Bringing Art Education into the Assisted Living Facilities of Brevard County: Benefits, Challenges, and Solutions

ALFs and the Arts in Brevard County
Brevard County is a seventy­two mile long stretch of land on the east coast of Florida which draws individuals from all over the world for their retirement. Persons age sixty­five and over account for over twenty percent of county’s population ((United States Census Bureau, 2013), and there are 113 assisted living facilities in the county (Florida Agency for Healthcare Administration, 2012). My survey of twenty of these facilities revealed that none offer art programming on a level that allows residents to express themselves creatively (Southland, Sonata at Melbourne, Emeritus at Melbourne, Sterling House of West Melbourne, Brookshire LLC, Buena Vida Estates, … ALF Platinum Oaks, 2013).

Kit based crafting activities with predetermined products are sometimes implemented by volunteers, but these emphasize technique rather than creative thought (Barret, 2003). While residents may enjoy participating in familiar crafts from their childhood, “The impulse to create a meaningful culture with members of one’s cohort is powerfully present in elders. With members of their own generation, elders shape many creative responses to the circumstances of old age” (Kirshenblatt­Gimblett, 2006, p. 36), and art educators have the special skills to facilitate this activity.

In addition, none of the facilities surveyed were in contact with artists or art teachers who could offer private lessons for the residents. This is disturbing, for Brevard County has a strong creative culture with much to offer. As the Arts and Cultural sector contributes $72.6 million annually to Brevard’s economy (Economic Development Commission of Florida’s Space Coast, & Brevard Cultural Alliance, 2012), surely the resources for providing creative arts education for residents in assisted living are available, but there is no infrastructure for ALFs to utilize these resources.

Benefits of Art Education for the Elderly
Creativity can play a powerful role in coping with the aging process. As Schmidt (2006) explains, “Artists who remain creatively engaged in later life also show flexibility in thinking and psychological adaptability to degenerative changes” ( p. 29). Schmidt offers prime examples of artists exhibiting this adaptability including Chuck Close, Renoir, Georgia O’Keeffe, and Matisse. Close, a celebrated photographer and portrait artist developed a new method of painting after a spinal blood clot rendered him quadriplegic. Renoir resiliently painted through arthritis, palsy, a stroke, and bedsores devising creative solutions for overcoming each ailment. When O’Keeffe developed macular degeneration she began experimenting with new media and using other painters, her “tools”, to whom she gave detailed instructions for realizing her creations. Matisse also responded to physical handicaps by exploring new media when cancer left him unable to stand at his easel. Rather than despair over his inability to paint, he began to use cut paper and charcoal to execute his work. However, this resilience, focus, and other positive effects of creativity do not exclusively belong to professional artists. There are clear mental, physical, and emotional benefits for all who pursue creative endeavors during old age.

Creative work keeps the brain healthy and active by promoting the development of neotenous traits [fetal and juvenile traits of a species…retained into latter stages of development (Sidelnick, 1993, p. 5)] and neurogenesis [a state of activity that can increase neurological wiring throughout the lifespan (Schmidt, 2006, p. 31]. “The artist hones his or her talent by repeated practice, and the ability to be stimulated by the creative process eventually becomes ingrained within the artist’s neural pathways. This neural circuitry provides the necessary scaffolding to increase the potential to feel inspired and to transcend physical and psychological pain through engagement in creative work” (Schmidt, 2006, p. 31). In addition to the physical impact on the brain, art education provides “opportunities to learn in different modalities and to understand one’s own unique characteristics” (Sherman, 2006, p.4) thereby allowing the student to broaden and adapt their worldview to accommodate the challenges that accompany aging. Engaging the mind in creative activity also slows the process of psychosclerosis, the hardening of the mind (Sidelnick, 1993), to further increase mental flexibility and acceptance of change.

Creative production may also serve an important role in pain management. According to Schmidt (2006), pain­suppressing signals may be activated by visualizing and actualizing valuable experiences that engage the cerebral cortex. When learning to create art, students visualize their work before actualizing it through artistic creation. If this process of imagining followed by doing is regularly repeated, the positive, pain­reducing response will follow habitually. “The anticipation of spending an afternoon creating in one’s studio or enjoying the outdoors with paint and paper stimulates these neurological pathways. The stimulation on these pathways reduces physical and psychological discomfort and increases concentration so that pain can be transcended” (Schmidt, 2006, p. 30). As students learn to slip into creative thinking patterns they are triggering the release of chemicals that promote a heightened state that diminishes pain.

