1. Collaboration in the arts and dementia care

•  Collaboration among practitioners from different disciplines and/or
•  Collaboration between academics and practitioners

2. Creative expression and communications in dementia care
Communication strategies developed through creative expression activities in dementia care in various care settings.

3. Research and evaluation methodologies in creative expression and dementia
Research and evaluation methodologies developed specifically to demonstrate the level of creative expression abilities of people with dementia. Although completed research findings are preferable, research in progress is welcome.

4. Caregiver insights
The conference encourages submissions from informal and formal caregivers providing care within the community at large.

5. Creative expression, dementia and the therapeutic environment
Changes in the environment that leads to positive changes in behavior, promotes independence, preserves the self and dignity, improves socialization and communication. Submissions with the focus on creative expression activities and dementia are encouraged.

6. State of the arts in dementia care; From diagnosis to treatment
Includes topics such as early detection and screening tools, mild cognitive impairment (MCI), use of pharmaceuticals, treatment options.

7. Culturally enriched activities
Working with ethnic minorities in various care settings to activate memories of customs, food, beliefs and the arts.

Conference 2006 Presenters' Abstracts:

Marjorie Woodbridge,
Rideaucrest Home
175 Rideau St.
Kingston, K7K 3H6
Canada
mwoodbridge@city.kingston.on.ca

with co-presenter,
Philomene Kocher,
Queen's University, Kingston, Ontario

"Close your eyes and see with your other eyes"
Expression through Haiku poetry
Through explorations of spirituality with residents with advanced dementia in an established spirituality group led by the chaplain it was noticed that poetry sparked an immediate and dramatic effect. Poetry had the capacity to transport the resident back to memories that were clear and evoked deep emotion. Haiku is a short subtle and concentrated form of poetry capturing the experience of the moment. It was decided to experiment using this form of poetry in the groups by inviting a guest poet from the community. This workshop will describe how we structured the sessions our collaborative approach and the miracles that happened. In each session observations and stories were woven into poems. We will also share some of the ripples that affected others who were not directly involved in the groups i.e. family staff and residents. Part of this presentation will also allow a hands-on experience with sharing haiku and a reading of the poems created in the groups. If time allows we may explore group poetry creation.

Biography
Chaplain Marjorie Woodbridge, BA, MTS has worked in long term care for seven years and has had an abiding interest in how the arts connect and enhance spiritual understanding and expression. Her experience as a chaplain on a psychiatric floor, and her work on a neurology unit have led her to an interest in deep truth as expressed in alternative ways of perceiving and knowing. She has an interest in drama, poetry and music and how they inspire one to be at play in the fields of God.

Philomene Kocher, BSc, is a poet who has been writing haiku for 14 years. Her work has been published internationally. Her interests include collage, photography and voice.

"Collage Conversations" communicating during late stage Alzheimer's/dementia
This workshop will feature the importance and effectiveness of using visual imagery in a collage format as a medium to facilitate communication and increase personal interaction with individuals in the verbally challenged later stages of Alzheimer's and related dementias. Workshop includes hands on collage construction and a demonstration of how to utilize this techique as a communicator. She will highlight the power of picture collage in tapping into remaining memories and abilities. There will be an exposition of collage conversations created by residents in nursing homes many of them in the later stages of life and a display of various collage activities. A procedure manual will also be available.

Biography
Katya De Luisa has been a professional collage artist and arts program developer since 1983. She began working with elder populations when the Sarasota, Fla. Alzheimer's Association and Hospice of SW Fla. contracted her to create arts programs that would enable professional and family caregivers to communicate with persons with dementia. She is an accomplished public speaker and has been invited to present her programs to numerous groups and conferences worldwide

