As part of 2023’s Experience: Arts, Health and the Older Person event organised in partnership with Réalta, the National Body for Arts + Health in Ireland, we commissioned a reflection on the day by writer, actor and activist Noelle Brown.
EXPERIENCE 2023: An Introduction to Arts, Health & the Older Person.
On Thursday, December 7th, I attended Experience 2023: An Introduction to Arts, Health & the Older Person at the Réalta Centre for Arts and Health at University Hospital Waterford. Organised by national development agencies Age & Opportunity and Réalta, this was the third year of ‘Experience’ and the first in-person iteration, post-Covid. The ‘Experience’ programme was set up to provide practical learning for artists working with or planning to work with older people in health and care home settings.
The speakers, facilitators and artists brought a wide range of perspectives informed by healthcare, varying art forms and experiences working in different care settings. They were:
Dr. Tara Byrne, Age & Opportunity Arts Programme Manager/Bealtaine Festival Artistic Director.
Claire Meaney, Director, Réalta, The National Body for Arts + Health in Ireland.
Dr. Lucy Pollock, Consultant Geriatrician and Author of ‘The Book About Getting Older’.
Tess Leak Interdisciplinary Artist.
Brian Dooney, Facilitator with Age & Opportunity.
Sarah Cairns, Dementia Educator; Activities Director, Bantry General Hospital.
Liam Merriman, Healthcare Musician & Trainer.
Ailish Claffey, Dance Artist and Curator; Dance Artist in Residence at Tallaght University Hospital 2015-2019.
Joanna Hopkins, Visual Artist.
Roger Green, programme participant, in conversation with Maeve Butler, Réalta.
Michelle Read, Theatre Artist & Brian Keegan, Composer. Performance of extract from On a House Like a Fire by Michelle Read.
As an artist who has created a theatre play with and for older people, worked as a performer in care homes, and has a 96-year-old mother with dementia currently in residential care, I was looking forward to this event as I believed it could be interesting to me both professionally and personally. The following is my reflection on some of the presentations and themes raised that spoke to me personally, and the learnings as an artist that I took from the material presented on the day.
The collaborative elements of artistic work with older people, the intended outcomes, and the need to see the individuality of the older person became the most vital themes of the day. These themes were explored comprehensively through a beautifully curated mixture of interactive experiences, discussions, presentations, provocations, personal testimonies and performance, all superbly woven together clearly and concisely.
Healthcare Musician and Trainer Liam Merriman facilitated an interactive group singing warm-up by way of introduction to the day, creating a sense of fun and helping diffuse any nervousness in the room. As a group, who were mostly strangers to each other, we needed to feel comfortable voicing our responses and posing questions about the material being presented throughout the morning and afternoon. The warm-up also provided insight into Liam’s musical work in care settings, which came across as person-centred, comfortable and wholly inclusive.
Tara Byrne of Age & Opportunity and Claire Meaney from Réalta provided the context for the day, highlighting the need for representation and the fundamental rights of older people to access the arts. Tara told us that while the art experience was central for the person, the outcome of a sense of wellbeing was also fundamental. In keeping with Réalta’s aims, Claire spoke about embedding arts in health and said that ‘bringing arts experiences to care homes, health care settings and private homes encourages artists learning as well’.
I found these opening statements significant as I have always felt that artistic projects for and with older people shouldn’t be something niche but a fundamental part of the day-to-day running of health and care home settings. With 80 per cent of care homes in Ireland privately owned and profit-driven, conversations with managements of these homes may need to happen to put further frameworks in place for space, support and funding to facilitate a wider availability for artists to work in care homes throughout Ireland. In this way, we can properly avoid excluding older people from access to the arts in care homes.
Medicine and Arts
‘I know a lot about medicine but little about art; the crossover interests me,’ explained Dr Lucy Pollock, who spoke about the medical aspects of ageing and older people’s contribution to society. According to Lucy, 23 per cent of 80-year-olds in Ireland are providing care for someone else. Over 75’s are also more likely to give to charities and contribute massively to caring for grandchildren. Lucy emphasised that they are net givers rather than takers from the ‘National Purse’.
