Arts for life

In the documentary, “Young at Heart”, a group of seniors, some in their nineties, travels across America performing in a choir. They sing songs from different eras, including their own unique take on the James Brown rock classic, “I Feel Good.” They travel long distances to perform. Nothing seems to slow them down – not daunting health problems, chronic pain, or trouble hearing the conductor. They simply love to sing together, and the social contact seems as important to them as the performance itself.

The documentary shows that age is no barrier to creativity. Whether singing in a choir or taking a painting class, older adults make new friends, rediscover the essence of who they are and find they still have much to contribute. They also report an easing of their pain, an elevation in their mood, and an improvement in their self-awareness and self-esteem.

However, there’s a dearth of hard scientific evidence that participation in the arts measurably improves the psychosocial and cognitive health of older adults. To help address this gap in the research, Baycrest is partnering with The Royal Conservatory of Music on a controlled study titled, “Exploring the impact of artful engagement with older adults.”

With the help of a grant from the Ontario Trillium Foundation, the mixed methods study will be piloted in early 2011. Most participants, ranging in age from 75 to 85, will be assigned to work for 12 weeks with professional artist-educators from The Royal Conservatory’s Living Through the Arts program, in partnership with Baycrest clinicians, on either a story-telling or a creative movement project. The remaining participants will be assigned to the control group.

The artists, who have been trained by the Conservatory in arts-based learning, will receive additional training in how to work with seniors. Participants in both groups will be assessed using the same set of quantitative measures before the study begins and again, at the end, to see if there have been any improvements.

Study coordinator Melissa Tafler, a social worker at Baycrest, says that the artful engagement study will also use qualitative measures. “We will conduct in-depth interviews with participants and artists to understand their experiences. And we are hypothesizing that the clinicians who worked with the artists will inform best practice around how these kinds of groups might be run in the future within a health-care setting.”

The research team involves four researchers – two from Baycrest, one from the Toronto Rehabilitation Institute and one from The Royal Conservatory. Each researcher will bring her own professional perspective to the study.

Cognitive psychologist Dr. Nicole Anderson, a senior scientist in the Kunin-Lunenfeld Applied Research Unit at Baycrest’s Rotman Research Institute, will be looking for improvements in verbal skills in the story-telling group. She will also assess participants’ ability “to hold verbal information in mind and manipulate it,” as well as their verbal fluency – that is, how fast they can tap into their store of general knowledge when story telling.

So-called “executive functions,” including the ability to sustain and switch attention and to transfer information between the brain’s two hemispheres, will also be measured before and after.

Dr. Takako Fujioka, a neuroscientist in the Rotman Research Institute, will investigate motor control, visual-motor coordination, and music perception. Based on knowledge acquired from her brain imaging research, she has designed pre- and post-assessments that examine abilities related to the creative movement group.

Psychosocial measures, including loneliness and mood, will be used in both the story-telling and the movement groups.

Results for both groups will be compared in the post-assessment process to see if either art form offers more benefit. The findings will also be compared to the control group. Another member of the research team, medical sociologist Dr. Pia Kontos, a research scientist at the Toronto Rehabilitation Institute, says that her interest in the study is based on her “commitment to incorporating arts-based methodologies that have demonstrated effectiveness in other health-care settings to improve the quality of care in longterm care facilities…this study offers an exciting opportunity to explore the unique elements of the arts that are efficacious, for whom they are effective, and under which circumstances.”

For its part, The Royal Conservatory is pleased to be a partner in the artful engagement project, says its director of Academic Research, Dr. Ann Patteson. “In this study, we will be able to add to the evidence from a social science perspective as to the benefits of art-making for older adults. We know that artmaking activities promote greater self-esteem, greater self-awareness, and an increased sense of well-being and empowerment. With this study we will have not only the social science perspective, but also the clinical evidence for what is happening in the brain.” Baycrest’s Bianca Stern, who is leading the integration of arts and healthcare, agrees. “What makes this study unique is that we are taking our knowledge around brain and cognition and the importance of keeping the brain fit, and linking it to our exploration of the art-making experience and its meaning and purpose for participants. If results show that expressing themselves creatively has made participants healthier, more socially engaged and more confident, we want to share that information not just with our own community, but with the wider world. We could support the development of these kinds of arts-based programs in nursing homes and in the community.”

Another important goal of the study, adds Stern, is to “create a replicable, scalable model for training professional artists to work with clinicians not just in hospitals and nursing homes but in community settings.”

One choir member in “Young at Heart” sums it up well. “I sing because it brings me joy.”