Subscribe to Dance for Connection monthly newsletter here.
I particularly enjoyed this issue of Goddard House February Newsletter. Here's the cover article. Goddard House offers terrific programming for the reesidents and for members of the community.
That Certain Something
By Ginny Mazur and Lance Chapman with Cindy Allard
When we walk onto Olmsted Place at Goddard House, despite the many challenges of memory loss, we find that the residents there are active, engaged and supportive of each other. These may not be the typical qualities that many of us associate with dementia. We’ve seen how much the ability levels of individuals with memory loss are impacted, when caregivers change their responses to them in supporting and
empowering ways. But how do they do it? What is that certain something?
Lance Chapman and Ginny Mazur sat down with Cindy Allard, RT, BSN, Olmsted Program Director, to have her offer some deeper explanations of how this engaging and supportive environment gets created. We tapped into Cindy’s wisdom which comes from her 30 years of experience in this field. She offered us an overview of the many considerations that go into planning programs, hiring and training staff and developing this memory support environment which then allows Olmsted Place residents to act and feel more like themselves. Cindy passionately offered her explanations: “We follow the habilitation model of meeting our residents wherever they are in their minds and emotions. In this model every interaction is considered an activity, part of the program. Meaningful, purposeful programs that connect with emotions are the foundation of care and, they are the spice of life that proclaim, “Feel good, have fun and live in the moment!”
“I’ve been working with older adults for over 30 years after getting a degree in recreational therapy. Over the years, I’ve worked in the full continuum of geriatric and Alzheimer’s care. Several years ago, I returned to school for a BSN in nursing. At that juncture, I truly felt that the people with Alzheimer’s, with whom I was working, needed and deserved more. I earned my nursing degree to broaden and deepen my work so that I could fully understand the needs of the whole person (mind, body and emotions) and have that knowledge translate into the high quality of care and programming residents experience each day on Olmsted Place.”
“We need to form trusting emotional and physical connections with Olmsted residents. We do this by responding to their invitation for us to engage with them in their space and world. It’s important not to initiate, but instead to wait to enter their personal space with their permission. When we wait for them, we earn their trust. That trust helps us develop a flow to each day on Olmsted Place. From early morning until 8 p.m. we are guiding people to and from activities, responding to all that we know about the individual. Groups begin with invitations to participate, introductions and greetings. There is a transition phase as we begin each program which needs to be engaging and focused without too many distractions or too much stimuli. People are welcomed by name and referenced by what’s important to each individual. It’s essential to know everyone and take time for that process of reintroduction many times each day. From there, we can emphasize shared connections and relationships that engage and build community.”
“During each program or activity, residents are asked questions in a failure-free atmosphere and allowed to experience the success of that. This allows residents to regain confidence and self-esteem which so often is lost with dementia. Olmsted staff members are constantly assessing the right balance of stimulation to maximize group participation. Staff, then, remind each resident of how much they enjoyed a past similar experience to have them evoke those emotions again, which frames the personal, emotional context for participation and their connection to their life. This technique offers structure, comfort and familiarity but always with a flexible back-up plan. If the group conversation is going in a direction all are interested in, there’s no need to intervene even if it goes off on a tangent – treasure those moments of full engagement.”
“At the end of each program we leave plenty of time for a recap of what has been covered and learned. This wrap-up phase also helps to wind-down and guide participants to the next activity so they do not feel idle, bored orlost. Anxiety, worry and pacing come out of boredom, out of not getting one’s needs for engagement met. When a person’s needs are addressed those behaviors occur far less frequently.”
“Finally, I believe this approach works so well because facilitating these real associations to experiences and preferences support each person being related to and having their needs fully considered. This differs for everyone. If I suggest to you, “Let’s go for tea”, and you’re a coffee drinker, we won’t connect. I’ve really got to know you. Caregivers need to evoke positive emotions that remain intact longer. It is essential for our staff to understand that the people who live on Olmsted are educated adults. Yes, they have memory loss, but in the moment, they can be who they always have been and experience having a continued purpose in life. We focus on what they can still do...on the person that is still there. As Maya Angelou said, “People will forget what you said, people will forget what you did but people will never forget how you made them feel.