Involving Persons with Dementia in Health Planning: Towards a Model of Inclusion
Individuals with dementia are beginning to influence the direction of dementia care creating new opportunities for innovative direction in planning for health services and supports. Results from a multi-phased multi-method research study which was designed to address organizational issues related to effective inclusion of persons with dementia in planning and decision-making about health services and programs will be presented. Conclusions suggest that much of the dementia care literature remains focused on individuals and increased attention to relevant organizational level planning is needed. With respect to organizational considerations the study found that factors facilitating inclusion are an increasing awareness and understanding of Alzheimer disease helps planners know what people with dementia want in terms of their service needs and interests. Policy-level support for inclusion also emerged as an important factor facilitating organizational inclusion initiatives. The study found that organizational initiatives with respect to inclusion are constrained in several significant ways. People with dementia interviewed noted that their efforts to advocate for their own inclusion have been met with varying degrees of resistance ad negativity. Stigma associated with having Alzheimer disease a lack of resources that support inclusion a historical focus on caregivers as the central client in Alzheimer organizations the progressive nature of Alzheimer disease and service fragmentation surfaced as major constraining factors. A model of inclusion will be presented. While recognizing the limitations of models the approach offers a useful way to synthesize concepts and ideas from both the literature and the study findings relevant to the concept of inclusion. The integrated model suggests that inclusion is multi-faceted and that inclusion initiatives occur at four levels: individual; organizational; inter-organizational; and system levels.

Biography
Areas of research relate to the creation of inclusive health service planning models where persons with dementia are key planning participants. Other research areas are: consumer partcipation, organizational planning, and service planning.

Sky....Diamonds - a play for everyone
Sky...Diamonds is an original play from the imagination of the playwright developed with the support of the Layton Research Center Oregon Health Sciences University Portland Oregon. It centers around the grandmother Monique a woman who attended Woodstock and her son who deals in artifacts but cannot relate to his mother and his daughter who is more able to accept her deteriorating grandmother as they share the bonds of music and family stories. Working backwards in time over 10 years from near the end of ability to communicate the dynamic woman with an inquiring and provocative mind is revealed as the pieces of her life come together for the audience. Theatre with its immediacy and yet clear line between reality and pretence offers a powerful means by which to open odors into the conversation around Alzheimer's and its effect on the family. By watching real people on stage feeling their emotional journey and engaging in discussion of that family perhaps an audience is more inclined to find out about the illness and to think about their own story. The audience feedback and that from professionals dealing with Alzheimer's and families indicate that this play has a powerful and positive impact on the audience. In public 2 readings over 120 people saw the play and on both nights at least half stayed for a talkback with a neurologist actors and the writer in spirited and frank discussion about the nature of the illness treatment and impact on families. This performance will offer scenes from the play read by 2-3 actors and the playwright (also an actor) with an opportunity for discussion of the writing of "Sky Diamonds" and the potential for theatre as a tool for education and awareness raising.

Biography
Kate, Founder/Artistic Director of the Well Arts Institute, creates and produces Performing Wellness. She is Adjunct Faculty in the Linfield College Theatre Department and the Linfield-Good Samaritan Nursing school where she teaches an Arts and Wellness Course. She is a theatre director whose professional directing credits include Quilters, The Weir, and Sweet Phoebe. On stage work includes lead roles in Medea, Equus, Painting Churches, and Eleemosynary. A produced playwright, her plays include "Composers In Skirts", commissioned for pianist and actress about 6 woman composers, that has toured throughout the USA, and "Singing our Way Home" a puppet play for children.

Making Sense of Dementia Through Metaphor
This presentation will examine ways in which people with dementia are providing essential insights into their experiences through poetry and highlight the important part that metaphor plays in this process. It will be illustrated by poems composed by individuals with the condition and recordings of the process of composition.

Biography
John Killick was Writer in Residence for a British health care company for over 10 years, working almost exclusively with people with dementia. Since 1999 he has worked at Stirling University examining the contribution which all the arts can play in providing opportunities for creativity for people with the condition. He is the author of 'You Are Words: Dementia Poems' and 'Openings: Poems and Photographs' amongst other books.

Weaving Cherished Memories and Childhood Dreams
At John Bryant House Uniting Church Homes a fascinating wool tapestry has been co-created with fifteen people with dementia working with fifteen high school students. The tapestry represents the residents' cherished memories discovered from reminiscence sessions interwoven with some of the dreams of the students. The idea was to provide an activity to allow young people to connect with the elderly. The technique of Hooked on Hessian used to create the tapestry could be graded to each person's abilities providing a failure free medium for creative expression. More than half of the residents became independent with this new skill during the project. The co-creation of the tapestry facilitated the sharing of ideas was an opportunity for the residents to reminisce and for the students to learn from the wisdom of the residents' life stories. All the participants experienced the joy of company friendship and a real sense of community spirit developed. The students' feedback was unanimously positive with many describing that it had changed their perceptions of people with dementia. They had thought that the residents would be "disabled" and "boring" and instead they found that they were "just like us" "still normal people" and expressed surprise that "elderly people could have so much energy". The positive and surprising outcomes of this project highlight the importance of giving people with dementia opportunities to be creative and learn new skills as it is possible for learning to take place when they are supported with a nurturing environment and community.

