Life Is A Stage: Dementia Care and the Dramatic Arts

DESCRIPTION (provided by applicant): Market potential exists for development of works of drama that can be performed in facilities providing care for persons with dementia, and which can involve such residents interactively. This approach represents a logical extension of the I'm Still Here approach to dementia care that is the hallmark of Hearthstone Alzheimer Care, and the title of a recently published book of the same name by John Zeisel, Ph.D., President of Hearthstone Alzheimer Care and P.I. of the current application. Access to the arts, creative expression, and engagement with stimulating activity are elements of a person-centered approach to dementia care. Therefore, the purpose of this Phase 1 project is to create two plays that can be performed in residences serving persons with dementia. One of these will be based on a classical play, e.g., one from Shakespeare, and the other will have a modern theme. We anticipate working with student actors from the Emerson College Dramatic Arts Department, who will perform these plays. These students will be trained by Hearthstone staff in effective communication methods when working with persons with dementia. We will determine if different themes produce differential effects. Participants will be 40 older adults residing in assisted living residences in the Greater Boston area. Specifically, there will be 20 residents from the New Horizons Assisted Living residence managed by Hearthstone Alzheimer Care and 20 residents from New Horizons at Marlboro assisted living residence matched for gender and cognitive status. Older adult participants will be observed taking part in standard large group activities before performance of the plays using a scale designed to assess engagement and affect seen during activities, and then observed during performance of each play. These observations will serve to assess effects produced by the product compared to standard activities programming. All key stakeholders, including residents with dementia, staff members of participating facilities, and family member of residents, will be assessed before the program and after performance of the two plays to determine if perceptions about abilities and capabilities of persons with dementia change after taking part in the program, and will be assessed regarding their satisfaction with the product. Therefore, the objectives of the program are: 1) To create two interactive plays for persons with dementia to be performed in residential settings; 2) To assess whether the type of play - classical theme or modern theme - differentially affects persons with dementia and their caregivers; 3) To determine if engagement is differentially affected by standard programming versus taking part in a play in residents with dementia; 4) To determine if perceptions of dementia and capabilities of persons with dementia, along with quality of life measures, change across time after performances; 5) To assess whether there are differences in the effects produced by the plays across different residential settings and resident samples. PUBLIC HEALTH RELEVANCE: The number of people in the US diagnosed with dementia related to Alzheimer's disease is expected to exceed 15 million by 2050 out of a total of 80 million worldwide. While efforts have accelerated to accurately diagnose dementia as early as possible, and to develop pharmacologic treatments, services for persons with early stage dementia and their families have lagged behind. There is an urgent need today to develop programs that include engaging, stimulating activities and meaningful social roles for these persons. The proposed Life Is A Stage program will help meet this need. It will create interactive dramas for persons with dementia that will be staged within long-term care facilities. Effects produced by the program and satisfaction with it will be assessed, and provide a basis for further development and refinement of this service in a Phase II project.