understanding the benefits - oclc

Understanding the Benefits

of Scrapbooking as an Art Therapy

Intervention for Individuals with Dementia

A Research

Project Presented to

The Faculty of Springfield College

In Partial Fulfillment

of the Requirements for the Degree

Masters of Science in Art Therapy/ Counseling

By

Rebekah Mekler

2014

Art Therapy and Dementia ii

Table of Contents

Page

Introduction . . . . . . . . . . . . . . . . . . . . . . 2

Methods . . . . . . . . . . . . . . . . . . . . . . . . .5

Participants . . . . . . . . . . . . . . . . . . . .5

Data collection Procedures . . . . . . . . . . . . .6

Data Analysis and Trustworthiness . . . . . . . . . 8

Results . . . . . . . . . . . . . . . . . . . . . . . . .9

Discussion. . . . . . . . . . . . . . . . . . . . . . . 11

REFERENCES . . . . . . . . . . . . . . . . . . . . . . .19

Appendix A. RESEARCH DESIGN . . . . . . . . . . . . . . 21

Statement of the Problem . . . . . . . . . . . . . 21

Definition of Terms . . . . . . . . . . . . . . . .21

Delimitations . . . . . . . . . . . . . . . . . . .24

Limitations . . . . . . . . . . . . . . . . . . . .24

Research Questions . . . . . . . . . . . . . . . . 25

Appendix B. REVIEW OF LITERATURE . . . . . . . . . . . .26

Types of Dementia . . . . . . . . . . . . . . . . .27

Current Treatments for Dementia . . . . . . . . . .29

Effectiveness of Art Therapy . . . . . . . . . . . 31

Challenges of Using Art Therapy . . . . . . . . . .36

Scrapbooking . . . . . . . . . . . . . . . . . . . 38

Scrapbooking and Dementia . . . . . . . . . . . . .40

Art Therapy and Dementia iii

Summary . . . . . . . . . . . . . . . . . . . . . .41

Appendix C. PERMISSION TO CONDUCT THE STUDY . . . . . . 45

Appendix D. INFORMED CONSENT FORM . . . . . . . . . . . 46

APPENDIX E. INFORMED CONSENT FORM . . . . . . . . . . . 48

APPENDIX F. WEEKLY GROUP DIRECTIVES . . . . . . . . . . 50

BIBILIOGRAPHY . . . . . . . . . . . . . . . . . . . . .100

Art Therapy and Dementia 1

Running head: ART THERAPY AND DEMENTIA

Understanding the Benefits

of Scrapbooking as an Art Therapy

Intervention for Individuals with Dementia

Rebekah Mekler

Springfield College

2014


The Benefits of Art Therapy with Older Adults

There are a variety of life changes and challenges

that older adults may experience. Loss of sight, hearing

memory, and mobility are potential physical and cognitive

changes that may occur. When older adults are no longer

able to fully care for themselves, relocation to a nursing

home or assisted living facility may be necessary, as well

as losing driving privileges (Stephenson, 2006). Older

adults who have dementia face even more challenges,

including difficulties with organization, planning,

sequencing, and processing abstract information (Stallings,

2010). They may also experience a decline in judgment,

comprehension, and verbal communication. Approximately

1.4% to 1.6% of individuals ages 65-69 years have been

diagnosed with dementia, and 16% to 25% of people over the

age of 85 have the diagnosis (American Psychiatric

Association [APA], 2000).

While current treatments will not cure dementia, there

are interventions that may reduce the effects that the

disease has on an individual's life, and provide the

individual with a sense of hope (Safar & Press, 2011). Art

therapy is one type of intervention that uses creativity

and art making to enhance and improve the mental, physical,


and emotional well-being of individuals of all ages

(American Art Therapy Association [AATA], 2013). According

to Stephenson (2006), the visual arts can help individuals

who have dementia and physical impairments further their

creative growth. Some older people who have dementia have

reported a sense of purpose, relief from loneliness,

feelings of achievement, and increased morale from

participating in art based activities (MacGregor, 2006).

Beneficial goals of art therapy with individuals who have

dementia may include focusing on a person's strengths, and

learning to perceive aging as a valuable asset that can

offer life experience and wisdom (Stephenson, 2006). Art

therapy and creativity can evoke the memories and emotions

of older adults, and provide the opportunity to explore

both past and present experiences. Interventions and

activities that incorporate life story work can be helpful

to older people who have difficulties speaking for

themselves (Puyenbroeck & Maes, 2006). Reminiscence and

life review have been used for many years as an art therapy

intervention for older adults and individuals who are

terminally ill (Stallings, 2010). Legacy projects are one

type of life review intervention that is used to assist

individuals and their families in creating a product that


can be enjoyed before and after the death of the individual

(Allen, Hilgeman, Ege, Shuster, & Burgio, 2008). A legacy

project may include a family cookbook, typed or audio-taped

stories collected from interviews, and a photo scrapbook

(Allen, 2009).