Biography
Hilary is a senior occupational therapist who trained in Oxford, England. She has specialised in a using a holistic and person-centred approach in the care of people with dementia. Hilary has qualified as an Advanced Dementia Care Mapper, and has a Certificate IV in Clinical Aromatherapy. She has undertaken postgraduate units in health research methods and is now undertaking a Masters in Science in research in dementia care. Hilary has a special interest in promoting well-being in people with dementia and is currently working on exploring the creative arts as a means of self-expression for people with dementia.

The Value of Reminiscence Theatre in Dementia Care
This workshop demonstration will illustrate the value of Reminiscence Theatre for older adults. Literature and practice have indicated that Reminiscence Theatre is a valuable tool that promotes healthy adaptation and transition into later life. It has been shown to increase esteem social interaction emotional engagement and physical activity. As well Reminiscence Theatre holds inherent therapeutic value in that it provides a context for the older adult to reflect on one's life experience reclaiming a sense of self as one's contributions to society are recognized and validated. Along with enhancing the quality of life for older adults the value of Reminiscence Theatre generalizes to the older adult's family caregivers involved professionals and program staff. This multi-modal interdisciplinary approach has been shown to be effective for dementia as it draws upon long term memory and goes beyond reminiscing alone. The drama/theatre component expands upon general reminiscence work in that the long term memories are re-created in the present providing a concrete form that can be replicated bringing memory into the short term. In this workshop participants will first view the Vancouver Island Health Authority / Applied Theatre Consulting Services joint pilot project DVD A Living History and be apprised of program expansion. Participants will have the opportunity to be engaged in an interactive demonstration of a Reminiscence Theatre sample session. The workshop will conclude with reflection and discussion in highlighting the benefits of Reminiscence Theatre programming and foster dialogue regarding emerging research and ethical considerations in this type of work. Relevant handouts resource materials and a display will be on hand.

Biography
Trudy Pauluth-Penner, B.F.A., M.Ed., is an applied theatre director/consultant. Currently, Trudy is an Associated Health Researcher on the Michael Smith Foundation for Health Research Infrastructure Grant received by University of Victoria's Centre on Aging, and has received a grant from the Society for the Arts in Health Care to expand Reminiscence Theatre programming. She is founder and director of Applied Theatre Consulting Services, providing drama applications that include Reminiscence Therapy.

Rachel Kail
The Edcon Group
P.O. Box 10620
Kansas City, 64188
United States of America
rachel@edcongroup.org

Taking Dementia Care From Ho Hum to Bada Boom!
By definition creativity is: to make or produce. But make or produce what? In the world of dementia we think creativity means producing moments of happiness within the charter of enhancing comfort and maintaining dignity. When gentle guidance combines with a nurturing environment people with dementia often feel open to self expression...free of inhibition. Creativity represents an area of freedom where there is no right wrong or absolute...no need for the skills or experiences of the past or ability to plan for the future. Creativity takes place in the NOW. Once people experience the safety of this artistic expression language often flows and vaults of stored memories open. The three speakers for this "SHOW HOW" program are practitioners from the "SHOW ME STATE." In 90 minutes you will experience an avalanche of creative ideas for expression and possess the skills to use them immediately following the session. You'll learn how to build laughs and spark "trigger/flash moments." This is not a sit stare and listen presentation. You are "in it" from the git go. Mary Rachel and Tim will be around and through the audience ensuring that you depart with a working knowledge of how to take dementia care FROM HO HUM TO BADA BOOM!

