Music and Dementia. Participants joined as a group an 8 week course on music. The workshops were conducted by a lecturer from the conservatorium and master students (that had been specifically trained for this task). This extraordinary music and dementia practice based on improvisation was imported from the U.K. to the Netherlands. The conservatoire conducted varies studies into the methodology of the programme and artists skills. Music and Dementia is now included in the master of music programme on a permanent basis. Each session of Music & Dementia with a selected group of people living with dementia starts with the same greeting or framing piece. It is the participants who conduct the music. The students watch for movements and make the music according to what the participants do.

Learning outcomes from this project included the importance of conversing individually each time with participants and using (singing) their name enabled better recognition from the participants with dementia. Using song for this conversation allowed me to reflect on the joy and peace that music can bring to people as was seen with the participants being more receptive and joyful with this approach.

Whilst it is becoming more common practice to play music to older dementia patients that may be from their era or past history I learnt that encouraging people to be more participative in music is really the key to opening up a heightened happy demeanour. Finally I believe that continued work with health care workers and family members is paramount, not only in this project but with all projects, as we look to approach healthcare more holistically we can begin by adapting an overall inclusive policy which brings all members of the patients family and health team onboard.

Dance and Parkinson: Dance is a creative outlet that can work with limitation of movement and slowness of reaction.

For What’s Dance got to do with it? I visited a modern dance performance by choreographer Marlien Seinstra with a mixed cast of able dancers and dancers with varying degrees of Parkinson’s. The dance was staged to incorporate the restrictions of each participant. Once on stage limitations were forgotten and in place were expressions of pure joy, companionship and sense of worth that made the performance moving. Of all the projects visited this one was truly special.

Learning outcomes from this project centred around the power of giving people a sense of worth. By enabling people with Parkinson’s’ to accomplish a dance production by simply modifying the dance movements and stage props to work with their restrictive movements instead of against them was empowering for me. It was this idea of looking outside the square to accomplish something that showed the respect that this project had for its participants.

When often looking after my patients in my own practice it is easy to treat the disease and its symptoms and forget to look beyond that to the person and the social and mental health implications. Before this project commenced the participants were interviewed and spoke about the effect the disease had on them not only physically, such as restricted movement, but also mentally with feelings of isolation and low self-esteem. Watching the performance you could see the joy, companionship and sense of worth that these dancers had given to themselves and each other and this is what made the performance moving.  Dance is a creative outlet that can work with limitation of movement and slowness of reaction, whilst helping to complete the daily tedium of exercise, socialisation, encouragement and hope to others and finally again using an approach to healthcare that is more holistic and inclusive of members of the patients family and health team. Yes, in this project partners were encouraged to learn to dance and participate.

Village cooperation Klooster & Buren: it is not bricks and mortar that make a house a home.

The project was slightly different as it took me into the village community in the very north of the Netherlands. Here villagers are bringing back a sense of belonging to a rapidly diminishing population. To do this they use various art and community projects to bring people together. The main attraction was a soon to be abandoned aged care home.

In Kloosterburen the village cooperation Klooster en Buren acquired the local residential home Olde Heem and turned it into a home for all. The home is now more connected to the village and open to everyone, regardless of age, support needed or place in society. The aged, teenagers, locals and part-time visitors can all call this place home. Why do we marvel at such an initiative? Could it be that we hope that this project is successful as it reminds us of how communities really should be? That is: joined and not separate.

Learning outcomes from this project is to encourage communities to re-connect with each other regardless of age, ability and standing within the community. Art is the platform which was used in this project and can be adapted in my organisation back in Australia. Bringing people together from different cultures and allowing them to share their culture through Art helps not only with social encounters assists with the intermingling of diverse communities. Australia is a land that has many different cultures that call it home and it is important that we respect and understand this. Pairing different generations in social context I saw do wonders to bridge this gap.

Art Gallery Alzheimer project: The change in demeanour is breathtaking!!

This Groninger Museum Alzheimer’s Project brings people with dementia into contact with beautiful, visual art paintings. The paintings are carefully selected and are specific to the area and history. These sessions are held on an afternoon when the museum is usually closed ensuring that there is a calming safe environment for people to participate.  During the session the paintings’ stories are not dictated, but rather all participants are given the time, space and security to connect with the scene. Eliciting the trapped and lost verbal communication of participants.