The use of scrapbooking as a therapeutic tool in the

field of mental health is just beginning to emerge

(McCarthy & Sebaugh, 2011). Scrapbooking in a group

setting may allow participants to feel less isolated, more

connected to other, and the participants can validate each

others emotional experiences (McCarthy & Sehaugh, 2011).

There are currently few studies published about using

scrapbooking as an art therapy intervention for older

adults with dementia (Mizen, 2004). The current study is

designed to better understand the benefits of scrapbooking

as an art therapy intervention for individuals with

dementia. The study will examine how scrapbooking with

older adults who have dementia affects mood, self-esteem,

self-expression, memory, and social connectedness.

The researcher expects to find benefits in using

scrapbooking as an art therapy intervention with older

adults who have dementia. These benefits may include an

improvement in mood, higher levels of self-esteem, and an


increase in self-expression. The researcher also expects

to find an improvement in memory and an increase in social

connectedness.

Methods

A qualitative research design will be utilized to

elicit and interpret the thoughts and feelings about the

benefits of scrapbooking with individuals who have

dementia. Individuals who have been diagnosed with

dementia will participate in a 8-week study involving art

therapy. Observations, direct quotes from participants,

and descriptions of participants artwork will be used to

collect data. The subsequent method section includes the

following: Participants, Data Collection Procedures, and

Data Analysis and Trustworthiness.

Participants

Participants will consist of approximately three to

four male and female persons who have mild to moderate

dementia and are between the ages of 60 and 100 years old.

The participants reside or receive services at an assisted

living facility in Western Massachusetts. Participants may

also include care givers, legal guardians, and family

members of the residents. The participants will be asked

to participate over an 8-week span. Participants will be


recommended by the activities director of the assisted

living facility and will be selected based on willingness

to participate in the study.

Data Collection Procedures

After approval is obtained from the Institutional

Review Board at Springfield College, the researcher will

request permission to conduct the study (Appendix C) from

the director of the participating assisted living facility.

The researcher will explain the purpose of the current

study and request permission to present the study to the

administration, residents and their legal guardians. Upon

receiving permission from the director of the facility, the

researcher will explain the study and provide Informed

Consent Forms (Appendix D) to the resident participants and

legal guardians, and participating faculty and caregivers

(Appendix E) prior to the initial interview. Participants

and legal guardians will have the opportunity to ask the

researcher any questions and/or voice any concerns

regarding the research and /or Informed Consent Form. The

informed Consent form will be signed by each participant's

legal guardian and returned to the researcher.

Observations, and art directives will occur in a quiet

space at the facility that is away from distractions and


noise, to provide privacy, and to protect confidentiality.

The researcher will write field notes during and after each

scrapbooking art group. Field notes will include

observations and direct quotes from the participants. Each

week the researcher will take a photograph of each

participants work without any identifying factors. The

researcher will also include feedback and observations from

the activities director of the facility (Appendix E), who

will be present during each art group.

During each art directive, participants who have

dementia will be observed interacting with the project, as

well as with other residents, family members, caregivers,

and faculty. Field notes will also be taken on each

participant's description of his or her artwork.

Information gained from the art directives, observations,

and verbal interactions will be used for data analysis.

The researcher will obtain data in the following ways:

(a) observations (b) field notes, (c) photographs of art

work and (d) art directives.

Observations. Participants will be observed in the

activities room of the assisted living facility. Field

notes will be taken based on participants' interactions

with the art activity, the materials and with the other


participants. Direct quotes from conversations among the

participants and the researcher will be included in the

field notes, as well as photographs of the art work with no

identifying factors.

Art Directives. Participants will be asked to create a

scrapbook over the course of 8 weeks consisting of one 60-

minute session per week. The scrapbook content will vary

for each participant and may include and not be limited to:

family and personal photographs, poems, letters, recipes,

collage, drawings, paintings, and embellishments.

Data Analysis and Trustworthiness

The researcher will code data from the art directives,

field notes, and observations beginning with broad open

coding and then narrowing the data into more defined,

condensed categories through axial coding (Merriam, 2009).

The researcher hypothesizes that participants' mood, self-

esteem, self-expression, and memory will be categories used

in coding. Categories will be condensed into themes until

all data is analyzed and saturation is reached. The

researcher will use observations, photographs, and field

notes, and obtain written and verbal peer reviews from

knowledgeable colleagues, to triangulate the collected

data.


Results

The prevalence of dementia ranges from 1.4% to 1.6%

for individuals ages 65-69 years, and rises to 16% to 25%

for people over age 85 years (The American Psychiatric

Association [APA], 2000). There are few studies published

on creating scrapbooks with individuals who have dementia

(Mizen, 2004). Creating scrapbooks in a group setting may

allow participants to feel connected to others, feel less

isolated, and help validate each others emotional

experiences (McCarthy & Sehaugh, 2011). Creating a

scrapbook is a tangible way to preserve family stories,

legacies and celebrate life events (Kohut, 2011).

