Mini-Review
“Emergence of Artistic Creativity in Dementia” (Brief Report)
H Lesniewska*
Corresponding Author: Dr Henryka Lesniewska, Doctor in Psychologie, Art-therapist, Psychotherapy Office, 76 rue du Ranelagh, 75016 Paris, France
Received: August 09, 2018; Accepted: August 23, 2018;
Citation: Lesniewska H. (2018) “Emergence of Artistic Creativity in Dementia” (Brief Report). Int J Intern Med Geriatr, 1(1): 5-7.
Copyrights: ©2018 Lesniewska H. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
 

Objective: This publication intend to show the presence of artistic creativity in dement patient’s non-artists, according to my experience of 20 years in art workshops for people with neurodegenerative disorders.

Background: Some authors underline the impairment of the abilities in Alzheimer’s patients with decreasing of visuospatial capacities and loss of motricity. Others note that almost disease creates a technic failure; the products keep a real artistic status. Such creativity can appear with « ingenuous » patients as seen in art-therapy productions.

Method: 70 patients with neurodegenerative disease, participants of an art therapy workshop (45 women/25 men) were selected. 42% of patients suffered of an Alzheimer’s disease, 30% of a vascular one, 14% of an ethylic one and 14% of other dementia. The MMSE score was 13.5 ± 6.2 on 30 and the “House Drawing Test” score was 9.5 ± 7.8 on 25. The weekly sessions of 2 h are livened up by an art therapist and a team leader. The study is illustrated by the case report of a 90 years old woman, affected by an Alzheimer’s disease at advanced stage.

Results and discussion: The results show a decrease of breakdown and behavioral troubles, stabilization of knowledge functions and apparition of a surprising creativity for regular attenders.

Conclusion: The pictorial creativity may be emerging even during advanced stage of disease and among “ingenuous” patients. So, it is therefore important to give a different status for them and that their production becomes a rising value as street art, tags or graffiti. This creativity has a therapeutically impact in affective, cognitive and social functioning of patients.

 

Keywords: Alzheimer’s disease, Art therapy, Creativity, MMSE, House drawing test

INTRODUCTION

The emergence of artistic skills has been documented in patients with frontotemporal dementia [1]. Some authors underline the impairment of these abilities in Alzheimer’s patients with decreasing of visuospatial capacities and loss of motricity [2]. Others note that almost disease creates a technic failure, the products keep a real artistic status: it is the case for artists like Espinel [3], Maurer and Prvulovic [4], Crutch et al. [5] and Fornazzari [6]. However, such creativity can appear with « ingenuous » patients as seen in art-therapy productions [7]. This publication intends to show the presence of artistic creativity in dement patient’s non-artists, according to my experience in workshops for people with neurodegenerative disorders [8]. The participants were enrolled in Arpajon Hospital, not very far from Paris, in Dr. Philippe Barboux geriatric setting. The workshop received 190 participants hospitalized between 1991 and 2012 with various pathologies. For the study the selected 70 patients showed a cognitive deterioration following the criteria of DSM-IVR [9]. They were 81.5 ± 8.4 years. 42% of these patients had Alzheimer’s disease, 30% had vascular dementia, 14% had alcohol-related dementia and 4% presented other forms of dementia. The weekly sessions of 2 h are livened up by an art-therapist and a team leader.

EVALUATION

Before admission to the art workshop, all participants were evaluated with MMSE [10], for drawing ability with House Drawing Test [11,12] and for some subjects, a neuropsychological appraisal with ADAS-cog [13] and Cornel Scale of Depression in Dementia [14]. Their mean score on the MMS was 13.5 ± 6.2 and 79 % had a score below 20. As if a cut-off value of House Drawing Test is 17, mean score of our patients was 9.5 ± 7.8.

RESULTS

Stakeholders have seen progress on several levels:

•      A decrease of breakdown and behavioral troubles, stabilization of cognitive functions, significant improved relations with family and environment, mood and physical state.

•      Technical progress in about 50 % of patients and apparition of a surprising personnel creativity and personal style for 30% of regular attenders.

CASE REPORT

Among 18 cases of creative patients, presented in my recent book [8], I chose this one because it seems to me very reveling concerning art therapy power, even in case of severe dementia. The patient was a 90 years old, right-handed woman, retired secretary at the post office. As documented by her sister, she played the piano and attended museums and exhibitions but without painting. She enters to the hospital for « fall and confusion ». During her stay in hospital she received Prozac 20 mg in the morning and Melleril 10 mg in the evening. The patient shows a deterioration of memory, temporal and spatial disorientation, language abnormality, poor judgment, wondering and a diagnosis of probable Alzheimer’s disease was made. The patient scored 6 on the MMSE and 54 on the ADAS-cog. Her coping of intersecting pentagons was normal but house drawing failed: instead of drawing she writes scrawl « drawing ». The Cornell Depression Scale shows the score of 23 out 38, with suicidal thoughts, psychomotor slowing, frozen mimic and sad faces of crying as well as frequent psychosomatic complaints.

If during the first sessions the patient does not do anything, inconsistent and disoriented, in a few sessions, stimulated by art therapist, she is a little more autonomous: asked to make a spontaneous drawing she sketches very quickly 4 trees on a road after taking a quick look out the window. Her works are sketched quickly in pencil and then ironed with felt or gouache, causing astonishment and admiration of animators. During a year of her participation in the workshop she performed thirty productions in a series of wooded road painted with little colors, between figuration and abstraction. Her mood improves, the behavior is more suitable, and her sister contacted by me to show her drawing board, surprised by these changes will decide her return at home.

DISCUSSION

This one year involvement in the art workshop had an impact on her emotional and behavioral state: a decrease of depression, of neuropsychiatric symptoms and emergence of creativity, surprising in 90 years old woman, no previous artistic experience, with an advanced stage of Alzheimer’s disease. This proves that even in a factual state of cognitive deterioration, there is always a small expressive flame that just awaits a tutor to accompany the creative act. If patients with mild diseases may be able to work independently, those with severe dementia likely require greater structure and creation of a comfortable, stimulating, encouraging environment. Is creativity possible in dementia? Even if judgments on the level of creativity are still relative and temporary, about 30% of regular participants suffering from different types of dementia were considered creative by the animators and training students in visual arts at workshop. If healing is not possible, evolution of the disease through this stimulating activity will be more moderate and slower. Creativity could be considered here as a factor of resilience.

It is therefore necessary to give a different status to the “memory patient” and that their production becomes a rising value as street art, tags or graffiti. Our experience of over 20 years of geriatric art workshop animation allows us to see that pictorial creativity may be emerging even during elderly life of patients: this creativity have a therapeutically impact in their affective, cognitive, social functioning and in their self-esteem.

DISCLOSURE

The author reports no conflicts of interest.

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