The emotional benefits of art education are also valuable for the elderly as they help to clarify and develop relationships and aid in communication. Sherman (2006) discusses the concept of the arts as a language that helps us “express, discover, and make meanings” (p.43). This is especially valuable for the elderly who experience unfamiliar emotions and must grapple with new emotional difficulties accompanying the aging process. “The arts are a way of engaging older adults in an imaginative exploration of themselves and direct relationship to the world. For some, what they learn through the arts can help them to express the complex, existential issues of aging. The arts also provide therapeutic benefits of building self esteem, coping with stress, opportunities for life review, and recovering from loss or illness” (Sherman, 2006, p. 43).
Teaching art in ALFs addressing the mental, physical, and emotional needs of residents in a way that empowers and validates their identity. By giving these individuals voices, art education also promotes the wholeness of the community. Brevard County would benefit from the perspectives, truths, and wisdom shared by the residents of its ALFs whose participation in the cultural conversation contributes a valuable voice.

Challenges and Solutions
The obstacles for bringing art teachers into assisted living settings are numerous, and the challenge of keeping them in these settings are ever greater. Champion (2013), past president of the Brevard Watercolor Society, used to volunteer teach watercolor in ALFs and offers perspective for artists and teachers who are considering working in an ALF:

“A couple of years ago, BCA [Brevard Cultural Alliance] needed a volunteer to teach at the Wuesthoff Rehab Center in Rockledge, so I did that for about 6 mos as volunteer. It was not easy. I did it because a couple patients there really wanted to learn this. They were all very sweet too, but I have to tell you sometimes it takes a nurse to work with the elderly as I learned,
and it can be very heartbreaking at times too. Plus it takes a lot of skill to maneuver wheelchairs, and adapt for each person’s physical needs and handicaps…some had had strokes etc and some could not use their arms, hands, fingers like they wanted to, some would over flow catheter bags…truly it takes a lot of skill to help at times, and I just wanted you to know that it does go much deeper than just teaching at times. As I watch the ones who had asked for this go down hill, it really did begin to affect me. I love people so much but it was hard for me to watch their decreasing progress too. That’s why I decided if I can teach somewhere, it has to be somewhere like a senior center for me. […] I would volunteer myself, but I am on overload and I need a part time paying job to support myself now.”

It is essential that art educators know what they are getting into before they begin to work or volunteer in an ALF. Regardless of an art teacher’s previous experience, without a willingness to listen, learn, adapt to a new environment, and form open, communicative relationships with nurses and staff in ALFs, it is impossible to create high quality, meaningful work with their students. The risk of burnout it also great, for it can be very discouraging to see the technical quality of student work decline as their health fails. Art teachers must be willing and able to confront death, disease, pain, uncertainty, regrets, despair, and bitterness. Some may be discouraged by this difficulty, yet art educators have overcome such challenges before in schools and prisons, and, though the problems presented by working in ALFs may seem daunting, they are not prohibitive. Alternatively, art teachers in ALFs may also be rewarded with kindness, peacefulness, satisfaction, wonder, companionship, wisdom, joy, and growth. Barrett (2011) shares how powerfully working with the ill, the elderly and their caregivers changed the lives of both students and instructors and describes personal and professional benefits resulting from this work. “I have grown from these experiences. I am more empathetic with all people. I have less fear of aging. I have new respect for the elderly. I gained hope for future work. As a teaching artist, I am more confident and willing to take risks with people with whom I might not otherwise engage” (p. 100).

There are many valuable resources for art educators seeking support in working with the elderly. The National Center for Creative Aging (2012) provides training, consulting, and opportunities for artists and art educators working with aging populations through partnerships with the National Council on Aging and the National Endowment for the Arts. Another excellent resource is Arts for the Aging (2012) which works “to model and promote how very important dignity and compassion are in the care of older adults, and that arts intervention strategies provide accessible and uplifting ways to cope with changing abilities as we age.” The National Endowment for the Arts (2013) also offers resources and a list of organizations that promote arts education for the elderly. With help from these organizations and a determined spirit, art educators may broaden their comfort zones and begin new work in a rewarding field.

