Patients at an Exhibition

Neurology Now
November/December 2006
Volume 2(6)
p 28–30
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On any other day, the Museum of Modern Art would be bustling with New Yorkers and flocks of tourists. But on this day, the museum belongs to a few dozen seniors who are continually losing parts of their memories and even pieces of themselves. What they hope to find today is a reconnection to the world they once knew.

They're sitting in rapt attention before “Christina's World”— Andrew Wyeth's iconic painting of a woman sprawled in a field gazing toward a distant farmhouse. A museum docent points to the painting and asks, “What do you think she's thinking?”

“She's thinking about the world she lives in and the world she wants to live in,” reflects Sally, a neatly dressed silver-haired woman in a wheelchair.

“She's yearning,” another elderly woman offers.

The discussion grows livelier until the docent asks a final question: “Do you think she's going to get to the house?” As one, the group responds confidently: “Yes!”

If it weren't for all the wheelchairs in the gallery, you might not guess that there was anything different about this group. But, in fact, everyone on this tour has Alzheimer's disease or another type of dementia, or is caring for someone who does. It's a monthly program specifically designed to give people with early to moderate Alzheimer's a chance to be drawn out by the engaging power of art.

The Museum of Modern Art (MoMA) introduced it last January following a series of pilot programs for residents of local assisted-living facilities. It's held on Tuesdays, when the museum is closed to the general public, and offered for free to people with dementia as well as their family members and caregivers. This November's session includes nearly 60 participants, who break up into three groups to make discussion easier.

While art therapy programs that involve making art have become increasingly common for people with dementia, there are still only a handful of programs that involve viewing art. In addition to MoMA's, similar programs are offered by the Museum of Fine Arts in Boston and the Bruce Museum of Arts and Science in Greenwich, Conn.

The Bruce's program is the brainchild of Alice Krause, a docent whose mother had been diagnosed with Alzheimer's several years earlier. As her mother's disease advanced, they found it harder and harder to talk. Their conversations deteriorated to the point where they could only talk about the weather, food, and old snapshots. “It got boring for both of us,” Krause says.

Then one day, Krause decided to try something new. On her regular visit, she brought along a catalog from the Bruce Museum. “I started talking with her about pictures in the catalog, just as I did with school groups,” Krause says. “I picked pictures that had stories that you could easily see, and then we'd talk about the stories. It was enjoyable for both of us—she was often more communicative, and I learned things about her life and how she saw things.”

Figuring that what worked for her mother might also work for other people with cognitive limitations, Krause returned to the Bruce and proposed a new program. She would take copies of prints from the museum's collection to adult-daycare centers and nursing homes, and talk to Alzheimer's patients about art.

Krause usually starts with Jan Verhas's “Broken Flower Pot,” a painting of two children gazing down at the shards of a shattered flower pot on a marble floor. “We can talk for an hour about that one picture,” she says. “I'll ask them what they think happened to the pot, if they think the kids had anything to do with it, what they think might happen next.” She uses props to draw out her participants—a piece of marble like the floors in the painting, fabrics that match the girl's yellow dress and boy's green suit.

“When I start, there's a broad range of reactions,” Krause says. “Some people are very hesitant and anxious, worried that they'll be asked to do something they don't feel comfortable or competent with. Others are very eager to participate. My whole purpose is to help people relax and be drawn into the experience. So I'm very upbeat, and I validate everything that everyone says. If someone notices the girl standing with her left foot tilted, I say, ‘Oh, you see the girl, and the gesture.’”

Figure. NEW WORLD ORDER Looking at “Christina's World,” Irene ponders a master's evocative painting and a MoMA docent's question.

Click here to enlarge

At the Museum of Modern Art in New York City, the docents choose rotating groups of paintings, often organized by a theme—like “places and spaces” or “representations of women in art”—so that the frequent visitors get the chance to talk about new works each time they come. The paintings range from representational works like Henri Rousseau's surreal “Sleeping Gypsy” and Vincent van Gogh's expressionist “The Starry Night” to more abstract works like Piet Mondrian's “Broadway Boogie Woogie.” There have been a few failures—like Roy Lichtenstein's “Bedroom,” which at 12 feet proved too large and overwhelming for most in the group.

But the painting that always provokes the most discussion is “Christina's World.”

Figure. ART APPRECIATION People with dementia look forward to being transformed by paintings in this MoMA gallery.

Click here to enlarge

“To a person, when people look at it, they come up with stories,” says John Zeisel, a founder of Artists for Alzheimer's, a project sponsored by the Massachusetts-based Hearthstone Family Foundation, which helped the MoMA staff create its program. “They'll say, ‘She wants to get home, she's ill, she's tired, she can't make it.’ They also have an incredible insight that nobody else has into the meaning of the work. Christina was the disabled sister of someone who lived near Wyeth's farm in Maine. She crawled around on her hands and knees after having had polio. Immediately on seeing the painting, many of these people will say, ‘She can't move. She can't get up.’”

Is this therapy, or just a pleasant day out?

Since these programs are so new, there's little scientific evidence to document whether the experience of looking at and talking about art offers real cognitive benefits to people with Alzheimer's. But staffers at MoMA and other museums have been made believers by the responses they see in their visitors.

When Sally came to the MoMA program's debut last January, she was hunched over in her wheelchair and barely responsive. The next time, she was like a new person—carefully groomed, wearing makeup, and eager to discuss the paintings. Another participant, who rarely spoke, was inspired by “Broadway Boogie Woogie” to talk about his young, single days in New York going out to nightclubs.

“Being in the galleries is transformative,” says Francesca Rosenberg, director of Community and Access Programs in MoMA's education department. “It's a free atmosphere, where they don't have to fear failure or saying the wrong thing, and they can focus positively on the abilities they have left.”

What's more, they can extend that focus beyond what they have left to what they can recapture.

“Viewing art is a treatment for Alzheimer's because it employs and wakes up the parts of the brain that are still functioning, while putting no pressure on the parts of the brain that are not functioning,” Zeisel says. “While they're engaged in the experience, they feel respected as people. They have dignity. They get their personhood back.”

Margaret Sewell, Ph.D., assistant professor of psychiatry at Mount Sinai School of Medicine in New York City, emphasized just that when consulting with MoMA about the program. “While few would argue that an art program is going to significantly ameliorate the serious cognitive deficits associated with Alzheimer's, there is evidence that art programs might improve behavioral symptoms like anxiety, aggressiveness, and mood,” she says. “It may also have some short-term impact on verbal functioning and increased attention and alertness. Frequently the paintings evoke long-term memories—of being a child, being in love, being young—which are also still preserved. For example, a patient with mild to moderate Alzheimer's disease may not remember what they had for breakfast or your name, but they can often recall their wedding day or mother's cooking in some detail.”

It's also therapeutic for the caregivers as well as the patients, Rosenberg notes. “We know that 70 percent of people with Alzheimer's disease live at home,” she says. “By coming to a program like this, it can relieve the stress and the burden on families and caregivers, and give them a new understanding of their loved ones.”

That's certainly true of the people viewing “Christina's World.” When the docent asks what thoughts are inspired by the painting, one woman responds, “How hard it is to get up!” The laughter that follows from everyone in the group says that they all know just what she means.

Section Description

How the mere act of viewing paintings in a museum can evoke lost memories and engage people with dementia

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