This study adds to the currently limited published

research on the creating of scrapbooks as an art therapy

intervention for individuals with early to end stages of

dementia. It was observed that participants in this study

were often able to recall the past when provided with

memory prompts. These prompts included items such as old

and more recent photographs of the participants' families

and pets, diplomas, newspaper clippings, and other personal

memorabilia that were provided by the participants'

families to be included in the scrapbook. At times, some of

the participants' short-term and long-term memory


functioning would fluctuate, while other times both long

and short-term memory would be intact. There were a few

instances where one participant was exhibiting low

functioning in both short and long-term memory.

It was observed that the participants of this study

that have been diagnosed with dementia were able to express

themselves both verbally and non-verbally. Not all

participants were verbally expressive during each group.

However, all participants were able to express themselves

non-verbally through choice of materials, scrapbooking

paper, color and design, selection and placement of pre-cut

words and images from magazines, and selection and

placement of their personal photographs and memorabilia.

All four of the participants were observed to be in a

happy mood the majority of the time, with the exception of

a two times where one of the participants appeared to be

bored and unengaged with the group. Three of the four

participants were observed to be both responsive and

initiating in conversation in almost all of the eight

groups. There were a number of instances where all four

participants, the two facilitators, and the researcher

would engage in conversations on a variety of topics

including age, work, family, men, hobbies, holidays, and


food. It was observed by the group facilitators and the

researcher that all of the participants exhibited positive

self-esteem over the majority of the eight group sessions.

Discussion

Art therapy and creativity can evoke the memories and

emotions of older adults, and provide the opportunity to

explore both past and present experiences (Puyenbroeck &

Maes, 2006). The use of scrapbooking as an art therapy

tool in the field of mental health is just beginning to

emerge (McCarthy & Sebaugh, 2011). The aim of this study

was to understand the benefits of scrapbooking as an art

therapy intervention for individuals with dementia. In

particular, the study examined how scrapbooking affects

mood, self-esteem, self-expression, memory, and social

connectedness.

Four females with dementia participated in the

qualitative research study. All participants live in the

same assisted living community and each utilize a

wheelchair. Participant (HP) and Participant (FT) have

beginning to middle stages of Alzheimer's disease and live

on a residential memory care unit. Participant (MR) and

Participant (MS) have more advanced stages of Alzheimer's


disease and reside on a secure unit where they receive

higher levels of memory care. During each of the eight

week groups, the researcher was assisted by Facilitator

(DC), who is the activities director of the assisted living

community, and by Facilitator (AM), who is an LPN and the

memory care coordinator of the assisted living community.

Facilitator (DC) and Facilitator (AM) provided

scrapbooks for the four participants who have dementia, as

well as scrapbook paper, scissors, glue sticks, and

embellishments (letters, stickers, etc.) Each week, the

researcher offered the participants a different theme as a

way of structuring the scrapbooks. The themes chosen by

the researcher were meant to serve as memory prompts. The

researcher would bring in pre-cut words and images from

magazines that relate to each theme for the participants to

use for their scrapbooks. Each of the families of the

participants who have dementia brought in belongings which

included old photographs, letters, more recent photographs

of the participants, their families, and other mementos

that could be used in the scrapbooks.

From the results of this study, the following

responses offer important consideration: Participant (HP)

is a 97 year old female that has beginning stages of


Alzheimer's disease, and always came to the scrapbooking

group with a smile on her face and in a happy mood.

Participant (HP) worked collaboratively with Facilitator

(DC) during each of the six group that she attended. Her

short-term and long-term memory was consistently functional

during every group. Participant (HP) demonstrated that she

had positive self-esteem during each group session. For

example, when the group was having a discussion about age,

Participant (HP) said, with a laugh,“you are only as old as

you feel, and I don't feel that old”. She was supportive of

other group participants and would show interest in other

participants' scrapbooks. For example, in one group,

Participant (HP) responded to a remark made by Participant

(FT) by asking her “where did you dance in West

Springfield, because I lived in West

Springfield?”Participant (HP) was responsive to others and

initiated conversation in every group except for week

three, which may be due to her recovering from an illness.

Participant (MS) is a 83 year old female in the

advanced stages of Alzheimer's disease. Participant (MS)

worked collaboratively with Facilitator (AM) throughout the

eight weeks. Participant (MS) would come to each

scrapbooking group in a happy mood, with the exception of


week three, when her mood was fluctuating. Her short-term

and long-term memory would also fluctuate from week to

week. There were two groups where Participant (MS)

demonstrated that both her short-term and long-term memory

were functional. During groups two, three, and four,

Participant (MS) did not demonstrate functional long term

or short term memory. (MS) was verbal and responded to

other participants seven out of the eight groups. She

initiated conversations six out of the eight groups.

However, on week three, Participant (MS) entered the group

appearing confused with fluctuating mood. Participant (MS)

was mostly nonverbal during group three, and demonstrated

that both her long and short term memory was not good, and

she did not respond or initiate conversation. Participant

(MS) would shake her hands, make noises, and appeared very

agitated. Facilitator (AM) determined that Participant

(MS) was too overstimulated and overwhelmed that it would

be best that Participant (MS) leave the group for the day.

