Received date: October 12, 2016; Accepted date: October 12, 2016; Published date: November 04, 2016
Citation: Gori G, Zilli I, Pizziolo P (2016) Preliminary Results of a Research Project we Initiated at the Public Day Care Centre (DCC) for Alzheimer “Le Civette” in Florence, Italy. Dual Diagn Open Acc 1:2. doi:10.4172/2472-5048.100026
Copyright: © 2016 Gori G, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Persons with dementia (PWD) still retain an ability to express emotions, to appreciate arts and to take part in creative activities. In this study we investigated the effects of artistic-expressive therapies on the quality of the relationship between PWD and their family caregivers (FC). Our results showed that agitation behaviour is rare during artistic-expression activities, while positive emotions and active participation are very frequent in both PWD and FC. These results suggest a way to improve relationship between the caregiver and the person assisted.
This pilot study investigated the effects of artistic-expressive therapies on the quality of the relationship between persons with dementia (PWD) and their family caregivers (FC). This DCC was founded in 2003 as a semi-residential structure for patients seriously affected by dementia, namely with important cognitive deficits and important psychological behavioural disorders (BPSD). Usually, the increase of BPSD makes families ask for help, and for this reason the DCC is involved in coping with the daily care of PWD and in supporting the FC. The routine activities of our DCC focus on three main aspects: emotion oriented therapy, appropriated use of verbal and non-verbal communication, and family counselling and training.
Previous studies underlined that persons with severe dementia still retain an ability to express emotions  despite the cognitive impairment. Furthermore they are still able to appreciate arts in general and to take part in creative activities [2-4]. Taking into account these findings, we aimed at promoting a better relationship between PWD and FC using Music-therapy (MT), Art-therapy (AT) and Story-telling (ST).
For this purpose we enrolled 5 couples consisting of a PWD and its respective FC (all spouses). PWD, 1F and 4M, were aged 82.1 ± 7.38 (mean ± SD), with a MMSE5 score of 8.60 ± 9.96. FC, 1M and 4F, were aged 77.4 ± 7.72. Each couple of participants underwent 5 sessions (3 MT, 1 AT, 1 ST), each one lasting 45 minutes and facilitated by a qualified therapist .
We evaluated the occurrence of agitated behaviour of PWD during each activity session and during meals (control activity) using the ABMI (Agitated Behaviour Mapping Instrument) . Moreover, we evaluated emotions and participation in the activity of both PWD and FC by means of OERS (Observed Emotion Rating Scale) and MiDAS (Music in Dementia Assessment Scale), respectively [7,8].
Data analysis indicates that
1. Agitated behaviour was present only in the 16% of all sessions of creative activities. In particular, the ABMI score during sessions was similar to those observed during meals (activity session: 0.41 ± 0.95; control activity: 0.35 ± 0.69);
2. in both PWD and FC, the frequency of positive emotions (pleasure: PWD=3.53 ± 0.49, FC=4.17 ± 0.37; alertness: PWD=4.39 ± 0.26, FC=4.89 ± 0.12) was remarkably higher than negative emotions (anxiety: PWD=1.12 ± 0.06, FC=1 ± 0; fear: PWD=1.55 ± 0.46, FC=1.23 ± 0.22; sadness: PWD=1.26 ± 0.22, FC=1.11 ± 0.18).
3. concerning the evaluation of the participation in the activities, the levels of interest (PWD=66.07 ± 29.36, FC=77.69 ± 18.65), response (PWD=67.76 ± 28.11 FC=83.46 ± 16.27), initiation (PWD=57.92 ± 26.44 FC=75 ± 25.52), involvement (PWD=73.61 ± 30.77, FC=88.07 ± 12.59), and enjoyment (PWD=69.23 ± 27,89, FC=76.23 ± 18.85) were prominent in both PWD and FC, although, as expected, FC showed higher values than PWD.
In conclusion, BPSD, which usually reduce the quality of positive interaction in the family, are actually rare during artistic-expression activities. Expressions of pleasure and interest are frequent in every couple, while anger, fear and sadness are quiet absent. These results suggest artistic-expressive therapies enable the couple to experiment new modalities of communication, in a sort of readjustment of the relationship, where a true interaction between peers replaces the asymmetry caregiver/ assisted.
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