Personhood, QOL, and Well-being in People with Dementia undergoing Creative Arts-based Therapies: A Scoping Review

ABSTRACT

Creative art-based therapies (cABT) provide a creative non-pharmacological approach in therapy to people with dementia and can potentially improve their personhood. This review identified cABT that focused on the personhood of persons with dementia living in residential facilities and determined how quality of life (QOL) or well-being were assessed. Searches were conducted on PubMed, Medline (Ovid), EMBASE, CINAHL (EBSCO), PsycINFO (OVID), and SCOPUS databases, to gather articles from 2010 to 2020. In this review, cABT encompassed art, music, and theater/drama. An overall of five studies were included and, in these studies, art programs were seen in the form of water painting, an intergenerational art program, live music performances, and medical clowns. QOL and well-being were assessed using the Greater Cincinnati Well-being Observation Tool, a QOL checklist, and transcribed from conversations to develop themes on participation and mental well-being. Personhood was promoted through self-expression and self-creativity. Increased number of participants are required for future cABT to further understand the impact the arts may have on personhood, on the QOL and well-being, and enhancing creativity for people with dementia.

KEYWORDS:

• Creative art-based therapies
• personhood
• QOL
• well-being
• residential care

Acknowledgments

We thank our librarian Sarah Visintini for her constant guidance and support during the review process.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Ethical considerations

No ethics committee or institutional review board approval was required for this study as this was a review.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/10400419.2023.2168895.

Notes

1. Perception of QOL in the eyes of a ‘healthy’ person on someone with an illness, can differ from the person with the illness itself (Ettema et al., 2005). Proxies, therefore, can misjudge or underestimate QOL of a PwD (Addington-Hall & Kalra, 2001). A disability paradox ultimately comes to the forefront, as QOL is specific to an individual (Carr & Hagginson, 2001). However, cases where individuals are diagnosed with advanced stages of dementia, a proxy can provide information that the PwD is unable to do so in their current state (Addington-Hall & Kalra, 2001). The debate on proxies and power of attorneys is an important perspective to consider but is not the focus of this review.

2. Note that higher scores in interest, sustained attention, self-esteem, & normalcy indicated higher levels of well-being and lower scores in negative affect and dadness indicated higher levels of well-being (see Table 3 in Gross et al., 2015).

3. Two dependent variables were identified: participation and mental well-being. Participation included human contact, the care relationship, and communication; mental well-being’s subscales were the positive and negative emotions, and communication, which lead to the creation of the observation lists based on the theoretical approaches by Götell, Brown, and Ekman (2003, 2009) and Holmes, Knights, Dean, Hodkinson, and Hopkins (2006). Communication was inclusive in both the participation and mental well-being dimensions of QOL (van der Vleuten et al., 2012) as music was noted to have positive impacts on the communication of the individual.

4. Strength-based psychology (SBP) is invested in the psychological strengths and assets of people (Scheel et al., 2012). In other words, SBP focuses less on the shortcomings or negatives of a person, instead it finds a way to emphasize what is right and helps use it (Psychology Today, n.d.; Scheel et al., 2013, p. 393).

5. The IRR of the GCCWBOT was similar to the average Kappa coefficient value of 0.65 seen in Kinney and Rentz (2005). Gross et al. (2015) calculated the IRR separately for each of the seven domains of the GCCWBOT this was later aggregated from a one-tailed significance level (r = 0.63, df = 10, p = 0.014).

Additional information

Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors