Stuff I need to start thinking about

Ethical approval - if I want to visit any care homes to do any sort of observation/creative workshops (as I am thinking I could do at the moment) I will need to apply for it from the university. What is broadly considered ethically good and do I need to make a plan to prove my research will be safe to carry out? 

Primary research - gathering data; qualitative vs. quantitive, which would be more appropriate? Qualitative would be better for observations and reportage, whereas quantitive would be better for findings to do with therapies (e.g. how many people take part in creative workshops vs. how many are on prescribed drug treatments). 

Images - find images to talk about! Photographs, illustrations, artwork created by dementia patients (potentially as part of a case study?) and whatever else could be relevant.

Practical work! - I sort of forgot we had to do this until now. Start watching documentaries/films and doing observational drawings, as at the moment I have no idea what sort of thing I would want to do for my practical brief. Take a sketchbook round Leeds and draw anything that might be of any use, even if it isn't later down the line. Visit care homes and do observational drawings there (not until ethical approval has been sorted). 

Potential Research Question

"Are creative therapies a better option for enhancing the quality of life of dementia patients than psychoactive drug treatments?"

(19 words)

Issues:

• Might be a bit too long
• Doesn't say anything about the impact of institutional design (does it need to though? Does this get covered in the introduction?)
• I want to say something about the negative psychological symptoms of dementia (again can I just say this in the introduction?)
• It needs to say more about having an overall longterm positive impact on enhancing the quality of life; psychoactive drugs may treat the negative symptoms "better" but have the negative effects like added confusion/risk of stroke.
• Is it a bit vague even though it's quite long?

I struggle every year with forming the actual question for the project, even if I am clear about the idea in my head. I need to speak to a tutor to see what they think and ask for advice on ways it could be improved. 

Other ones I didn't like...

"Is art therapy a viable positive option for increasing the quality of life of dementia patients?"

"Should we be pushing art therapy as life enhancement for dementia patients over psychoactive drugs?"

"Does art therapy have a greater impact on enhancing the quality of life of dementia patients than psychoactive drugs?"

More Research

Library Research - Books

As the LCA library is a specialist arts library, there is predictably very few books that are relevant to the subject I am researching; a few on arts therapies, but they are mainly written on psychological issues such as depression, which is not what I want to focus on. I found a few small pieces relating to dementia but I will have to find another library with a more extensive science and psychology collection to get as many book references as possible (Leeds University or Leeds Beckett University libraries? I will have to find out how I can access them). 

Summary and ideas:

• If someone develops an interest or skill for/within the arts after diagnosis of dementia, it should be encouraged and given a positive focus. It gives the sufferer an outlet, provides an arena in which they can function effectively and something they are good at, when they may be unable to do things they enjoyed or were good at before. 

• Art therapies will not help with curing or slowing down the progression of dementia, but can help with reducing the negative psychological effects associated with the disease. There are many recorded cases of art therapy reducing stress, anxiety, antisocial behaviour, communication problems and other issues. 

• Quality of life is a factor that is heavily focused on and repeatedly mentioned when arguing the positive outcomes of creative therapy for dementia sufferers. This will probably be a major part of the final essay!

• With creative therapies it needs to be taken into account what area of the brain is affected, as some therapies may not work for some that do well for others; for example, music therapy might be a better option for someone who has lost the use of the muscles in their hands. 

• Offers a non-verbal assessment and communication option for sufferers who are language impaired and don't want to/can no longer speak as they used to.

Potentially Useful Article Links

Sensory Stimulation in Dementia: An effective option for managing behavioural problems 
British Medical Journal, 7th December 2002

http://pubmedcentralcanada.ca/pmcc/articles/PMC1124787/pdf/1312.pdf


Multisensory Stimulation to Improve Functional Performance in Moderate to Severe Dementia - Interim Results
American Journal of Alzheimers Disease and Other Dementias, 2010

http://www.snoezelen.info/wp-content/uploads/2016/02/sensory_rooms_functional_preformance_dementia.pdf 


The Journal of Quality Research in Dementia, Issue 1: Drugs for behavioural symptoms in people with dementia in care facilities
Alzheimers Society, 2004

https://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=77&pageNumber=2


Anti-psychotic Drug Use In Older People
British Geriatric Society, 2002

http://ageing.oxfordjournals.org/content/31/4/225.short

Looking at previous dissertations for ideas...

