Art therapies and dementia care: A systematic review

Despite steadfast interest in the use of arts therapies (ATs) with individuals who have dementia of the Alzheimer's type (DAT), a systematic review of the literature has not been conducted. This paper aims to critique this evidence base, including music, visual arts, drama, and dance/movement therapies between the years 1990 and 2010, and make suggestions on how it can be strengthened. The review addresses four questions: (1) What is the focus of the empirical base on using AT with persons who have DAT? (2) (How) have these studies been designed and evaluated? (3) What findings are reported? (4) What does this tell us about the potential of AT for enriching the lives of people with dementia? This analysis reveals that systematically designed, documented, and evaluated AT studies are scarce. Information on research design, operational concepts, measurement tools, and methods of evaluation/analysis are vague, if provided. Disagreement exists about the utilization of theoretical concepts and measurement/evaluation tools. The evidence base is further divided between studies focusing on the ‘product’ versus the ‘process’ of art. Shortcomings in dementia-specific research include a paucity of accounts from participants, failure to extend therapies to individuals in the early stages, a lack of application to those living at home, and often superficial attention to the meaningful aspects of doing art. Models investigating subjective well-being, or ‘enrichment,’ rather than objectively measured biomedical approaches privileging the management of deficits, would expand the evidence base and help ensure that those with dementia receive the services they want, since strictly allopathic methodologies will continue to fall short of adequately evaluating what are deeply idiosyncratic psychosocial issues.