Alzheimer’s disease, the most common form of dementia (representing 50%-70% of all dementia cases) often first manifests as hippocampal disruption. The hippocampus, a limbic structure in the brain, is responsible for the formation of new memories as well as some spatial functions. The hippocampal decay in Alzheimer’s prevents the formation and recollection of short-term memories (interfering with autobiographical memory) and also leads to problems with coordination and navigation, though the hippocampus isn’t directly responsible for some types of memory. Implicit memory, like procedural memories and skillsets that are unconsciously recalled, does not appear to depend on the hippocampus, instead originating from other structures in the temporal lobe. The hippocampal damage doesn’t affect these memories, like how to hold a paintbrush or play the clarinet, and new skills can even be learned.
Art therapies encourage dementia patients to remain cognitively active. Most patients are already familiar with handling art supplies or playing music or dancing, and class-like settings are low-pressure situations that stimulate learning and minimize frustration. Other brain functions are slower to degrade in Alzheimer’s, and these patients can strengthen their neuronal connections and even forge new ones by keeping their brains engaged as often as possible. But one of the most important aspects of Alzheimer’s care is psychosocial.
Alzheimer’s disease is incurable, and no pharmaceutical drug can really belay or halt the progression of the dementia. Therefore, heavy emphasis is often placed in symptom management and eventually complete caregiving, with many in long-term care facilities or nursing homes. Unfortunately, in many cases, strong sedatives and hypnotics are used to control the patient and lessen the caretaker’s burden, which can be detrimental because of myriad negative physical and emotional side effects. In I Remember Better When I Paint, a part-memoir, part-textbook about the incorporation and use of painting therapies in Alzheimer’s care, the editor Berna Huebner describes her mother’s decline from a self-sufficient painter to effectively an invalid, suffering from memory loss and agitation but also depression and listlessness in the nursing home she was moved to, feeling isolated and unstimulated. Huebner notes that these symptoms were alleviated dramatically after specific instances where her mother was allowed to paint in her room, or to teach other patients how to paint. This is firmly in line with the most important aspect of care for dementia patients, that of maintaining a high quality of life. Art therapies have been proven to help stimulate patients by introducing changes in their routine, allowing for physical exercise and movement (even just the act of lifting a brush and stroking paint onto a surface counts), socialization, and emotional release. The low pressure environment of an art therapy workshop discourages some of the frustration and agitation that can arise with other forms of cognitive or behavioral therapies, making it ideal for caretakers as well as for the patients themselves.
The aptly-named “memory care” program at the Brookdale Senior Living compound in Olympia offers art and music therapy sessions there to four times a week, depending; after each two-hour block of “Art with Linda!” or “Music with Bob!” there is a marked change in the residents who participate. I ask one of the nurses there if she sees positive effects she thinks could be contributed to the art therapies, and she answers that she does. “That’s why the afternoon socials and exercise classes are always after the art,” she says. “They seem so much happier and more engaged after those workshops. A lot of our friends here were great musicians or artists when they were younger.” Before the dementia. “We’ve been talking about adding more painting and music to the schedule if we can get our hands on more volunteers.”
It seems to really help with residents’ confidence, I offer.
She laughs and writes something on her clipboard. “Yeah, well, it would probably do all of us some good, then.”