"Play" and People Living With Dementia: A Humanities-Based Inquiry of TimeSlips and the Alzheimer's Poetry Project.

This paper is a humanities-based inquiry, applying Huizinga's framework of homo ludens ("man the player") to consider "play" in the context of two participatory arts programs (TimeSlips and the Alzheimer's Poetry Project) for people living with dementia. "Play," according to this Dutch historian, is at the heart of human activity and what gives meaning to life. Despite empirical research on play across the life course, play in dementia care is a relatively new idea. In addition, there is a dearth of reports based on humanistic inquiry which has slightly different goals than the growing body of qualitative and quantitative studies of participatory arts interventions. Play is not used to infantilize and trivialize people living with dementia but as a way to explore potential for expression, meaning-making, and relationship-building in later life. The arts programs were conducted at two residential care facilities, Scharwyerveld and De Beyart, in the Netherlands over 10 weeks. Close readings of the transcripts and notes from the programs resulted in three observations: people learned to play again, there is power in playing together, and play often led to expressions of joy. Overall, the notion of play may be a helpful framework for future research into innovative arts-based approaches to dementia care.

What affects pleasure in persons with advanced stage dementia?

We examined the impact of environmental, person, and stimulus characteristics on pleasure in persons with dementia. Study participants were 193 residents of 7 Maryland nursing homes who were presented with 25 stimuli from these categories: live human social stimuli, live pet social stimuli, simulated social stimuli, inanimate social stimuli, a reading stimulus, manipulative stimuli, a music stimulus, task and work-related stimuli, and two different self-identity stimuli. Systematic observations of pleasure in the natural environment were conducted using Lawton's Modified Behavior Stream. Analysis showed that pleasure is related to stimulus category, personal attributes and environmental conditions. In the multivariate analyses, all types of social stimuli (live and simulated, human and nonhuman), self-identity stimuli, and music were related to significantly higher levels of pleasure than the control condition. Females and persons with higher ADL and communication functional status exhibited more pleasure. Pleasure was most likely to occur in environments with moderate noise levels. These results demonstrate that these nursing home residents are indeed capable of showing pleasure. Caregivers of nursing home residents with dementia should incorporate social, self-identity, and music stimuli into their residents' care plans so that eliciting pleasure from each resident becomes the norm rather than a random occurrence.

Holistic health promotion: putting the art into nurse education.

The role of the arts in health care and health promotion is enjoying belated attention as a way of promoting people's mental health and well-being. Canterbury Christ Church University offers a course which examines how nurses can use the arts to enhance the health care experience for both staff and patients. The Holistic Health Promotion course is compulsory for all final year pre-registration Bachelor degree students in Adult and Child Nursing. The content and process of the course are described, and the findings from the evaluation data are discussed. Through the use of autobiographical literature, active learning in the classroom, visiting speakers and visits within the local community, the course provides a positive learning experience for many students and broadens their perceptions of how to carry out mental, emotional and spiritual health promotion.