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Aging: What’s Art Got To Do With It?

By Barbara Bagan, PhD, ATR-BC

Creative art pursuits provide older adults with multiple benefits, not the least of which is enhanced cognitive function.

Throughout history, artists have known that art provides benefits for both the creator and viewer. Current studies in the fields of art therapy, music therapy, and other creative modalities confirm that art can affect individuals in positive ways by inducing both psychological and physiological healing. We know that, in general, exercising our creative selves enhances quality of life and nurtures overall well-being. We all are creative—not just a select few.

Less well known is the effectiveness of incorporating expressive arts into programs for older adults and patients who are diagnosed with Alzheimer’s disease, Parkinson’s disease, and other chronic degenerative diseases. Recent clinical research validates what some professionals and others who work with older adults have known for years—that making art is an essential, vital component of activities that offer a wide range of health benefits. Several studies show that art can reduce the depression and anxiety that are often symptomatic of chronic diseases. Other research demonstrates that the imagination and creativity of older adults can flourish in later life, helping them to realize unique, unlived potentials, even when suffering from Alzheimer’s or Parkinson’s disease.

Erik Erickson’s eighth and last stage of psychological development culminates in an integration of the individual’s past, present, and future to confront the conflict between integrity and despair. The result can be either despair or wisdom. When older adults pursue activities that are based in meaning, purpose, and honesty, they can attain the wisdom and integrity about which Erickson writes rather than experiencing longing and despair. Therapeutic art experiences can supply meaning and purpose to the lives of older adults in supportive, nonthreatening ways. 

Neurological research shows that making art can improve cognitive functions by producing both new neural pathways and thicker, stronger dendrites. Thus, art enhances cognitive reserve, helping the brain actively compensate for pathology by using more efficient brain networks or alternative brain strategies. Making art or even viewing art causes the brain to continue to reshape, adapt, and restructure, thus expanding the potential to increase brain reserve capacity.

According to Bruce Miller, MD, a behavioral neurologist at University of California, San Francisco Medical Center, while brains inevitably age, creative abilities do not necessarily deteriorate. Actually, the aging brain responds well to art by allowing the brain’s two hemispheres to work more in tandem. This ability to use one’s creativity throughout a lifetime and the impact of crystallized intelligence gained from the years of accumulated knowledge and life experiences, help to cultivate the aging, creative brain.  

Art’s Positive Effects
Gene Cohen, MD, PhD, director of the Center on Aging, Health & Humanities at George Washington University in Washington, DC, and the first researcher to conduct a national longitudinal study on the quality of life, found that the arts have a positive effect on health and illness as we age.

Clinicians and healthcare workers in the field of aging recognize and applaud the importance of Cohen’s work. Although the final results from his groundbreaking study initiated in 2001 are not yet tabulated, positive significant outcomes continue to be documented. As a board-certified art therapist with graduate degrees in art therapy, psychology, and gerontology who designs programs, teaches expressive arts therapy at the university level, and conducts individual and group sessions with older adults, including those with Alzheimer’s and Parkinson’s disease, I can attest to the significance, efficiency, and effectiveness of expressive art activities. Such activities offer a wide range of benefits, including the following:

  • helping individuals relax;
  • providing a sense of control;
  • reducing depression and anxiety;
  • assisting in socialization;
  • encouraging playfulness and a sense of humor;
  • improving cognition;
  • offering sensory stimulation;
  • fostering a stronger sense of identity;
  • increasing self-esteem;
  • nurturing spirituality; and
  • reducing boredom.

Additionally, expressive art exercises constitute innovative interventions to promote self-expression and improve communication with others.

“A picture is worth a thousand words” became a reality when a stately gentleman diagnosed with Parkinson’s disease showed his peers at the day care center a collage he had made from small scraps of colored construction paper that were then glued onto a larger piece of construction paper in an expressive arts session. Prior to that experience, he would silently sit in the back of the art room, observing and listening as others shared their work. When asked whether he wanted to say anything about the collage he had made or whether he wanted to give it a title, he told the group members that the title said it all: “A Scattered, Shattered Life.” Group members nodded in validation, quietly expressing their empathy.