With the exception of week three, Participant (MS)

contributed in all eight scrapbooking groups. During the

fifth group session, Participant (MS) explained to the

group that she was a fourth grade teacher, saying: “I had

to keep there minds interested in what I taught. It was


never about me but always about them. I always wanted to do

something that helps others.”

Participant (FT) is a 90 year old female with early to

moderate Alzheimer's disease. The researcher worked one-on-

one with Participant (FT) for all eight weeks. Participant

(FT) came to every group in a happy mood and with positive

self-esteem. Participant (FT) demonstrated excellent long

term memory, however, her short term memory was not as

functional. With the exception of two groups, Participant

(FT) would express that she was aware that she was

repeating herself. Participant (FT) was able to remember

events and people from the distant past, including her

childhood and most of her adulthood. For example,

Participant (FT) was explaining to the group about an old

photograph that she put into her scrapbook, and said: “that

was a country house in northern New York, 25 miles from

Canada, and, ah,... what was I going to say? This happens

to me often”. Participant (FT) would often repeat the

same stories and in great detail. Participant (FT) was

very good in terms of social relatedness. Participant (FT)

responded and initiated conversations in all eight groups.

Participant (FT) demonstrated that she has positive self-

esteem and good communication skills. For instance, during


the group on week six, Participant (FT) shared with the

group a story about her father in law, saying: “We heard

him on the radio one evening...we didn't have television

yet. We were thrilled because he worked so hard doing what

he wanted to do. We were so pleased that he won!”

Participant (MR) was a 93 year old female who suddenly

passed away two weeks after the last scrapbooking group.

Participant (MR) had moderate to advanced stages of

Alzheimer's disease. Facilitator (DC) worked

collaboratively with Participant (MR) throughout the eight

weeks. Participant (MR) generally came to scrapbooking

group in a happy mood, with the exception of two groups

where she appeared to be bored. Participant (MR)

demonstrated that her short and long term memory was

functional during two groups, and one group where just her

short term memory was intact. However, there were five

groups where her short term memory was not good, and six

groups where her long term memory was lacking. Participant

(MR) communicated verbally during six of the eight

scrapbooking groups. She initiated with other participants

during two of the eight groups, and responded to others

throughout all eight group sessions. For example, when

Facilitator (AM) asked Participant (MR): “How about the


word “love”, what does that mean to you?” Participant (MR)

responded with: “I love my family”. Participant (MR)

appeared to have positive self-esteem during all groups

except for the final group.

At the end of the the last scrapbooking group on week

eight, the research investigator asked each participant how

they felt about their experience of creating a scrapbook.

When each participant was asked if she enjoyed

participating in the scrapbooking group, all four

participants expressed that they had liked the experience.

(HP) responded with “I enjoyed it very much!” Participant

(FT) said: “I like to do this... I didn't realize what it

was all about when I came here...I did not

realize...scrapbooks...I just never did, but I have enjoyed

it”. Participant (MR) replied with “Oh, I did!”, and

Participant (MS) said “yes, it was fun! I will probably

look at it (the scrapbook) every day and smile.”

Limitations and Future Research

This research study was conducted from a qualitative

perspective. In order for the researcher to

collect in-depth data, the sample size was kept small, with

only four participants. All participants are female and

between the ages of 83 and 97 years old. All four


participants reside in the same assisted living facility.

Future research may include larger sample sizes of both

male and female participants from different assisted living

communities, nursing homes, or private residencies in order

to make the findings more generalizable. The researcher

may also direct the group facilitators to encourage the

participants to share more, allowing for more of an

opportunity for the participants to communicate their

thoughts and feelings. Future researchers might suggest

that the facilitators encourage the participants to make

more of the art related choices and be cautious about

influencing the participants art-based decisions. Future

researchers may want to consider extending the length of

each group session from a one hour time frame used in this

study to an hour and a half. The 60 minute sessions often

did not seem long enough for the participants to finish

working on their scrapbook pages. The opportunity for the

participants to share with the group what they had created

at the end of each session frequently seemed rushed. Also,

future researchers may consider rearranging the order of

the weekly themes into order of perceived importance or

relevance.


References

Allen, R. S., Hilgeman, M. M., Ege, M. A., Shuster, J. L.,

& Burgio, L. D. (2008). Legacy activities as

interventions approaching the end of life. Journal of

Palliative Medicine, 11(7), 1029-1038.

Allen, R. S. (2009). The legacy project intervention to

enhance meaningful family interactions: Case examples.