Biography
Rachel has become a seasoned presenter and author of a guidebook for capturing the biographies of elders?and is not yet 25. She has been a professional speaker for more than 5+ years using cutting edge adult learning methods and dramatic delivery to captivate audiences. Her BA is in psychology with a specialization in dementia care. This backed with almost 10 years of interaction and care of elders makes her observations wise beyond her years. On the platform, you see her amazing presentation skills. With elders, you see her heart. Rachel has spoken to caregivers across the US and Canada as well as in the South Pacific.

Creative Caring Practices of Registered Nurses with People Experiencing Dementia
The purpose of this presentation of case study narratives is to indicate the specific outcomes that may be evoked by a range of creative caring practices used by registered nurses and Liscensed Practical Nurses (LPNs) such as: humor presence use of music and voice art and reminiscence. Although many might consider this approach to be an 'Arts in Medicine' approach it represents what nurses have done since the time of Florence Nightingale.

Biography
Dr Carole-Lynne LeNavenec is a Professor of Psychiatric and Mental Health Nursing and Nursing Scholarship at the University of Calgary. She is an author of several books and articles, the most recent one being:
LeNavenec, C., & Bridges, L. (2005). Creating connections between nursing care and the creative arts therapies. Springfield, IL: Charles C Thomas.
See further info on her website: www.ucalgary.ca/cait

Co- Presenter
Elisabeth Antifeau, RN, MScN, GNC(C)
Clinical Lead for Dementia,
Interior Health Authority, Nelson
Elisabeth.Antifeau@interiorhealth.ca

Communicating the Diagnosis of Dementia: The Art of Disclosure
With the increased incidence of dementia comes an increased need to compassionately and effectively communicate this diagnosis to clients and caregivers. However qualitative studies of the attitudes and experiences of clients caregivers and physicians indicate that the disclosure process and outcomes are frequently not positive. While learning the diagnosis of dementia can be potentially devastating for both the client and family and very uncomfortable for the physician an understanding of the process of disclosure and communication strategies that are sensitive and caring can provide the means to better accomplishing successful communication. This presentation will focus on the art of disclosing the difficult diagnosis of dementia. Participants will learn to: 1) identify the social ethical and medical rationale why early disclosure of the diagnosis of dementia is important; 2) compare and contrast the perceived benefits and barriers to early diagnostic disclosure of dementia from both the client/family and physician perspectives; 3) identify and discuss common first reactions; 4) describe specific examples of communication techniques which provide support for clients and family; 5) identify follow-up approaches to care (including resources) which provide long-term support for clients and families 6) assess positive client and family outcomes that result from early disclosure.

Biography
Dr. Alan Gow graduated from the University of Glasgow in 1971 and after eight years in hospital and general practice moved to Canada in 1979. For almost twenty years he practiced family medicine in a rural setting in the Central Interior of British Columbia before moving to the Shuswap in 1998. In 2000 he accepted a position as Consulting Physician to the Elderly Services Programmes of Interior Health in the Shuswap area. These services focus on the physical and mental health needs of seniors and include the diagnosis and management of dementia in community and facility settings. In addition to clinical work Dr. Gow is a member of the Interior Health Dementia Advisory Group and the Dementia Clinical Practice Working Group which is developing Best Practice Guidelines for dementia care at all stages of the disease.

Biography
Elisabeth graduated as a Registered Nurse from VGH School of Nursing in 1979. Her professional background includes BScN (UVic), MScN (UBC) and Gerontological Nursing Certification (Canada). She has 27 years experience working with elderly populations in acute, community, residential and mental health settings. She is currently working as the IHA Clinical Lead for Dementia to collaboratively develop a Phased Dementia Pathway that includes clinical practice recommendations which are evidence-informed, cross-sectoral, interdisciplinary and applicable to the full spectrum of dementia.

Creative Scrapbooking as a Venue for Fostering Reminiscence
The contribution that scrapbooking can make to the quality of life for individuals with dementia is explored in relation to reminiscence therapy. Scrapbooks provide caregivers with relevant information about an individual who is participating in reminiscence therapy. They stimulate the recall of past events feelings and thoughts that facilitate pleasure quality of life and even adaptation to present circumstances. Some research supports the view that there may be positive effects for older adults who are anxious or depressed which are common clinical problems in individuals with dementia. This presentation will review the literature in relation to scrapbooking and reminscence therapy and explore the implications for further study. One of the presenters will share components of a scrapbook created in memory of a family memory and describe potential application for health care professionals and family caregivers.