I was inspired to write this poem as I prepared to present with Dr. Richard Coaten in London this past Monday.
To Dance in an Imaginal World: An Ode to Containment
I see you, imaginary person with dementia
I can be with you in your suffering
if you are in pain.
I don’t have to look away.
I cannot be with all people in their pain.
I don’t feel afraid of the suffering of dementia.
I am not afraid of not-words, not thinking, not-memory, non-rational.
I’m afraid of a world without love.
I can only touch down for a moment or two
to be with you in your despair.
If I stay longer, I won’t be able to help.
I, too, will be stuck in the mire.
But perhaps I can lift you up
and you can lift me up
and then we can touch down again when need be.
You need me to get you started.
and I need you to play
so together we can dance in an imaginal world.
I am looking forward to Richard's and my presention this coming Monday, Jan. 19 in Leeds.
John Zeisel interviewed me for his show on Hopeful Aging for Bedford TV. The video is posted to youtube.
I heard from Magdalena Schamberger, Chief Executive & Artistic Director of Hearts & Minds of the new documentary style film called Hearts & Minds : Behind the Nose. You can see the film here. The film offers insight into the development of the characters of the clowns as well as the affect of this positive programming. At 18:28, begins the part about Elderflowers. Professor June Andrews, Director, Dementia Services Deveopment Centre, clarifies that what Hearts & Minds clowns do is not just entertain, but more importantly, finds out what's important to the residents.
Andrews also speaks of researchers often measuring the wrong things when trying to the assess the affects of a program on a person with dementia. Even though the person may not remember what they did, they have a sort of happy hangover. I love that description, as it certainly fits my experience. In fact, yesterday, sadly, I had an experience of contributing to a person's cross hangover. When I wasn't looking, a lovely woman had folded up my playlist and I could see the tiniest bit of it peaking out of her pocket. When I playfully asked if I might see what she had there, pointing to her pocket, she immediately became irritated and left the group. She came by after the group was over and although she didn't seem to remember me, she expressed feeling disgruntled and walked away muttering and calling me names. The experience left me curious if a different approach might have worked, or if my usual ignoring is the only best response.
On another UK front, unfortunately Inside Out of Mind, a play by Tanya Myers about the experience of dementia care will be playing in the UK after I am no longer there. The description looks very enticing:
Touching minds and hearts, nurses and patients search for love, rhyme and reason on
‘the ward with no name’. Dancing inside out and outside in, the play moves between multiple
realities where time and identity drift apart.
Anything that helps us bridge the worlds between ourselves and those who perceive the world differently would certainly be helpful. And, of course, that would be anyone who isn't us.
One audience member in 2013 wrote: “Compelling performances from a strong cast powerfully invoke understanding of just how important it is to see people with dementia as individuals with rich life experiences. Everyone should see this deeply moving play”.
You can download the flyer here: Download IOOM Flyer If you see the play, please comment or write and let me know what you discovered. I'd love to let people know more.
Embodied persons: drawing on wholeness and creativity in professional practice
An ARTISTIC and HOLISTIC CO-‐OPERATIVE INQUIRY
Saturday 24th January 2015
Queen Margaret University, Edinburgh in collaboration with Moving Forth SCIO
“We may be in a period of exploring the ways in which … we can both be and promote
others’ being, as whole human beings.” (Lincoln & Denzin, 2000, p. 185)
This one‐day co‐operative inquiry is shaped by a vision to challenge dominant perspectives of effective health and social caregiving, embracing a truly holistic and person‐centred approach. New knowledge will be generated, translated and disseminated through an active learning model of inquiry. Lincoln & Denzin (2000) argue that we are in an era when promotion of the ‘whole human being’ is being applauded by educators, researchers, policy makers and strategic thinkers. Whilst the language of wellbeing, mindfulness, compassion, person‐centredness and human flourishing is commonplace in key policy documents, so too is that of fiscal prudency. This is a living contradiction that both challenges and enables the growth of creativity in research, teaching & learning and clinical practice in health and social care.
This day of active learning creates a space to experience and engage with artistic and creative embodied ways of being and knowing. The day offers opportunities to play, debate, discuss, reflect, have fun, engage in co‐operation, think, take risks and share learning.
