Articles from my blog: Musings of a Dance / Movement Therapist
The National Coalition of Creative Arts Therapies Associations (NCCATA) has declared this week Creative Arts Therapies Week.
The first day of my week was quite extraordinary. I ran a monthly dance movement therapy group with people with dementia at a long term care facility. It was, as usual, so very rewarding. Mrs. T. who speaks no English, sits by herself in the same chair at the same table every month for over 3 years, initially shaking her head no, looking more disheveled than usual, remained engaged for the entire 60 minutes, shaking the maraca, smiling and laughing when I mirrored her movement. I don't know what goes on in another person's mind, but it sure looked as though she was grateful for the attention that I paid her. Mr. J., who infrequently participates,cognitively higher functioning than most, when asked if he had any wishes, said he wished for more groups like this. Sighhhh! Where is the funding for such desperately needed groups?
This is a group which I run once a month and have been for the past 3 years. It is not a "typical" DMT group with people with dementia, because it is only once a week, rather than once or twice a week, which would be preferable. Still, the folks there remember me from month-to-month, although not my name.
I am billed as an entertainer. I come in, and staff bring in as many people from the unit as they possibly can. Again, this is far from ideal. There can be as many as 22 residents gathered at once. What makes it most difficult is that they are in big chairs or wheelchairs, and therefore the circle is very big. It certainly doesn't create a sense of intimacy. Still, most of the residents are familiar with the routine which contributes to their feelings of emotional safety, and their willingness to participate.
At first the movements are quite small. I'll hand out props for 2 reasons. First, it helps to have something which makes the movement look larger, so that they have a greater feeling of accomplishment. I stapled together 3 streamers that are arms length. Because it's the Christmas season, I'm using red and green streamers. The streamers are long enough that they billow. Also,if they stuff them into the baskets of their walkers or in their clothes, they can keep them if they like. Life offers them so little in the way of new things, or things they can keep. Also, I don't have to reuse them, so we're not contributing to the possibility of passing germs.
I also have some brightly colored bows. They'll be able to choose the ones they like, and wear them. That's because I want them to understand that they are gifts, each of them contributing to the circle in their unique ways. All will do as much as they can. Even those with the least abilities will likely be alert and watching the others.
I will name each person many times during the course of our hour together, naming them and the movement that I see them doing. I will encourage others to join me in mirroring that person's movement. Only a few will initially respond to my directions.
There are some residents who will wander in and out. One in particular tends to get on the others' nerves. She is very negative with a grating tone, and goes directly up people, intruding on their personal space. She seems to enjoy getting people all worked up. They usually respond with great hostility. But for this hour, I will be her target. I will let her come too close to me. I will reflect her tone, and I will try to catch her off-guard, by dancing and playing with her. I have to be very careful, or she can take offense. For that hour, the others are mostly off the hook. I'll try to incorporate any of their words, movements, moods.
Staff love this group as much as residents. I usually have as many as 1 to 4 staff who join in, and they dance with the residents. I use music that both the residents and the staff like. In the case of this particular group, many of the staff are from the Caribbean, so I make sure to play their familiar music. They will come in when they hear the music that they love, and will invite the residents onto their feet, so that those who can will have a partner. Meanwhile, I dance around the circle with those who are seated and in their wheelchairs.
Here's my playlist, from which I will choose at least some of the
songs related to the holidays:
Christmas Song, Nat King ColeFor one hour, once a month, the residents have a feeling of group cohesion. The staff are pleased to see the residents enjoying themselves. I feel gratified, because they so appreciate the time and attention. I do love working with them, and they deserve nothing less.
Winter Wonderland, Aretha Franklin
Blue Christmas, Elvis Presley
Sleigh Ride, Johnny Mathis
It's Beginning to Be a Lot like Christmas, Dionne Warwick
Santa Baby, Eartha Kitt
Have Yourself a Very Merry Xmas, Judy Garland
Let It Snow, Bing Crosby
Winter Wonderland, Bing Crosby
Frosty the Snowman, Bing Crosby
I Wish You a Merry Christmas, Bing Crosby
White Christmas, Ella Fitzgerald
My Favorite Things, Tony Bennett
All I Want for Christmas, Nat King Cole
Jingle Bells, Dean Martin
Winter Wonderland, Peggy Lee
Baby It's Cold Outside, J Mercer & Margaret Whiting
I've Got My Love to Keep Me Warm, Les Brown
Rockin' Around the Christmas Tree, Brenda Lee
A Marshmallow World, Dean Martin
Feliz Navidad, José Feliciano
Dance often and dance now!
That is the conclusion Richard Powers makes in his article "Use It or Lose It: Dancing Makes You Smarter." Powers looks at the Verghese study reported on in the NEJM article in 2003 in which it was found that dancing frequently had a 76% reduced risk of dementia, more than any activity studied, cognitive or physical. He then looks at the study in the context of other studies, concluding that involving yourself "in activities which require rapid-fire decision making" is most helpful." Dancing integrates several brain functions at once, increasing connectivity. Dancing simultaneously involves kinesthetic, rational, musical and emotional processes." He looks at the kinds of dancing most likely to be helpful. If you work with people with dementia, you'll want to read this article.