What About Art Therapy?
It is important to distinguish between art education and art therapy to understand their relationship with the healthcare system. The American Art Therapy Association defines art therapy as “a mental health profession in which clients, facilitated by the art therapist, use art media, the creative process, and the resulting artwork to explore their feelings, reconcile emotional conflicts, foster self­awareness, manage behavior and addictions, develop social skills, improve reality orientation, reduce anxiety, and increase self­esteem” (American Art Therapy Association, 2013) Art therapy is a mental health profession, and, while art therapists may be more familiar with the healthcare system than art educators because of the nature of their work, most ALF residents do not require the specialized skills of an art therapist to benefit from a creative arts process. Art educators must not assume that addressing the needs of individuals in the healthcare system is some other profession’s responsibility. Rather there is an exciting opportunity for research and work in the development of curriculum and teaching techniques for elderly populations.

Conclusion
The National Art Education Association explains its vision that, “Students of all ages benefit from comprehensive, balanced, and sequential learning in the visual arts, led and taught by qualified teachers who are certified in art education” (American Art Education Association, 2012). It is time for art educators to overcome the obstacles preventing our profession from serving those in the healthcare system and to put a little more emphasis on “all ages”.

References
American Art Education Association. (2012). About Us. National Art Education Association. Retrieved March 1, 2013, from http://www.arteducators.org/about­us
American Art Therapy Association. (2013). AATA about us. American Art Therapy Association. Retrieved March 1, 2013, from http://www.americanarttherapyassociation.org/aata­aboutus.html
Arts for the Aging. (2012). About Us. Arts for the Aging. Retrieved February 3, 2013, from http://www.aftaarts.org/about­us/
Barret, D. B. (1993). Art programming for older adults: What’s out there? Studies in Art Education, 34(3), 133­140.
Barrett, T. (2011). Experiencing art with the ill, the elderly, and their caregivers. Teaching Artist Journal, 9(2), 90­100.
Brevard Cultural Alliance. (2012). Art in public places. Brevard Cultural Alliance. Retrieved February 3, 2013, from
http://www.artsbrevard.org/programs­and­grants/for­artists/art­in­public­places.html
Champion, J. A. (2013, February 2). Judy Champion on her experience as an art educator in an assisted living facility [E­mail interview].
Economic Development Commission of Florida’s Space Coast, & Brevard Cultural Alliance. (2012). The economic contribution of arts and cultural organizations in Brevard County, Florida (Rep.).
Florida Agency for Health Care Administration. Assisted Living Facility Directory. Florida Agency for Health Care Administration, 1 May 2012. Web. 28 Feb. 2013.
Kirshenblatt­Gimblett, B., Hufford, M., Hunt, M., & Zeitlin, S. (2006). The grand generation: Folklore and the culture of aging. Generations, 30(1), 32­37.
Larson, R. (2006). Building intergenerational bonds through the arts. Generations, 30(1), 38­41.
National Center for Creative Aging. (2012). Training and consulting. National Center for Creative Aging. Retrieved February 3, 2013, from
http://www.creativeaging.org/who­we­are/training­consulting
National Endowment for the Arts. (2013). Arts and aging resource list. Arts and Aging Resource List. Retrieved February 3, 2013, from http://www.nea.gov/resources/Accessibility/rlists/ArtsAging.html
Schmidt, P. B. (2006). Creativity and coping in later life. Generations, 30(1), 27­31.
Senior Care Authority Network. (2013). Assisted living in Brevard County (Florida). Assisted
Living in Brevard County (Florida). Retrieved February 2, 2013, from http://www.seniorcareauthority.com/assisted­living/fl/brevard/
Sherman, A. (2006). Toward a creative culture: Lifelong learning through the arts. Generations, 30(1), 42­46.
Sidelnick, M. (1993). Art education: growing old or coming of age? Studies in Art Education,34(3), 141­148.
Southland, Sonata at Melbourne, Emeritus at Melbourne, Sterling House of West Melbourne, Brookshire LLC, Buena Vida Estates, … ALF Platinum Oaks. (2013, January 30). Survey of art activities offered by Brevard County assisted living facilities [Telephone interview].
United States Census Bureau. (2013, January 10). [Brevard County, FL quick facts]. Unpublished raw data.

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