Clinical Gerontologist, 32, 164-176. doi:

10.1080/0731711082677005

American Art Therapy Association. (2013). Retrieved October

4, 2013 from website: http://www.americanarttherapy

association.org

American Psychiatric Association. (2000). Diagnostic and

statistical manual of mental disorders (4th ed., text

rev.). Washington, DC: Author

Merriam, S. B. (2009). Qualitative Research. A guide to

design and implementation. San Francisco: Jossey-Bass

McCarthy, P. G., & Sebaugh, J. G. (2011). Therapeutic

scrapbooking: A technique to promote positive coping and

emotional strength in parents of pediatric oncology

patients. Journal of Psychosocial Oncology, 29, 215-230.

doi: http://dx.doi.org/10.1080/07347332.2010.548443

http://dx.doi.org/10.1080/07347332.2010.548443


Mizen, M. B. (2004). Scrapbook photo albums are therapeutic

for Alzheimer's patients. Creative Memories. 1-4.

doi: http://www.creativememories.com/AlzheimersAlbum.PDF

Puyenbroeck, J. V, & Maes, B. (2006). Program development

of reminiscence group work for ageing people with

intellectual disabilities. Journal of Intellectual &

Developmental Disability, 31(3), 139-147.

doi:10.1080/13668250600862988

Safar, L. T., Press, D. Z.(2011). Art and the brain:

Effects of dementia on art production in art therapy. Art

Therapy: Journal of the American Art Therapy Association,

28(3), 96-103. doi:

http://dx.doi.org.ezproxy.spfldcol.edu/

10.10.1080/07421656.2011.599734

Stallings, J. W. (2010). Collage as a therapeutic modality

for reminiscence in patients with dementia. Art Therapy:

Journal of the American Art Therapy Association, 27(3),

136-140. doi:10.1080/07421656.2010.10129667

Stephenson, R. C. (2006). Promoting self-expression through

art therapy. Generations 30(1), 24-26.

doi:10.1080/01609513.2011.60311


Appendix A

RESEARCH DESIGN

Individuals who suffer from dementia range from 1.4%

to 1.6% of people ages 65-69 years and increases to 16% to

25% for individuals over the age of 85 (American

Psychiatric Association [APA], 2000). Dementia is a

general term for a decline in mental ability that causes

severe problems in daily living (Alzheimer's Association,

2013). Currently, there are no cures for dementia, but

there are a variety of therapeutic interventions that may

reduce the negative effects that the disease has on the

life of an individual who has dementia (Safar & Press,

2011).

Statement of the Problem

The researcher intends to study the possible benefits

of scrapbooking with individuals who have dementia by

conducting a qualitative study. The researcher will

collect data by writing field notes and making

observations.

Definition of Terms

The following definitions will be used within the

context of this study:


Caregivers

For the purpose of this study, caregivers will be

defined as someone who tends to the needs of a participant

who has dementia. This may include a guardian, family

member, or hired attendant.

Dementia

It is stated in the American Psychiatric Association’s

Diagnostic and Statistical Manual of Mental Disorders,

(2000) that the “essential feature of a dementia is the

development of multiple cognitive deficits that include

memory impairment and at least one of the following

disturbances: aphasia, apraxia, agnosia, or a disturbance

of executive functioning” (p. 148).

Persons With Dementia

Participants of this study will have previously been

diagnosed with having dementia by a licensed physician.

Art Therapy

The American Art Therapy Association (2013) has defined 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


self-awareness, manage behavior and addictions,

develop social skills, improve reality orientation,

reduce anxiety, and increase self-esteem.

In this study, scrapbooking as an art therapy

intervention will be the therapeutic modality used with the

participants who have dementia. Weekly group sessions will

focus around using a variety of artistic medium to help

improve mood and self-esteem, encourage self-expression,

and boost memory..

Mood

The Oxford dictionary (2013)defines mood as “a

temporary state of mind or being: angry, irritable, or

sullen.” For the purposes of this study, mood is

operationalized by observations and conversations with

participants.

Self-esteem

The Oxford dictionary (2013) defines self-esteem as

“confidence in one's own worth or abilities: self-respect”.

For the purposes of this study, self-esteem is

operationalized by observations and conversations with

participants.

Self-expression

The Oxford dictionary (2013) defines self-expression


as “the expression of one's feelings, thoughts, or ideas,

especially in writing, art, music, or dance”. In this

study, self-expression will be explored through the

creative process of scrapbooking.

Memory

The Oxford dictionary (2013) defines memory as “1)the

faculty by which the mind stores and remembers information

2) something remembered from the past; a recollection”.

For the purposes of this study, memory will be

operationalized by observations and conversations.

Delimitations

The delimitations of this study include the following

factors:

1. Participants will be recruited from an assisted

living facility in East Longmeadow, Massachusetts.

2. Data for this study will be collected over a 8-week

span.

3. The study will focus on mood, self-esteem, self-

expression, and memory as the potential benefits of

creating scrapbooks with individuals who have dementia.

Limitations

When interpreting the results of this study, the

following limitations should be considered:


1. The researcher will not be able to conduct formal

interviews with participants who have dementia due to

varied levels of functioning.

2. The results of the study will be limited to the

analysis and interpretations of data by the researcher.

Research Questions

This study will examine the following Research

questions:

1. How has scrapbooking affected mood?

2. How has scrapbooking affected self esteem?

3. How has scrapbooking affected self-expression?

4. How has scrapbooking affected memory?

5. How has scrapbooking affected social connectedness?


Appendix B

REVIEW OF LITERATURE

Older adults are often faced with a variety of life

changes related to loss (Stephenson, 2006). Physical and

cognitive losses can include the loss of sight, hearing,

mobility, and memory. Many older people experience death

of family members and friends. Independence is often

compromised, by needing to relocate to an assisted living

facility or nursing home and losing driving privileges.

