This progression may sound daunting when you imagine designing a program to support the changing needs and abilities of participants, especially in the later stages. It does require careful planning, ongoing reflection and adaptation, and great sensitivity to the participants, but you can create an engaging and meaningful program at any stage of dementia. At the AGH, Artful Moments began in a hospital setting, with people in the middle to late stages of dementia, and now Artful Moments is offered for people who have been recently diagnosed. And the results are significant in all cases.
Artful Moments has proven successful at every stage of dementia. You’ll use different strategies for different levels of ability, and you will begin to see that each person experiences changes in their abilities in different ways.
There is one note of caution. From experiences at the AGH, we have learned that groups with participants at very different stages is not always as successful. Feedback from participants has led us to understand that they are more comfortable in groups with others who are at similar stages.
One reason for this is practical – the approach and activities (which will be explored in subsequent modules) are quite different as abilities change and as a facilitator it becomes difficult to balance significant differences in one presentation.
The second, and more important reason is related to the comfort of the participants themselves. For those who have been recently diagnosed or are in the early stage, adjusting to their prognosis can lead to discomfort or fear, and joining a program with those in the later stages has caused those feelings to grow for some of our participants. For them, the sense of connection with people in similar circumstances builds comfort, acceptance and social support, and for us this is an important part of the program. For those whose journey has progressed, there is less awareness of the changes in their abilities, leaving them more comfortable with, or less aware of the changes taking place with other around them.
It can be difficult to screen participants based on their current stage in their journey with dementia. Abilities may change differently for each person, and from one day to the next. In communication materials, you can carefully address more specific abilities in your participants, and individual conversations with participants and/or their care partners can help to identify those who might be better suited for a different program.