Learning outcomes from this project centred around the idea of giving people time, space and security to connect. The use of vibrant paintings of often familiar memories from the participants youth worked wonders in encouraging verbal communication of dementia patients. Allowing time and not dictating to the participants also allowed memories and experiences to resurface and be told. Again in this project the involvement of families and care-staff showed that the giving and receiving of communication which bought about a positive change in the person’s demeanour was beneficial to all involved. Families stating that the glimpse of the person before the disease and connection to their memories being a pure joy to see.

What is next?

There were many benefits that I observed during my time on tour with these special projects.  At the Sydney International Arts in Health Conference we shared the following with the audience to take away with them:

To integrate Arts and Culture into our Aged Care we need to look at and develop more sustainable and holistic practices. The involvement of the healthcare worker is crucial for the projects to be successful.  Many workers have very little time in their daily working schedule and a concept such as pairing arts and culture with healthcare is a strange to them . This needs to be addressed! Workers need to be educated about the benefits and potential outcomes of any project that you begin otherwise it may be doomed from the start. Families should also not be overlooked but educated in new practices of integrating Arts and Health. When designing programs we need to remember to have more involvement of the participants. It was clearly shown that allowing participants to take the lead, while working with and accepting limitations and ensuring that staff could follow and improvise led to experiences that gave a sense of belonging, a sense of usefulness, a chance to socialise and lastly allowed for all participants to just be and experience joy.

Finally we need not to be afraid to share information. It is the simple concept of sharing of our information that is crucial to enabling everyone to benefit and learn.

Susan’s personal observations

For myself personally, I will bring many of these ideas into my own practice. I have always had a keen interest in what benefits that The Arts and Culture could bring to healthcare. Having trained as a nurse in a hospital training system, my days were a blur of completing tasks and medication rounds with hardly a moment to understand or connect with the person that was my patient. If my workload was completed that day and I had no unfinished jobs that I had to hand over to the next shift I considered that a day done well. It was not until I began to realise, many years later that I had barely spoken to my patients, too busy completing tasks, that I realised that this was not the way that I wanted my work practice to be. Moving into Aged Care unfortunately did not immediately alleviate this problem, often staff ratios were worse.

Searching for a more holistic approach to nursing I became interested in Arts and Culture and its many benefits that I perceived not only for patients but also for my own practice. I approached my work with ideas of bringing Art into our practice and thankfully was meet with encouragement. In a twist of fate I moved here to The Netherlands and I was overjoyed when I meet Saskia Van de Ree and immediately offered myself up to become involved in the HAendekunsten in any way that I could. Being able to tag along on many of the projects has truly opened my eyes and confirmed my beliefs that The Arts is the way forward. Witnessing the benefits that I have described above and taking away the learning outcomes has made me reflect and adapt my work to encourage participation in Arts programs that allow participants to take the lead and to give them time and space to engage and interact. To not rule anyone out but to adapt my practice so that everyone can share in the pure joy of The Arts. Finally thankyou to everyone that I met during my time here and for sharing your knowledge, passion and pride in bringing Arts and Culture to our Ageing Society.

For myself and my organisation we believe: The World is gearing for a silver economy, and within healthcare, Arts and Culture are no longer willing to wait in the wings, for us it is the new partner of care.

Susan Tredenick,
juni 2018

Wilt u de blogs teruglezen die Susan Tredenick schreef voor HAendeKunsten? Klik dan op onderstaande links.

  1. Music to my ears; Conservatorium music and dementia client. Prince Claus Conservatoire, Hanze University of Applied Sciences, Groningen
  2. Seeing beyond the disease: Students painting dementia. Minerva Academy, Hanze University of Applied Sciences, Groningen
  3. What’s Dance got to do with it?: Ballet dancers with Parkinson’s. DeDansDivisie, Leeuwarden
  4. What do you feel?: Exhibition over Intimacy and sex in Aged Care. Sunenz, Drachten
  5. It is not bricks and mortar that make a house a home: Olde Heem, Kloosterburen
  6. In motion: Dance classes for people with movement disorders. InBeweging, Groningen
  7. Dementia in the Art Gallery: Groninger Museum’s Alzheimer Project
  8. Do you see me? DeDansDivisie, Groningen
  9. Sometimes little things can make the difference! Plus Café, Groningen
  10. Being accepted for who we are! Roze50Plus Oldambt, Winschoten

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