Anne, aged 91 and diagnosed with Alzheimer’s disease, resided in a small group home when her daughter could no longer care for her. The daughter contracted an art therapist to visit Anne once a week in the home to do art with her—something her mother had always wanted to do but, for whatever reason, had not done. In their weekly sessions, she and the art therapist painted, listened to music, and laughed together. Anne regained some of her lost sense of humor, which became apparent when she coyly named a bright floral painting “Yellow, Yellow Catch a Fellow.” She completed three other exuberant acrylic paintings before she died. The paintings now serve as a cherished legacy for her daughter. The daughter used one of the paintings to create a card in remembrance of her mother, which she sent out to friends and family. 

John, recently diagnosed with mild cognitive impairment and early Alzheimer’s disease, had previously enjoyed painting watercolors, filling his home with beautiful landscapes.  After receiving the diagnosis, he had become depressed and gave up painting. His wife contacted an art therapist who came to their home to assist him with painting again. 

At first, John was reluctant to respond to the therapist. The fact that his verbal skills were affected by dementia didn’t help the situation. After a slow start that included trying different approaches, as well as getting John’s medications regulated, he and the art therapist eventually settled into a collaborative creative process. During the sixth session, he drew the entire simple composition on the paper, choosing and mixing his colors, and painted the picture by himself. During that session, the art therapist noticed that he was holding his brush differently and making a variety of brush strokes on the paper to create texture and depth. His hand and arm were remembering how to move, how to paint.

That particular art class provided a breakthrough for John. Rather than his wife inquiring when the art therapist could return, as she always did at the end of each session, John asked the question himself. Prior to that session, John had been enduring the sessions for his wife but not really for himself. Later, he admitted that he had tolerated the classes because his wife thought they helped. But his experience changed, and he recognized that it had. He was painting and once again experiencing pleasure in the creative process.  In addition, he said artistic pursuits provided a good reason to get up each morning. 

These three examples are indicative of some of the ways that art can be implemented in working with older adults. Expressive art exercises are not designed simply to fill a time void. Finding meaning and purpose is important at any age but even more so as we become older. In a parish workshop on expressive art, the leader asked why art is important. An older woman responded firmly and succinctly, “Art keeps us going.” When designed and directed by a trained individual, the interventions provide meaningful and purposeful activities, with specific objectives to address the needs of an individual or a group. 

Summoning Elders’ Creativity
Art can serve as therapy under either of two approaches: art as therapy and art in therapy. Both art as therapy and art in therapy offer outlets for expression. Artists, art educators, and healthcare workers usually incorporate the former approach into their work. This method primarily emphasizes the value of the creative process itself. This method assists individuals in tapping into and expressing their imagination and creativity.

Art in therapy integrates art and clinical psychology. This method, employed by a trained art therapist, pursues therapeutic objectives for the identified client or the group as a whole. This method uses therapeutic art activities to address specific treatment objectives. In addition, these interventions facilitate the mind-body connection that supports healing and recovery both psychologically and physiologically.

Artists, art educators, healthcare workers, and others who are interested in working with older adults through various art media can be trained in classes or workshops to use art as therapy. Education and training to become an art therapist and competent to use art in therapy requires a master’s degree, with specialized education and training in psychology and expressive arts.

Expressive arts, including visual arts, music, dance/movement, writing, and poetry, are empowering tools that can assist in the aging process. Similar specifically designed art activities may serve as therapeutic interventions for those individuals diagnosed with chronic diseases.

In Successful Aging, John W. Rowe, MD, and Robert L. Kahn, PhD, discuss three aspects of successful aging: low risk of disease, high mental and physical functioning, and being actively engaged in life. Expressive art activities promote active engagement in life.  They keep us engaged in life in positive, healthy, and fulfilling ways.

Case studies, observations, testimonials, and articles regarding the significance of integrating art in our work with aging populations are beginning to proliferate around us, both in the United States and abroad. This is an exciting time with current, stimulating research that supports the inclusion and enhancement of art activities into programs for older adults. 

Further ongoing results from Cohen’s study continue to validate the hypothesis. Experts remain hopeful that encouragement and the passion of those working in this area will continue to support additional research related to the importance of incorporating art into programs for older adults. Personal experience suggests that engaging in this distinctive, gratifying work is as meaningful and fulfilling for healthcare workers as it is for the individuals with whom they work as they discover and explore the creative process together.

— Barbara Bagan, PhD, ATR-BC, is a professor of expressive arts therapy at Ottawa University in Phoenix, AZ. Founder of ART & AGING, LLC, she is the author of Expressive Arts, Aging, Alzheimer’s, and Parkinson’s, a manual for artists, art educators, healthcare professionals, and others who work with older adults, and Draw from Within, a workbook for self-expression and self-discovery.