Mary had just turned 100 years old and was in the late mid-stage of Alzheimer’s. She and four others with the disease were visiting the Peabody Essex Museum in Salem, Mass., as part of a program called ARTZ, or Artists for Alzheimer’s.
Mary was mute and frail in her wheelchair as she sat gazing at a 23-foot-long scale model of the passenger liner Queen Elizabeth I. The ship, a luxury liner built in the late 1930s, ferried the rich and well heeled from one continent to another. After 15 minutes or so, Mary surprised everybody by speaking up. Gesturing toward the ship, she said, “There were a lot of soldiers involved, and there was a war.”
Leaders of the tour were flummoxed by Mary’s observation. Then she told them, and they later confirmed, that during World War II passenger liners like the elegant Queen Elizabeth were transformed into troop ships.
Connecting art to personal stories
Mary had, in fact, used her damaged brain in ways that thrilled John Zeisel, one of the founders of the ARTZ program and a specialist in Alzheimer’s. She’d made a connection between the art object and her own history, awakened a personal memory and in a way announced that there was still a unique person inside her diminished body.
Zeisel, a sociologist who has taught at Harvard and Yale universities, has designed Hearthstone Alzheimer Care residences in New York and the Boston area—homes that seek new, creative ways to reach those with the disease. In 2002, Zeisel and Sean Caulfield, an artist, began organizing the ARTZ program in New York, with two purposes in mind. First, they wanted to find a way to engage Alzheimer’s patients and awaken whatever feelings and memories were still locked in their damaged brains. Second, they wanted to give artists, caregivers and the public a new way to think about and interact with the person with that disease.
Two years later, ARTZ took its first group of men and women with Alzheimer’s on a special tour of the Museum of Modern Art in New York. Today, ARTZ volunteers lead carefully structured visits to the Museum of Fine Arts in Boston, the Louvre in Paris, the Harvard Museum of Natural History in Cambridge, Mass., and the National Gallery of Australia in Canberra—as well as a number of smaller museums in the northeastern United States. And the list is growing.
Zeisel says his dream is to have cultural institutions in every major city open their doors and develop programs for people with Alzheimer’s.
Visiting these elegant sites, looking at paintings, sculptures and artifacts carefully chosen to rekindle memories and emotions can be an extraordinary experience for people with Alzheimer’s—and for those who love them. The visits are special social occasions, lively outings for men and women who live with this disease.
How art engages people with Alzheimer’s
Zeisel says that while these men and women are losing the ability to link complex thoughts and to think clearly and logically, they rely more and more on reading, understanding and communicating through emotions. One reason—their “hard-wired” abilities still work, he explains. They still have the ability to read facial expressions such as sadness, happiness, fear, disgust, suspicion, disdain and love. And these skills, learned very early in life, can short-circuit logic, even thought, to reach and retrieve long-buried memories. Indeed, observing or making art seems to enhance and take advantage of these skills.
“Alzheimer’s doesn’t take away memory,” Zeisel says. “The part of the brain that’s damaged is the part that gives a person access to that memory. But emotions can revive old memories.”
There are currently 5 million Americans with Alzheimer’s disease, and that number is expected to grow as the population ages. Many of these men and women, rich or poor, loved or abandoned, sit in their own blank world all day. Loved ones give up—why should I go see her, she doesn’t even recognize me?—and wait for a merciful end.
Even when told of the fresh approach to Alzheimer’s through art, caregivers can be skeptical.
“Oh, she couldn’t get to a museum,” says one loving son of his 96-year-old mother, pointing out her ravaged hip joints and anxiety about change. “What would be the point? She never even understands what’s happening on television.”
Awakened memories, new interactions
Zeisel has another question: “What’s the point,” he says, “of medicine keeping us alive longer if we don’t have a life worth living?” In his latest book, I’m Still Here, Zeisel maintains that the Alzheimer’s mind is a working, even creative mind. The average person, he says, has 100 billion active brain cells. A person with Alzheimer’s has 90 billion, which shows there is still a mind at work if only we can discover ways to reach it. For Zeisel, the way into the mind is through the emotions.
“Art touches and engages the brain in a more profound way than other activities,” Zeisel writes.
Although scientific research is in its infancy, decades of anecdotal evidence suggest that arts such as music and painting provide detours around dysfunctional areas of the brain.
A September article in the Lancet Neurology, a British medical journal, notes the establishment of a new institute in London—the International Centre for Research in Art Therapies at Imperial College—to “bring arts-based therapies in from the scientific cold” by conducting rigorous scientific studies.
People with Alzheimer’s are very good at expressing what they think and feel at the moment, instead of editing themselves according to others’ opinions. So they are natural artists and make a natural audience for works of art as diverse as paintings, drama and poetry, Zeisel says.
Zeisel emphasizes that any individual can provide such tours, but urges careful preparation. [See “ARTZ Tours.”]
The ARTZ tours—on days when the museums are closed to the public—are not casual visits. They are carefully orchestrated ahead of time so that participants will be at ease. ARTZ leaders study galleries and other locations for access, configuration and size. Tour leaders are trained to understand the unique skills and needs of people with dementia. They do not quiz those with Alzheimer’s about the name of the art or the artist, or ask them to compare one work with another. Questions are specific. What do you see? Why is the woman in the field?
Even the works of art are vetted ahead of time—by people with Alzheimer’s. At the Museum of Modern Art in Manhattan, for example, ARTZ experts selected 30 paintings they thought might be suitable and showed them to potential visitors. Based on the visitors’ reactions, the experts concluded that 10 paintings weren’t understood at all, 10 were well understood and the remaining 10 fell somewhere in the middle. After this research, ARTZ experts recommended seven of the works, including two from the middle group but none from the not-understood-at-all works.
One special painting
The most compelling painting at MOMA for the Alzheimer’s viewers? The well-loved Christina’s World by Andrew Wyeth, which shows a lone woman in a field with a house in the distance. Zeisel says they immediately see that there is something special about the house. They see the woman in the field longs for the house. “She wants to get to the house. So do I,” one viewer said.
Among the MOMA paintings that confounded or did not at all engage—the huge colorful canvas Broadway Boogie Woogie by Piet Mondrian. Most of the people with Alzheimer’s looked at its pattern of horizontal and vertical lines and asked questions like: “Why would someone hang a tablecloth on the wall?”
At the National Gallery of Australia in Canberra, an ARTZ group pondered a painting called Sunday Stroll by Robert Dickerson, in which a man and his two daughters walk together through a town looking at buildings. They come to one whose windows are all black. Why are they black, a leader asked? The ARTZ group thought they might be dirty, or that the building was unoccupied.
Finally, one woman said “Oh yes, I had the windows done in my house this morning.” Morning was just three hours before, a particularly vexing time frame for a person with Alzheimer’s who has little short-term memory. But she was right—a window-cleaning crew had been at her nursing home that morning. The painting had elicited a memory, small but in the case of this woman, loaded with content. The painting brought meaning to her life through memory of home, of being in charge, of living.
Linda Greider is a freelance writer who lives in Washington.