I prefer making notes in a notebook when I am researching rather than typing it straight up onto here; it's more flexible (for example allows me to research on the train/bus as my laptop is big and unreliable) and personally I find it quicker to write than type. I also find it easier to read off of paper than screen, so it's easier this way for when I will be reading it all back. For these reasons I will do my written research blog posts as scans of my notebook, summarising the most important points and findings at the end. 

As I was feeling a bit stumped about how to start, I went to the library to find some dissertations that may have been on a similar topic to get some good ideas of what the dissertation even looks like and potentially good texts. I am happy for my current vague idea to take a different path and change if thats what it takes to be a more refined topic, so looking at other previous projects could (and has been so far) be massively helpful. 

Summary and ideas:

• Can the look and design of an institution affect how people feel and change their emotional responses on a day to day basis? Is this particularly important in care homes, especially in dementia wards, as people can become frustrated and anxious due to not fully understanding where they are and why they are there? Can the colours/lighting they are exposed to have an extra effect on this (for example if it feels especially clinical and they do not remember they have dementia, and wonder why they are in a hospital and not at home)?

• Can other factors, such as sounds and smells, have an added effect? What is assumed to induce the sense of homeliness and comfort and is this taken into consideration?

• Are there certain colours/smells/sounds that could be used to calm down the majority of potentially anxious dementia sufferers in wards? 

• Is it important to invest in the design of wards for the residents health and wellbeing? How many institutions regard this as something important? How many institutions have the budget to be able to do this, and how many would like to be able to?

Thoughts

I have been reading past dissertations and books from the library (will blog the relevant findings next) but I am starting to have some thoughts towards a more refined direction. I 
want to summarise them and write them down before I forget them.

In short...

The types of art therapy that could be potentially used to "treat" dementia would be 'art as a life enhancement' rather than 'art as rehabilitation'. This is because there is currently no cure for dementia and it would not help in stopping the degeneration of the brain caused by the disease, or improve it. However, life enhancement is something I feel very strongly about and that the quality of life for dementia sufferers should be as positive as possible. 

To focus more on art therapy as life enhancement would be a much better direction than art therapy as a whole, as it is more relevant to dementia. I could also focus on factors like the impact of institutional design/exposure to art on the NHS compared to private hospitals and care homes, as this is something that would surely affect quality of life. 

COP 3 - Starting to use my brain again after most of summer

I will come clean straight away and admit I have not done as much work as I should have done up until now. I was busy having too much fun and forgot what the date was. 

I have begun to get my head back into COP by re-reading my proposal - it was written 5 months ago now, and to be honest I can barely remember what I had written. I know I need to seriously start whittling the idea of art therapies and dementia down; pick sub themes and explore them more deeply, rather than looking at the subject as a whole. It is too broad even for 9000 words. 

I potentially like the idea of looking into NHS vs Private treatments for dementia and the availability or choice of creative therapies within these treatments; I don't know what sort of question I would be developing yet. Within this I could look at the use of art and design within healthcare environments such as dementia wards and homes, various creative treatments and have a vast number of studies to research into and reference. I could touch on subjects such as colour and design psychology, what different therapies are available in private hospitals and homes compared to the NHS, and does/could this have any sort of lasting effect on the patients. 

I am interested to find out that if on the NHS, as they have less time and money, they push creative therapies less as some people would deem them less effective than certain medications; for example in calming dementia induced anxiety, as it is easier to shove someone a pill rather than sit down and spend quality time with them. I want to see if the extra money private institutions have to spend on the hospital/care home environment and extra staff make a difference; for example do NHS homes have events staff that can do creative workshops with residents? 

I know these ideas are still to waffly and I still need to condense it all down, but I feel better about it than I did before; at least now there is some sort of direction within all the mess.