Photo by Charles Daniels Gallery
Gradually, the OctabandTM is making its way into the media. In a program about Alzheimer's disease on Chronicle, the OctabandTM was being used just as the wife of a gentleman with dementia was praising Hearthstone Alzheimer Care for their engaging activities. Unfortunately, the OctabandTM was not named, but it was seen.
The other day, friend and colleague Nancy Beardall pointed out a photo of the OctabandTM in JOPERD, The Journal of Physical Education, Recreation and Dance, February 2011 issue. On page 30, there is a photo with the caption, "Students perform the Octopus Story dance." The article is "Strategies for Teaching Dancers of All Abilities" by Theresa and Stephen Cone. Certainly seems a good fit, since the OctabandTM is for All Ages and All Abilities. A numbert of "Inclusive Dances" are described, one of them being "Octopus Story."
"This dance uses a small parachute with plastic streamers tied to the handles [OctabandTM] as a prop to join all the dancers together as they move in different ways to tell a story about an octopus living under the sea. The students hold onto one or two of the streamers as the limbs of the octopus. The teacher calls out different ways to move the limbs, such as up and down, side to side, in and out, or across and open. Students can also add ideas. After exploration, a story is told to support a sequence of movements... "
It's my strikeout and addition of the word OctabandTM because that is what is pictured in the story, and it certainly works better than the contraption described. So if there's anyone out there looking for the "Octopus" pictured in the JOPERD article, you can find it here or on www.octaband.com.
Several years ago Suzy Matheson wrote a lesson plan using the OctabandTM to enhance the octopus image while leading a creative movement group for young children and accompanied by the Beatles' "Octopus's Garden" which she posted to her website movement expressions. You can see a video of Suzy leading a group and using the OctabandTM with children in a piece called "Dance Movement Therapist Suzy Matheson" filmed for The Art of Living and produced by Veria.
Of course, the image of an octopus was what inspired its name. Because an octopus's mouth is in the center, the tentacles reach out into the environment, grasp its food, and bring it to its mouth in the center. That image symbolized the synergy I experienced when leading a successful DMT group with people with dementia. I would reach out to each person in the circle and hopefully bring a little bit of something of them into the center, which would feed the group energy.
Leaders can call it an OctabandTM or not, leaving the imagery up to the group, and people have used it in wildly different ways.
The Friendly News, from Friends Village at Woodstown Fall/Winter 2010 issue has a lovely article about the program that I ran for 9 months there, from January through September 2010.
Results of the training, from my perspective and from the perspective of staff who trained:
"The shifts that have been recorded have been small; but, they do indicate a significant change in the way staff members now perceive people with dementia and their role in improving residents' lives."
"Staff members, incorporating what they learned in the Nonverbal Training classes, utilize music and dance to bring joy to withdrawn residents. Additional positive outcomes have developed from many techniques including staff members offering a resident their hand, moving more slowly, bringing a quieter presence, making eye contact..."
"Participants have reported that they find working with residents challenged by memory issues is now less stressful because they are using techniques they have found to be successful. They also find that residents are participating more in their daily activities."
This training is being offered to dance therapists and caregivers/staff of people with dementia at Kinections in Rochester, NY June 10 - 12. For more information, contact daniellefraenkel@kinections.com.
In "The Acute Effects of a Specialized Movement Program on the Verbal Abilities of Patients with Late-State Dementia" (Alzheimer's Care Today, April - June 2009), Shoshana Dayanim, PhD looks at research studies comparing the effects of engagement in movement programs for people with mid to late stage dementia as compared to control groups and/or engaged in bingo or social groups. In addition, Dayanim presents the findings of a small study which she did in which 22 people on a locked dementia unit in a hospital home were given pre-group and post-group tests. Findings were that
The specialized movement therapy program has the ability to provide immediate acute effects on memory recall of patients with late-stage A.D. After 20 minutes of movement therapy, participants appeared more organized in their speech abilities.
These findings are certainly in line with my everyday experience in leading dance movement therapy groups with people with dementia. People who do not speak prior to a dance therapy group or whose thoughts are disorganized are certainly more focused and demonstrate greater ability to speak, present their thoughts in an organized manner, and/or demonstrate higher level cognitive abilities during group.
I recall Mrs. A. who prior to group was talking about her doctor saying she could not play golf and therefore couldn't come to dance therapy group. (She was probably remembering this from many years prior, as she had neither the ability cognitively nor physically to play golf for some years.) As she talked, she came along with me to the group. Once in group, we were using the Octaband for the first time. Mrs. A. was sitting, focused quite intently on the center of the circle while others stretched and moved. Finally, she announced that we needed to put something on top of the circle to see if we could keep it bouncing there. She was delighted when we tried out her idea and tried to work cooperatively.
I know that such experiences are common among my colleagues. I would love people to comment with their stories of increased cognition and speech after dance therapy groups.
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