The day will challenge dominant perspectives of effective health and social care-giving, and explore and embrace a truly holistic and person‐centred approach.
Ways of working
This is not a typical conference with keynote speakers, concurrent sessions etc. Instead we intend to create safe and democratic spaces where collaborative creative‐reflective inquiry can be nourished. The day will be organised to maximise opportunities for participation in creative inquiry as well as time for reflection, discussion and debate. To help create that ethos we have invite some lead creative facilitators:
Donna Newman‐Bluestein, USA - Dance/MovementTherapist, Counselor & Educator
Magdalena Schamberger, Scotland - Clown Doctor, CEO, Hearts and Minds
Jenny Elliott, Northern Ireland, Dancer-in‐Residence, Health & Social Care
Simon Jackson, Scotland, Visual Artist, & Counselor with ‘GroupArtProcess’
Susan Worsfold, Scotland, Theatre Director & Artist, Voice Coach
Allied Health Professionals eg OTs, Physios, Podiatrists, Arts Therapists; Counsellors, Psychotherapists, Psychologists; Nurses; Health and Social Care support workers and managers; Care commissioners; NHS Scotland senior management
Cost -‐ £80 per head
Venue – Queen Margaret University, Musselburgh, Edinburgh, EH21 6UU
My workshop is described thus:
‘Seeing with the Heart’
An embodied approach to care that considers persons first.
How do we convey trustworthiness, warmth, and caring through our nonverbal communication? In this workshop we will explore the basic elements that make up nonverbal communication through expressive movement and dance. Leave the judge at home and come prepared to have fun and be curious.
I will be leading 4 workshops in January in the UK: January 12, London; January 19, Leeds; January 21, Salford; and January 24, Edinburgh. If you're in the UK and you dance or work with people with dementia, please join me as together we make the world a better, embodied place for people living with a dementia. This blog post is about the first 2 only. See additional posts for 2 more workshops.
Together with Dr. Richard Coaten, Jan. 12 at Green Candle Dance in London and Jan. 19 at West
Yorkshire Playhouse, Leeds:
in partnership with “The Knowing Body Network”
“Dancing the in-between”… An experiential Masterclass in Movement, Dance & Dementia
This is a unique opportunity for practitioners with some experience running movement and dance groups
with older people and those with memory problems, coming together to share and learn with two leading experts in the field…
Quality of life is improved, relationships maintained, and resources expanded for older people who engage in Dance Movement Therapy according to the latest findings based on a research study of providers (Brauninger, 2014).
The day will present simple structures and approaches including the use of props, for leading high-‐ quality dance/expressive movement groups for older people, and those with concerns about memory. We will explore the basic elements of dance, Force, Time, Space and Flow, relevant to leading groups, based on the teachings of U.S. pioneer, performer, theorist and teacher, Barbara Mettler and her pupil, dance therapist and educator, Norma Canner. What are the essential skills of group leadership? How might the psychological theories of Donald Winnicott and John Bowlby be relevant to leading groups with this population? How does one develop spontaneity and authenticity? Why is mirroring so effective? And what do any of these have to do with improving the quality of life for people with dementia?
Workshop 1: Monday January 12th 2015
Where: Green Candle Dance Company Ltd, Oxford House, Derbyshire Street, Bethnal Green, London E2 6HG Tel: (0)20 7739 7722
Directions: nearest Underground tube station: Bethnal Green
Times: 09.30am to 4.30pm
Cost: £50 (not including lunch)
Workshop 2: Monday January 19th 2015
Where: West Yorkshire Playhouse, Playhouse Square, Quarry Hill, Leeds LS2 7UP Tel: 0113 213 7700
Directions: nearest rail/bus station is Leeds City Centre
Times: 09.30am to 4.30pm
Cost: £50 (not including lunch)
For more information on course content, please leave a comment for me.
“[P]lay could be the key to discovering the giftedness that is in everyone.” - Stuart Brown
Stuart Brown is one brilliant man. Psychiatrist and founder of The National Institute for Play, his Ted Talk, Play is more than just fun; play is serious, is truly inspiring, shedding a great deal of light on a topic in desperate need of research funding (as is dance/movement therapy).
