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Getting to know your participants is essential for the success of every program, and in cases like Artful Moments, it is important to have a period, and a process, of observation and ‘assessment’ each session. This does not mean that you should try to diagnose or label their condition, abilities or progression, but simply to use what you see and hear to inform your approach. You can use careful questioning to do this.

Over time you’ll come to know participants by name, by the ways they typically interact and participate in the program, and what their abilities and mindset are like most times. Because of the changes in the brain that happen with dementia, you can see fluctuations in cognition, language and communication, perception, mood and physical abilities. These fluctuations can occur within a session, from one session to the next, and across a program. This is why careful observation is so important.

Start with a fairly open question, and see how people respond. We often use a question like, “Tell me what you see when you look at this painting”. This is an open question, one that is not fact-based and can be answered in a number of ways. Here is what often happens:

  • A person will answer with very concrete, simple observations: “I see a dog, and a man and a woman”.
  • A person will provide a more complex answer: “A man and a woman are talking on a bridge, and she seems to be telling him something”
  • A person may respond with an unrelated answer: ”Today I came on the bus, and I missed my lunch”
  • A person will have difficulty answering.

By listening to the answers each person makes, you will have many clues as to how to proceed:

  • Did they understand the question? Did they look to their care partner for help or clarification?
  • Was it easy or difficult to compose an answer? Did they speak right away, or take time to find the words?
  • Was the answer related to the artwork?
  • What kinds of words or gestures did they use?

Take note of each participant’s response, as your approach will likely be different for each person depending on their abilities. For AGH programs, we do this step at the start of every session, and at several points during a conversation. It is a good practice to test how well your approach is working. In every case, always be prepared to adjust your approach – the rate of speech or vocabulary that you use, the length of sentences, the complexity of the questions, and the type of answers that you ask for. Step questions up or down based on replies. Try to adjust your level of vocabulary to match or suit the level used by your participant when possible. As you facilitate a conversation, be sure to connect with each participant regularly. Use follow-up questions to move the conversation along, or if you observe difficulties, ask that participant a related question in a different way. Have a plan to always be prepared to adapt on the fly.