Lucy’s words were an important reminder, as older people are regularly used as an explainer for hospital overcrowding because of increased health issues, housing shortages because older people want to stay in their homes in older years and also a perception that they are past their ‘usefulness’, as they are no longer earning. Perhaps, as Lucy reminded us, ‘we should remember that we are all apprentice older people and decisions we make now around the care of older people may affect us all in the future’.
Lucy raised the critical theme of the individuality of the older person in informing the medical care that older people receive. Lucy urged carers to find out what the person’s job was and to find out who they are. These personal details are also significant in creating and presenting artistic work for older people and tie in with Lucy’s view that creative art can give older people a voice and help us see the person.
Visual artist Tess Leak sees her work as a way of holding on to the ephemeral, how we hold onto stories. She spoke passionately about her work and introduced us to her Community Museums projects, which were created collaboratively with older people. These included the Museum of Song, a postal project created during the pandemic, the multi-sensory Museum of Country Life, and the Museum of Folklore, which involved collecting stories from older people that culminated in a book and exhibition.
Having worked for twelve years in Arts and Health, she felt that it’s important, when creating collaboratively with older people, to practice the art of listening and make sure two people are involved when documenting stories, one to record and one to facilitate the stories.
As an artist, I was particularly struck by the continued sense of ownership she gave older people over the stories she gathered. She was constantly checking that what she had compiled was accurate, thereby giving an essential element of respect to the person and the stories they shared. While as an artist, she was working collaboratively, ultimately, the details of the stories belonged to the older person.
This attention and respect also influenced how she sought consent from the older person to use the stories. Instead of formally signing a document, she took the view that permission, as opposed to consent, was being sought and facilitated permission being given verbally with a witness present. This struck me as a sensitive adaptation that other artists could make when working with older people.
Tess also emphasised that an artist should go into a care setting with a project that they are really excited about and be prepared for a LOT of talking. What we can make collectively can bring joy throughout the experience, she told us. It was an important reminder for me as an artist, that carefully structuring projects with clear outcomes should always be an essential goal when working with older people.
As a theatre artist, I initially found the prospect of working in a care home daunting simply because it was a world I was very unfamiliar with. Sarah Cairns, presenting on Diverse People in Diverse Spaces, provided a superb toolkit for how artists can work effectively and comfortably with staff and residents of care homes.
According to Sarah, artists must have an induction with the person in charge, including walking the unit with an explanation of the work there. It is essential to choose a check-in person, and every time you are in the care home, check in with them. The staff must also know the artist’s function in the home so it can be written in the care plan, and there must be awareness for them during handovers to prepare the patients.
Artists should also remember that they are weaving into a system rather than standing alone and always acknowledge that they are not care workers and will need staff support. She said questions to ask when being inducted should include:
-Who will join?
-Who to avoid?
-Who’s new or leaving?
-Any falls or risks?
-Are they mobile?
-Is there anything I need to know medically?
-Any literacy issues?
She urged artists to include everyone in the room, regardless of limitations and to find their individual skills. It would help if the participant discovered how they can be their unique selves without pressure and remember there are different realities, depending on cognitive issues. For instance, in situations where short-term memory is an issue, verbal environmental cues are essential. Don’t ask questions, but rather, Shall we…or I was thinking we might, or would you…?
As other speakers throughout the day reiterated, because 93 per cent of our communication is non-verbal, it is crucial that we are clear with our movements. She urged artists to embody what we’re saying and hone our tone of voice when speaking.
Healthcare Musician and Trainer Liam Merriman told us when language fails, music speaks. He sees his work in health care settings as a positive human interaction facilitated by music. What he sought to achieve as an artist in care settings was to find the music inside the person and bring it out gently.
Building on music’s power to connect to the person with the right song or melody can also provoke a chat, conversation, recollection, and banter. Liam creates complexity with his work beyond the older person being simply an audience member. His collaborative approach for both the artist and the older person, I felt, assigns the older person respect and the choice to be part of something if they so wish. Crucially, he reminded us that artists need to remember that they are in someone’s personal space and that we must manage that space respectfully and remain calm and present throughout.