Brown “first discovered the importance of play by discerning its absence in a carefully studied group of homicidal young males”. In Brown’s studies and interviews of mass murderers, he found the only common denominator was “the absence of play and a progressive suppression of developmentally normal play”.
Wanting to understand more about the role of play led to Brown’s research in the 1980’s. Stuart has learned:
Play emerges early in the development of the relationship between infant and mother. The first type of play is what he calls body play, what dance/movement therapists and certified movement analysts might call exploring and learning through movement, following one’s intrinsic curiosity.
Brown cites Brian Sutton-Smith, "The opposite of play is not work, it's depression.” Stuart suggests jumping up and down and wiggling around purely for its own sake. “You're going to feel better.”
Another type of play is object play. “The human hand and manipulation of objects is a hand in search of a brain and the brain in the search of a hand, and play is the medium by which those 2 are linked...”
Through the chaos of rough & tumble play, preschool kids can learn emotional regulation.There is also spectator play (think spectator sports), ritual play, and imaginative play. Through play, children learn empathy, how to communicate with others, and how to roll with the punches, to be resilient.
“Belonging is a basic human need, fundamental to our sense of happiness and well-being.” IF YOU WANT TO BELONG, YOU NEED SOCIAL PLAY.
Stuart asks, “What does imaginative play do for the brain? . . . NOTHING LIGHTS UP THE BRAIN LIKE PLAY. 3 dimensional play fires up the cerebellum, puts a lot of impulses into the frontal lobe, the executive portion, helps contextual memory to be developed, and, and, and”.
So what is the relevance of play re dance/movement therapy with people with dementia? As dance/movement therapists, we use play, humor, and props, engaging in body play, object play, spectator play, ritual play, and imaginative play!!! In a recent first time group with folks with cognitive deficits, I was introducing myself, offering my hand for a handshake to one woman. When she withdrew from me quickly and dramatically, yet with a twinkle in her eye, I could tell immediately that she was a terrific tease. I spontaneously dropped to my feet in a begging gesture and pleaded with her to take my hand. Everyone in the group laughed, and we were off to a great start. I don’t know about you, but I surely want to light up my brain and the brains of others I come in contact with.
Calvin Hunt, one time general manager of the Alvin Ailey American Dance Theater, said “Part of our job [as dancers[ is the attitude that we carry and the vibe we can create.” That is exactly how I see my job as a dance/movement therapist in working with people, especially those with advanced dementia. That is the main aspect of our jobs, bringing the attitude, and the gift of self, the willingness to let that spontaneous self emerge.
The latest John Zeisel interview on Hopeful Aging aired on December 4 on Bedford TV, Community Access Television. You can see it on youtube. Ellen Soares is the Docent Program Manager at the Peabody Essex Museum in Salem, MA. Soares was speaking about a group of older adults with cognitive challenges who had gone to see the Iris Apfel fashion exhibit. (I saw the exhibit, and it was quite fabulous. See my Feb. 10, 2010 blog post.) Soares described one woman who earlier seemed to have an air of being above it all, who announced after seeing the exhibit,
“I need to postpone dying. There is so much more I need to see.”
Zeisel spoke of the objects in the museum and the experience itself as “the mediating object . . . that is having something in front of you gives you something to talk about. The object beings to grow the conversation. . . The experience is a conversation generator.”
That is exactly what my dance/movement therapy groups intend to do. One of my mantras is “Let’s Give ‘em Somethin’ to Talk About” (Thank you, Bonnie Raitt). It is my intention to provide people with top quality stimuli, whether the clothes I wear, the music, or props, whether octabands (of course), colorful scarves, rhythm instruments with good sound, hats, or the improv itself.
Additional resources relevant to play:
American Dance Therapy Association. Donations to the Marian Chace Foundation of the American Dance Therapy Association support the educational, scientific, literary and artistic development of the dance/movement therapy profession.
Contact Jeff san Tatsuki <firstname.lastname@example.org>
And, by the way, nothing is more likely to make it so than giving. Give the gift of self this year.
Sharon Chaiklin, in an obituary for dance/movement therapist Arlynne Stark, co-founder of the American Dance Therapy Association (ADTA), describes the work they did, "Our work covered the spectrum of all human needs because we live in our bodies. . . We worked with those who had mental health problems, were drug-addicted or had physical problems. And they ranged from children to the elderly. It was a total experience."
Some quotations of Stark's in the article:
"The body reflects personality, so I use movement to identify a person's feelings," said Ms. Stark, who said she welcomed the challenge of working with patients who had severe emotional problems.
"I'm successful with them," she told The Sun in 1978. "And I never know how they're going to be. I get to act out their fantasies with them. They make me a part of their world."
Ms. Stark began her group sessions by taking note of how patients sat in the room and how near they were to fellow patients. She picked up on their eye contact."
Ms. Stark was a certified movement analyst (CMA), who did her final certification project on dance/movement therapy with people with dementia.
It will be fitting for me to offer this workshop in Tokyo this coming Valentine's Day, 2015. I am posting the flyer in Japanese. I hope to offer one translated into the English at some point soon as well.
Thanks to Sue Lembeck-Edens, Board-Certified Dance/Movement Therapist and Licensed Massage Therapist for sending me this essay by Yu-Rong Gao, PhD grad student in neuroscience. Yu-Rong participated in some of Sue's DMT groups and initiated a group for the nursing home residents. The essay below is her way of sharing this experience. I am including it in toto.
Dance Evoked Memories: A Dance Practice as a Neuroscientist
Voluntary locomotion promptly increases neural activity and local cerebral blood flow in certain brain regions, which is the subject I, a neuroscience PhD student, study at Penn State. At the same time, I am a Ballet, Modern and Chinese Classical dancer and practice dance on a daily basis. Personally, I love dance, because it helps me forget sad things and recall good memories.
This summer, I volunteered in a Dance/Movement therapy group under the guidance of Sue Lembeck-Edens, BC-DMT, in a local nursing home at State College, PA. I wanted to experience what Dance Therapy was like with older individuals. After several weeks of initial observations in a morning stretch session at the facility, I came up with a dance project for the residents to diversify their daily exercises with dance moves and music. At the same time, I wanted to see how dancing will help with social interaction for the elderly. The main idea of this project was to create a dance by working together with the residents and using dance as a way for people to relate to one another. With some discussion and helpful suggestions from Sue, we decided our dance theme was ‘Summer Memories’ since we would dance three months throughout the summer. We came up with some simple movements, dance combinations, and group activities to encourage the participation. These became the dance frame. In addition, we found some poems about summer to evoke participants’ memories about summertime.
For 8 weeks, there were about six residents who attended the group. The residents are in their 70s-80s, all in wheel chairs. Most of them have age-related dementia (memory loss, trouble to focus and pay attention) of varying degrees and need 24-hour skilled nursing care. The Therapeutic Recreation staff chose the residents for the group based on their knowledge of the resident’s interests and abilities.
Each group session started with introductions and warm-up exercises done specifically to activate the major muscle groups and open joints. As their bodies relaxed and opened through movement, the residents gradually got to know the leaders and opened up about their summer memories. The highlight of the dance came with everybody sharing one of his/her most memorable things about summer and then creating a series of dance movements to narrate the story again with body language. Here are some of the memories and the movement people shared during the group:
Mike: “I remember teaching tennis to kids and adults.” Mike actually taught us some upper body movements like a tennis serve; tossing the ball up with one hand and striking it downward with the other as he did when he was a tennis coach.
Pat: “I lived on the water. I personally like sailing. My sailboat was red. We had races. There was room for 2 people in the boat; somebody steering and somebody screaming! In1940 a hurricane came and smashed the boat against the rocks…that was the end of our boat.” Pat described many details about the good time they spent with the boat and expressed the pity that they lost the boat in the storm. Her story brought everyone to an imaginary boat as we waved side to side as if we were in the sea.
Most of the residents in this group were native Pennsylvanians, many from the same local regions. As time went on, residents found that they happened to go to some of the same places or even came from the same communities.
Dorothy: “We escaped from Shamokin and spent summers in Eagles Mere. I swam and played in the sand with my brother Joe. Shamokin Creek was black from coal, as black as the ace of spades.” Dorothy recalled that she thought creeks were black until she married and left Shamokin. Then she realized that not all creeks had coal washed in them.
Anita: “We went to Atlantic City from Kulpmont which is near Shamokin. We walked on the boardwalk.” The group moved their feet as though walking on the boardwalk reminiscing about what they had seen, smelled and tasted, like salt water taffy!
Jeff: “From Philadelphia, we went to Atlantic City in the summer. We ate lunch and played in the sand. My sister Cathy and I helped Grandpop dig for clams. Grandpop cut the clams open with a pocket knife and ate them all!” Jeff’s memory gave the group an opportunity to reach toward the floor as if it were sand and use our hands in a digging motion to scoop up some clams.
The movement experiences offered participants opportunities to connect with one another and share more of themselves with their summer stories from decades ago. There were times when family members participated in our dance and we got some unexpected effects. When Jeff’s daughter joined our dance, Jeff told his story about going to Atlantic City as a child and digging for clams. His daughter was very surprised. That was her first time hearing this story from her father and through this experience she got to know more about him. I also noticed that when there were family members around, residents tended to participate more in the group especially with encouragement and support from the family members.
Jack: “Back then there was Raystown River. When the water was low we could walk across. The water was up to my neck. We would take the row boat out and sometimes we saw friends taking a bath in the river; they even brought their own soap!”
Among all the participants, Jack stood out as a former tap dancer. He was very excited about telling us his interesting stories about being a tap dancer. During the dance movement activity, he volunteered to teach some basic tap steps to all of us. We realized that tap is a perfect dance form for those people in wheel chairs as its very rhythmic and involves the use of the feet and legs. Jack described the opening of a dance piece he had done before when all the dancers walked onto the stage in a line. Therefore, we reproduced this opening in our dance with people walking in wheel chairs either with or without assistance in a line. It turned out to be a very powerful opening, as everyone was excited to be involved. In one of the last sessions, Jack was so excited during the dance that he suddenly stood up from the wheel chair and danced for one minute with some assistance, although he suffers some leg problems. As a dancer myself, I was so touched and empathized with Jack at that moment. I can imagine I would feel revitalized if I got a chance to dance and to teach others dance when I am in my eighties.
My experience this summer illustrated for me what we now know in neuroscience about the importance of dance. Scientifically, dance has been known to be the only physical activity to offer protection against dementia1. Dance involves the integration of music rhythms and coordination, requiring complex somatosensory-motion system activation and synchronization of many brain regions2, such as superior temporal syrus for hearing music, frontal lobe for motion planning, cerebellum for motion coordination, and basal ganglia for motion prediction and so on. Dance generates new neural networks helping to maintain and improve our mental intelligence. Combining dance with other social activities, as we created in this program can improve cognition in older adults.
1.Verghese, J. et al. Leisure activities and the risk of dementia in the elderly. The New England journal of medicine 348, 2508-16 (2003).
2.Brown, S., Martinez, M. & Parsons, L. The neural basis of human dance. Cerebral cortex 16, 1157-1167 (2006).
Yu-Rong Gao is currently a fourth year PhD student at the Pennsylvania State University majoring in neuroscience, minoring in statistics. She started dancing at age four and trained in pure Chinese Classical Dance for ten years. After she came to the United States in 2011, she resumed dance but included ballet and modern dance and co-founded a Chinese Dance Club at Penn State. Her interest is in benefiting people with/without neurological diseases by means of dance and music, and her belief is that arts, especially dancing, are the source of happiness without boundaries. Contact email: email@example.com
Susanna Lembeck-Edens is a graduate of Penn State University and of the Goucher College Dance/Movement Therapy program. Sue’s background in Creative Modern Dance serves her well in working as a Dance/Movement therapist, a licensed massage therapist and a wellness educator. No matter which “hat” Sue wears, she specializes in working with older adults; engaging and enhancing the physical, emotional, spiritual and social aspects of life. Sue believes that through movement and dance, opportunities for real connections are made and meaningful experiences are shared. Contact email: firstname.lastname@example.org