Design for Dementia - An Ontario Perspective
Over the past seven years Ontario's long term care market has seen a tremendous regeneration with the establishment of a new set of Design Standards for Long Term Care and the redevelopment of approximately 20 000 long-term care beds. Presented by Barbara Miszkiel a Principal of Stantec Architecture and former consultant to the Ontario Ministry of Health and Long Term Care this presentation will discuss design strategies specific to the successful integration of residents with dementia into long-term care facilities. Barbara will draw upon successful case studies in the Ontario market and provide valuable "lessons learned" in both the development of a successful set of Design Standards as well as project implementation. Discussion will focus on design layouts that support resident independence orientation socialization and differentiation of personal space. Specific case studies will illustrate the successful reduction in aggression and frustration in residents.

Biography
Barbara graduated from the University of Waterloo in 1982 and became a member of the OAA in 1987. She is the principal-in-charge for long-term care projects in our Toronto office. Over the years, she has established a strong relationship with the Ontario Ministry of Health and Long-term Care. During 1997, she acted as full-time consultant to the Ministry where she was instrumental in the development of the new Design Standards for Long-term Care facilities in Ontario. More recently, Barbara worked with KPMG and the MOHLTC to assess submissions for the 2001 bed awards for long-term care. Barbara is a member of the Ontario Association of Non-Profit Homes and Services for Seniors, the Ontario Long-term Care Associarion, and the Alzheimers' Society of Toronto. Her primary focus is with supportive housing, complex care, long-term care and specialized design for mental health. She has acted as a visiting lecturer at the University of Toronto, the Alzheimers' Research and Education project in Waterloo, conferences in Ontario and the United States, as a professional advisor to the Jury for the Hamilton Sesquicentennial Design Awards, and as Vice-Chair of the Toronto Society of Architects.

Health, Memory, and Architecture: Indigenous Knowledge perspectives
Indigenous perspectives on memory and place are looked at here to understand how works of architecture help Elders to retain memories and physical health. Examples of architectural works from long-resident cultures around the world are presented in drawings or photographs and correlated with traditional wisdom that ties each building type with stories wisdom and complex ideas retained over countless generations. Forms details orientation relationship to site interior planning and language associated with buildings and places all assist with recollection. After looking at structures and their ties to Elders' physical and mental health Indigenous Knowledge concepts of architecture and memory are briefly correlated with theories from neuro-psychology and other occidental sciences. The comparison suggests that Indigenous architecture/ memory correlations contribute detail and insight to our understanding of place and memory. Architects landscape architects and other design professionals might consider the on-going significance of culturally sensitive design and community restoration to Elders' mnemonic and physical well-being.

Biography
After years of private architectural practice in British Columbia, Nancy Mackin completed an Interdisciplinary Ph.D. in Architecture and Landscape Architecture with an interest in the interface among health, indigenous knowledge, and the designed environment. She is currently Principal Investigator on a SSHRC (Social Sciences and Humanities Research Council) grant entitled "Textbook of Indigenous Ecological Knowledge in Northern British Columbia". Nancy is an adopted member of the Nisga'a First Nation.

Mineo Tanaka and Nancy Mackin Architects
100 - 125 West 2nd Street
North Vancouver, V7M 1C5
Canada
mta@direct.ca
nma@direct.ca

