Art Museum Program for Seniors With Cognitive Disorders and Care-partners
Condition: Dementia
MeSH terms: Dementia; Cognitive Dysfunction; Cognition Disorders
Study type: Interventional

Summary: 
      As the population ages, there is increasing interest in developing innovative approaches to
      promote and sustain mental and emotional well-being. Recent studies have linked engagement
      with the arts with supporting cognitive functioning, promoting empathy and greater sense of
      life purpose. The need to develop alternative approaches to sustain emotional well-being is
      especially acute for the nearly 6 million older Americans who suffer from Alzheimer's
      disease. There is a need for quality activities that can be done virtually for homebound
      individuals with cognitive disorders and the individuals' family care-partners.

      The investigators intend to institute a 3-session virtual art museum pilot program for
      seniors with cognitive disorders and care-partners using the Visual Thinking Strategies
      approach. The investigators hypothesize that participation in a virtual guided visual arts
      experience will enhance emotional well-being and self-esteem for both seniors with cognitive
      impairment and the seniors' care-partners.
    

Detailed description: 
      A number of innovative programs currently exist nationally that are exploring ways to connect
      to connect older adults with cognitive impairment with the arts. One example is the "Meet Me
      at MOMA" program at the Museum of Modern Art (MOMA) in New York City, which ran a monthly
      program for adults with dementia and the adults' care-partners. Researchers studying this
      program found that participants benefited in terms of improvement in measures of well-being,
      including higher ratings on scales looking at self-esteem and quality of life . Additionally,
      other art-based interventions have shown improvements in well-being and mood for the
      care-partners of individuals with dementia.

      One well-validated approach to engaging individuals with works of visual art is "Visual
      Thinking Strategies". Visual Thinking Strategies (VTS) uses a structured technique to guide
      viewers to engage with visual art that builds on lived experiences and does not presuppose
      any knowledge of art or art history. Previous work has utilized Visual Thinking Strategies in
      educational settings and for clinicians to promote professional identity formation. It has
      not been studied in clinical settings with patients or with individuals with cognitive
      disorders. Yet, this approach may have particular benefits for elders with cognitive
      impairment as it encourages the elders' engagement in the "here and now" and therefore, also
      provides immediate positive feedback and validation to participants. As such, Visual Thinking
      Strategies has the potential to contribute to emotional well-being, self-esteem, and meaning
      for older adults with cognitive impairment.

      Subjects: The Johns Hopkins Club Memory Group consists of about 25 older adults with
      cognitive disorders and the older adults' family care-partners. This group meets twice
      monthly for social interaction and engagement and is led by senior nurse, Andrea Nelson,
      Registered Nurse (RN). As this will be a small pilot program, individuals with cognitive
      disorders and the individuals' care-partners will be individually invited to participate in
      the program by Andrea Nelson, RN. The investigators intend to recruit a total of 4-6
      individuals with early to moderate cognitive impairment and the individuals' care-partners
      for this pilot program.

      Consent process:

      Andrea Nelson, Registered Nurse, will obtain telephone consent from both the individuals with
      cognitive disorder and the individuals' family care-partners. For those individuals who agree
      to participate, Andrea Nelson, Registered Nurse will screen for eligibility and will do a
      Clinical Dementia Rating Scale determination by telephone. Participants will receive a
      written copy of the study by mail.

      Study plan:

      All study dyads will participate in 3 scheduled Visual Thinking Strategies sessions via Zoom.
      Each session will last about an hour and will include a guided discussion of pre-selected
      visual art using the Visual Thinking Strategies approach. It is anticipated that two pieces
      of art will be shown during each session. The three sessions will be scheduled one month
      apart. In advance of each session, participants will be mailed the study instruments listed
      below along with an addressed, stamped envelope to mail the completed forms back to Andrea
      Nelson, Registered Nurse upon completion.

      Immediately prior to the start of each Visual Thinking Strategies art session, both members
      of the study dyad will be asked to complete the following scales.

        1. Rosenberg Self-Esteem Scale- This is a 10-item self-report scale with items answered on
           a 4-point Likert scale from strongly agree to strongly disagree. Although originally
           developed for adolescents, it is considered to be a valid tool for self-esteem
           assessment in adults.

        2. Smiley Face Mood Rating Scale- A pictorial self-report Likert scale with 5 smiley faces
           ranging from very unhappy to very happy Immediately following each art session, both
           members of the study dyad will be asked to complete another Smiley Face Mood Rating
           Scale.

      In addition, after each art session, a feedback questionnaire will be completed by the
      individual with cognitive disorder and a separate feedback questionnaire will be completed by
      the care-partner. The feedback questionnaires will be completed anytime in the subsequent 2
      days following the VTS session. The questionnaires solicit feedback about how enjoyable the
      art session was and what changes in emotional well-being were experienced as a result of the
      art session participation.

      Participants will return the completed Rosenberg Self-Esteem Scales, Smiley Face Mood Rating
      Scales, and post-session questionnaires in an addressed, stamped envelope to Andrea Nelson,
      Registered Nurse.
    

Intervention name(s): Virtual visual art experience guided by Visual Thinking Strategies
Intervention type(s): Behavioral
Intervention description(s): All study dyads (where study dyad consists of a participant with dementia and his/her care-partner) will participate in 3 scheduled virtual visual art sessions via Zoom. Each session will last about an hour and will include a guided discussion of pre-selected visual art using the Visual Thinking Strategies approach. It is anticipated that two pieces of art will be shown during each art session. The three sessions will be scheduled one month apart.
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: dementia; caregiving; self-esteem