As I was trying to visualise how live music impacted the actual healthcare settings, Liam explained how carers, staff and family can also be part of the experience, sending a collective sense of wellbeing into the wider community.
As mentioned by other artists during the day, he spoke about the need to learn to manage emotional impacts, yours, theirs and even staff sometimes. Do not ignore; always acknowledge that people have permission to feel. He said ‘we can’t cure, but we can strive to improve things and have a positive impact’.
After a beautiful, interactive introduction to her practice with everyone in the room, Ailish Claffey told us that movement is our first language, dance is the poetry of that language, and to move is to become. She highlighted that her practice is less about one body making things happen; it is more organic than that.
Bringing her experience as an artist in residence in Tallaght Hospital for several years, Ailish provided valuable insights into facilitating arts practice in healthcare settings and the importance of maintaining your own practice as an artist to bring your best to the work.
She told us that there are many different ways of making art in healthcare settings and that there doesn’t necessarily need to be a central place to start from when making work. In creating opportunities for yourself as an artist to work in healthcare settings, she emphasised that it is self-motivated and useful to put yourself on mailing lists for arts and health notices like Age & Opportunity and Create.
Making art in health settings obviously cannot happen for artists without funding and support. As an artist who has spent the last fourteen years immersed in numerous funding applications, I was struck by how visual artist Joanna Hopkins clearly and concisely explained the different applications and budgets for funding arts-related projects with older people. She highlighted the documentation required and the importance of documenting your work for follow-up reports to funding bodies, as well as providing valuable insight into your practice. She has learned that you should always overestimate your time working with older people; the pace is slower, and more time is needed to accomplish things.
In keeping with the theme of seeing the older person as an individual, we listened to Roger Green in conversation with Maeve Butler about his experiences and outcomes after participating in a visual arts programme facilitated by Réalta through its Waterford Healing Arts programme.
Interested in learning to draw but feeling blocked, Roger became part of an innovative arts programme, Art at the Kitchen Table, whereby an artist came to his home to teach him the tools to engage in art. He learned the importance of really looking, and though he felt intimidated by colour initially, his confidence grew as the visits progressed.
He told us you have to start where the person is and avoid false praise, which older people can spot and can leave them feeling patronised. For artists, it’s essential to know, according to Roger, that older people’s heads are not always where you think they are. There are often health issues that they have to fight against and, at times, the putting aside of grief. His interest in creating art has continued growing, and he now attends the weekly art workshops at Réalta. He has also moved on to other art forms and draws outside the weekly gatherings ‘when the spirit moves him’. Having been blocked, he is willing to experiment, but drawing will always be his first love he told us.
Maeve spoke about the context for the work at Réalta and the model it presents that could be replicated around the country. Its profile is growing significantly, with waiting lists currently in Waterford City and West Waterford. Both as an artist and with my mother in residential care, I feel these initiatives are fundamental to facilitating wellbeing and quality of life for older people in Nursing Homes. I have seen my mother engaging in creative art projects, which always seem to bring her joy and connection with the artist and the broader community of the care home.
An excerpt from Michelle Read‘s play, ‘On a House Like a Fire’, was a really beautiful finish to the day. The piece, performed by Michelle, was both a funny and moving insight into her experiences of navigating her mother’s journey through Alzheimer’s.
Attending Experience 2023 provided a significant learning curve for me as an artist in approaching making work in health and care home settings. Along with Age & Opportunity’s Toolkit for Arts and Creativity in Care Settings, Experience 2023 is another valuable learning for artists. I hope ‘Experience’ will continue with in-person events at locations around Ireland over the coming years and that the right to access the arts for older people continues to be acknowledged as a fundamental human right. As artists, we strive to make collaborative and fulfilling work outside of care settings; we owe it to older people to bring these same standards and aims when creating artist projects for and with older people. To reiterate Lucy Pollock, perhaps we do need to remember that we are all apprentice older people.
Noelle Brown Actor/Writer/Activist http://noellebrown.com/