Older adults with dementia may face even more significant

challenges.

The prevalence of dementia ranges from 1.4% to 1.6%

for individuals ages 65-69 years, and rises to 16% to 25%

for people over age 85 years (The American Psychiatric

Association [APA], 2000). It is stated in the APA (2000)

that the “essential feature of a dementia is the

development of multiple cognitive deficits that include

memory impairment and at least one of the following

disturbances: aphasia, apraxia, agnosia, or a disturbance

of executive functioning” (p. 148). An individual with

dementia may have difficulty with planning, organization,

sequencing, and abstract information, and experience


decline in comprehension, judgment, and verbal

communication (Stallings, 2010). According to the

Alzheimer's Association (alz.org, 2013), dementia is a

general term for a decline in mental ability that is severe

enough to cause problems in daily living. Dementia may

result from a variety of underlying medical conditions,

including “head trauma, HIV/AIDS, substance use,

Huntington's disease, Parkinson's disease, and Alzheimer's

disease” (Stallings, 2010, p. 136).

The following review of literature will focus on the

different types of dementia, prevalence, causes, and

characteristics. This review will explore a variety of

creative interventions for dementia, including

reminiscence, collage, life story work, and scrapbooking.

The review will also focus on the effectiveness of art

therapy with clients who have dementia, as well as the

potential challenges.

Types of Dementia

There are ten types of dementia categories (alz.org,

2013). Alzheimer's disease is the most common type of

dementia, accounting for 60-80% of dementia cases.

Vascular dementia is the second most common form of

dementia, and accounts for up to 40% of dementia cases. It


occurs because of conditions that block or reduce blood

supply to the brain. The progression of vascular dementia

may be slowed by controlling the risk factors associated

with the disease, such as quitting smoking, lowering high

blood pressure, and high cholesterol (Harrison-Dening,

2013).

Dementia with Lewy bodies (DLB) is caused by clumps of

the protient alpha-synuclein that can develop in the cortex

of the brain, which can result in dementia (alz.org, 2013).

The progression of Parkinson's disease can cause alpha-

synuclein clumps that develop in the brain, which can cause

degeneration of nerve cells that produce dopamine (alz.org,

2013). Frontotemporal dementia (FTD) usually produces

symptoms at a younger age and has a shorter survival rate

than Alzheimer's disease. Creutzfeldt-Jakob disease (CJD)

is a rapidly fatal disorder that causes symptoms of

dementia (alz.org, 2013). Normal pressure hydrocephalus is

caused by a build-up of fluid in the brain and can

sometimes be corrected by surgical procedures (alz.org,

2013).

Another disease that causes dementia is called

Huntington's disease, which is caused by a gene defect that

causes abnormalities in brain protein (alz.org). Wernicke-


Korsakoff syndrome is caused by a severe deficiency of

thiamine (vitamin B-1), often from alcohol misuse, and

leads to chronic memory problems (alz.org, 2013). Lastly,

mixed dementia is a result of more than one type of

dementia occurring in an individual.

Current Treatments for Dementia

It is stated in the DSM-IV-TR that “the reversibility

of a dementia is a function of the underlying pathology and

of the availability and timely application of effective

treatment” (p. 152). Current therapeutic interventions

will not cure dementia, but they may reduce the effects

that the illness has on an individual's life, and provide

the person with a sense of hope (Safar & Press, 2011).

There are a variety of treatments that are currently being

used to treat dementia. Medications such as cholinesterase

inhibitors and memantine are prescribed for individuals

experiencing cognitive symptoms such as memory loss,

confusion, and problems with thinking and reasoning. High

doses of vitamin E are also prescribed by doctors to treat

cognitive changes from dementia (alz.org, 2013).

Non-pharmaceutical treatments may also be beneficial.

For instance, reading, writing, and doing word games are

shown to combat memory loss, and to increase vocabulary


(Hannemann, 2006). Creative therapies, which include

drama, dance, music, and movement activities, have been

shown to enhance communication and self-expression, and

provide pleasure and enjoyment for people with dementia

(Rylatt, 2012). Creative therapies can also help

individuals with dementia cope with their condition.

Cognitive stimulation therapy (CST) is a type of

intervention used for individuals with mild to moderate

dementia (Harrison-Dening, 2013). CST is a non-

pharmacological group intervention that combines reality

orientation, reminiscence therapy, and psychosocial

therapies for dementia (Tuppen, 2012). The cognitive

benefits of CST in slowing mental decline are comparable to

cholinesterase inhibitor drugs, that are used to treat

dementia, and CST is also cost effective (Spector, Gardner,

& Orrell, 2011). Studies show that CST is “effective in

improving memory, judgment and use of language and

reasoning, as well as providing social stimulation”

(Harrison-Denning, 2013, P. 135). It is also the only non-

drug intervention used for the treatment of cognitive

symptoms of dementia that is recommended by government

guidelines (Spector, et al., 2011). A CST group is

typically run by two trained facilitators, and usually


include eight to ten participants (Tuppen, 2012). The

group runs for seven weeks, meets twice a week for two

hours, for a total of 14 sessions (Tuppen, 2012). There

are reasons why some individuals with dementia may not be

able to participate in a CST group, such as having severe

sensory impairments, inability to get to a group, or

because they refuse to participate (Orell, Woods, &

Spector, 2012).