Involving Seniors in design of creative facilities: a case study from Vancouver,
As architectural practitioners and educators we present the community-led design process for two separate expansions of a seniors' activity/ creativity centre in southern British Columbia Canada. The first expansion designed in 1993 by Nancy Mackin Architecture involved over fifty meetings with committees formed among the seniors' centre members who range in age from sixty to nearly one hundred years and include retired professors engineers interior designers politician homemakers health care professionals and teachers. The second smaller expansion co-designed in 1999 to 2000 by architects Mackin and partners Mineo Tanaka and Dalia Gottlieb-Tanaka met mainly with a single design committee who were also involved throughout programming design construction and occupancy. During pre-design meetings seniors asked that the architecture provide spaces that would assist them with their creative activities and ultimately with physical and mental health. Committee members explained that the building needs to help all seniors to enjoy a healthy diet physical activity contact with the out-of-doors creative opportunities emotional fitness community involvement and physical safety. Features most likely to facilitate physical and mental strength included clean air in all workspaces particularly woodworking and painting areas; clear circulation and spatial planning to facilitate recollection of where things are and how to access them; adjustable sound systems to suit the hard-of-hearing; cafeteria spaces that provide healthy meals and social opportunities; natural and artificial lighting suited to each task; materials that minimize off-gassing and can remain clean and dust-free; activity spaces that encourage physical and creative activities. Committee members also addressed the psychological benefits of design including access to the out-of-doors from many of the creative spaces; natural materials and colours selected to stimulate ideas and emotions; and of paramount importance the avoidance of anything with an institutional appearance or implication since they found many existing institutions intended for seniors blocked creative expression and damaged their sense of well-being and independence. Through this and other projects we have learned that intensive involvement of seniors in design processes contributes to buildings and landscapes in which people may stay mentally physically culturally and socially connected into advanced age.

Creating Synergy through Science and Art
Creating Synergy in an Adult Day Centre Creating Health Promoting Environments Keep the music keep the art keep the Massage and Don't stop Dancing! In an Adult Day Centre there is a synergy that is created in not only how the focus is on a sense of family and community but through the blending of Art and Science. There is provision for the physical health and Nursing knowledge in planning activities that are health promoting. There is an equal provision for the spiritual and emotional and the development of relationships that creates the link between the Art and Science. It is through how programs are developed such as art massage music singing dancing intergenerational connections as well as physical activities that nurture self-esteem and brings a diversity of people together for fun. Within this structure individuals have an opportunity to have a sense of belonging creative expression and sense of purpose within a caring environment. Staff volunteers schools artists musicians family and community come together to create this salubrious environment. In this presentation I will be working with Adult Day Centre Staff Music Therapist Art Therapist from the Kootenai Art Institute and Massage Practitioners as well as other community members to develop an overall view of the importance in working in collaboration to create successful interventions and most of all creative solutions that enhance the quality of life for people who are challenged with dementia.

Biography
I am a Registered Nurse graduated in 1969 from the St. John's General Hospital in Newfound land. I have been living in British Columbia since 1970 working in a variety of health service areas from Psychiatric Nursing, Operating Room, Medical and Surgery units. In 1983 I began to work psycho geriatrics both in the facility and community as a Nurse/Manager at an Adult Day Center. This position has allowed me to combine my love of music and dancing with my role as a nurse. My work is focused on the psycho social model creating an environment that combines Science and Art that nurtures people to function at their highest ability enhancing the quality of lifefor people who are challenged with Dementia.
"We find greatest joy, not in getting, but in expressing what we are... The happy man is he who lives the life of love, not for the honors it may bring, but for the life itself." - R.J. Baughan

Best Practice: Responsible Research with Vulnerable Populations
The term 'vulnerable populations' has been described as groups within society against whom inequity and injustice have been enacted including sex/gender race culture sexual preference socioeconomic status and age. This presentation provides an overview of the nature of ethical behaviour with respect to vulnerable human subjects the challenges faced by researchers and recommendations for responsible practice. The relationship between researchers and participants as well as the policies of institutions are discussed. Integration of ethical practices as these apply to multiple roles and in multiple settings is explored as these relate to working with individuals with dementia.

Biography
Marlene Cox-Bishop Bio-Data
Computer-assisted design, the development of visual literacy in others, and visual communication skills as these affect our lives are primary foci of Professor Cox-Bishop's research and teaching. Here creativity is seen as process as well as product. Enhancement of the built environment can be facilitated through creation of works of art and design. In addition, the Arts can be utilized within a holistic medical treatment model to improve the health and well being of individuals.
Marlene is an artist, designer, and educator. She holds a Doctorate in Arts Education from Illinois State University; a Master of Fine Arts degree from Cranbrook Academy of Art in Bloomfield Hills, Michigan; and a Bachelor of Education degree from The University of British Columbia. Many of Marlene's works of art on paper and textiles are housed in public and private collections in the United States and Canada.

Dr. Cox-Bishop is currently a design professor in the Faculty of Agriculture & Forestry in the Department Human Ecology at the University of Alberta.