Effectiveness of Art Therapy

The creative arts, including painting, sculpture,

music, dance, and theater, have been used since the early

ages as a way for humans to express and symbolize without

using words (Hannemann, 2006). Creating is a part of being

human, and can be done communally or when solitary

(MacGregor, 2006). The creative arts can be adapted to

suit anyone, regardless of age or ability (Stephenson,

2006).

Art therapy as a profession emerged in the 1940s when

psychiatrists began showing interest in the art work of

their mentally ill patients (American Art Therapy

Association, 2013). At about the same time, educators were

discovering that developmental, cognitive, and emotional

growth were reflected in the art of children. According to


the website of the American Art Therapy Association (2013),

an art therapist is a mental health professional who uses

“the creative process of art making to improve and enhance

the physical, mental and emotional well-being of

individuals of all ages”. The association goes on to say

art therapy can help people resolve conflicts and problems,

develop interpersonal skills, manage behavior, reduce

stress, increase self-esteem and self-awareness, and

achieve insight.

Creative expression can improve mental and physical

health, promote a sense of well-being, encourage a positive

outlook, and boost the immune system (Hannemann, 2006).

The visual arts can be successful in furthering the

creative growth of individuals who suffer from dementia

and physical impairments (Stephenson, 2006). Some older

individuals with dementia who participate in art activities

reported having a sense of purpose, a feeling of

achievement, relief from loneliness, and an increase in

morale (MacGregor, 2006).

Art therapy techniques can be adapted to meet the

needs of individuals with dementia and to focus on their

strengths and abilities (Stephenson, 2006). Art therapy

can be useful in the rehabilitation of physical problems,


and in addressing psychological and emotional needs (Safar

& Press, 2011). According to Stewart (2000), individuals

who have mild dementia and participate in an art therapy

program are often able to include depth, proportion,

appropriate use of color, and a great amount of detail in

their artwork. In cases of participants who have moderate

dementia, three quarters of individuals may include

baselines and skylines, use color in a somewhat appropriate

way, and may attempt to create representational forms and

figures (Stewart, 2004). While some participants with

severe or profound dementia may not be motivated to

participate in an art therapy group, those who do will most

often make scribbles and use colors randomly.

Art therapy tends to place more importance on the

process of creating than the final art product (MacGregor,

2006). Focusing on the strengths of the individual can be

a beneficial goal of art therapy, as well as perceiving

aging as something valuable that offers wisdom and life

experience (Stephenson, 2006). When art therapy is used

with elderly adults with dementia, it can offer a source of

pleasure and involvement, while exercising the parts of the

brain that still function (Stewart, 2004). Art therapy can

also promote self-expression, sensory stimulation, and


increase quality of life. Despite the proven benefits of

using art therapy with older people who have dementia, it

is rare to find facilities that offer it to residents

(Stewart, 2004). For art therapy clinicians who do work at

a facility, they often spend limited amounts of time with

the residents because of complicated documentation

procedures.

Reminiscence

Reminiscing is when people remember personal life

events and share their memories with others. Psychologist

Erik Erikson believed that a person can reconcile the past

self with the present self by recalling the past and

reaching integration (Puyenbroeck & Maes, 2006, p.139).

For more than five decades, reminiscence and life review

have been used in art therapy with older adults and

terminally ill patients (Stallings, 2010). Reminiscence

can be effective in improving mood and cognition (Rylatt,

2012). Art therapy and the creative process of making art

can evoke many emotions and memories of older adults, and

may provide an opportunity to explore past and present

experiences (Stephenson, 2006). According to Robert

Butler's theory of life review, it is a natural occurrence

for older people to feel regret and disappointment when


reflecting back on their life, and to have issues that are

unresolved (Stephenson, 2006). The process of art making

allows older adults to explore and work through the good

and the bad in his or her life in a safe, nonverbal, and

symbolic way in order to feel comfortable in accepting the

end of life (Stephenson, 2006).

Older adults with cognitive difficulties may find

memory triggers helpful, such as by viewing old photographs

and vintage objects (Puyenbroeck & Maes, 2006). Support

workers can help older people who have difficulty speaking

for themselves, by using interventions and activities that

incorporate life story work. Buron (2010) studied how

creating life history collages for nursing home residents

who have dementia effected the relationship between

residents and the nursing home staff. The information

gathered for the collages included “birth-place, members of

family of origin, where the individual grew up and most

significant previous residence, present family, education,

work experiences, significant past experiences, known

traits and attributes, and life story” (p. 39). The

information about each individual, as well as photographs

to be used in the collage, came from a surrogate who had

known the resident for at least 25% of the resident's life.


After collecting all of the data from the surrogates, the

researcher met with a graphic design artist to create a

history collage to be hung in the clients room. The

residents with dementia were passive participants, meaning

that they were not involved in the life story collage-

making. The results of the study showed improvement in the

knowledge of the staff members about the residents they

work with. The researcher did not measure the effects that

the life story collage had on resident's behaviors,

attitudes, or cognitive functioning.

Legacy projects are a family-based intervention for

individuals approaching the end of life (Allen, Hilgeman,

Ege, Shuster, & Burgio, 2008). Legacy activities are

defined as projects “that assist individuals and families

in initiating the process of life review and result in a

product that can be enjoyed by family and friends”. A

legacy project may include a photo scrapbook, a family

cookbook, or typed or audio-taped stories elicited from

semi-structured interviews (Allen, 2009). The family and

the patient work together to create a lasting memento

through the processes of life review and components of

cognitive behavioral therapy (CBT).

Challenges of Using Art Therapy


While art therapy has potential in slowing the

progression of dementia, there are challenges of using art

with this population. For example, individuals with

progressive dementia may mistake art materials for food,

have trouble cutting with scissors, and may put glue on the

wrong side of the paper (Stallings, 2010). They also may

have trouble recognizing and producing forms in drawings.

Individuals with illnesses such as arthritis can have

difficulty with the execution of some art activities due to

limited mobility, range of motion, and poor fine motor

skills (Hannemann, 2010). When elderly clients are not

able to fully carry out their creative ideas, art

therapists must rely on imagination and artistic abilities

to “empathically carry out the creative intention of the

client” (Stephenson, 2006).

Another factor is that some individuals find art to be

intimidating because they may have been told that they were

not good at it (Stewart, 2004). People who are resistant

to art making and art therapy may become less fearful if

they are reminded that the goal is to find enjoyment in the

process, not to be critiqued. It is important for all art

materials to be safe and non-toxic (Stewart, 2004). Due to

“cognitive loss, decrease in manual dexterity, and


increased importance of the tactile sense” (Stewart, 2004,

p. 150), art materials that are considered regressive

actually work well with individuals with dementia, such as

crayons and finger-paints.

Scrapbooking

The art of scrapbooking dates back to the Renaissance

period when scholars and other literary-minded people would

copy their favorite passages or poems into blank books in

order to create their own personal anthologies (McCarthy &

Sebaugh, 2011). These books were known as commonplace

books and would often include “classical quotations,

personal anecdotes, astrological predictions or devotional

texts” (Kohut, 2011, p. 124). Scrapbooking became a

popular hobby in the 19th century with well-known people

such as Mark Twain expressing enjoyment with the pastime

(Kohut, 2011). Twain created more than 300 of what he

called drawing room books that held keepsakes of family

stories, as well as mementos such as feathers and pressed

flowers (McCarthy & Sebaugh, 2011). In the year 1900, the

Brownie camera became accessible to the middle class, which

led to an increase in scrapbooking as a way to capture,

organize, and save scenes and memories caught on camera

(McCarthy & Sebaugh, 2011). Since the 1990s, scrapbooking


has become a multibillion-dollar business and one of the

fastest growing hobbies in America (McCarthy & Sebaugh,

2011). There are many styles and approaches to

scrapbooking (Kohut, 2011). A scrapbook cover can be large

or small, store bought or homemade from inexpensive

materials. The papers that go inside of the book come in

virtually limitless colors, prints, and patterns.

Stickers, ribbons, and stamps are an example of

embellishments that can be used to decorate scrapbook pages

and add a personal touch.

Using scrapbooking as a therapeutic tool in the mental

health field is just beginning to emerge (McCarthy &

Sebaugh, 2011). Scrapbooks can be a helpful coping method

for people experiencing challenging events such as loss,

grief, and recovery (Karns, 2002). Both the process and

the product of scrapbooking can be beneficial to people of

all ages (Kohut, 2011). Creating scrapbooks in a group

setting may allow participants to feel connected to others,

feel less isolated, and help validate each others emotional

experiences (McCarthy & Sehaugh, 2011).

Scrapbooking may be helpful with a variety of

populations as a way for individuals to chronicle important

events, express emotions, and explore ideas (Karns, 2002).


Creating scrapbooks have been shown to be an effective

intervention at reducing symptoms for groups of women with

post-traumatic stress disorder (PTSD; Davidson & Robison,

2008). Visually and verbally sharing stories about

traumatic experiences were found to be beneficial. Another

study by Washington and Moxley (2004) used scrapbooks and

portfolios as interventions to help women recover from

substance abuse. A study by Kohut (2011) about the effects

of a scrapbooking bereavement support group indicated that

creating a memory book can help to resolve grief and

promote healing in a non-threatening and appealing way.

Scrapbooks created for foster children by their foster

parents provide the children with a documented history of

their earlier lives (McCarthy & Sebaugh, 2011). Foster

children often do not have any photographs or written

stories about themselves when they were younger.

Scrapbooking has also been used in neonatal intensive care

units as a way to encourage parents to bond with their ill

infants.

Scrapbooking and Dementia

There are few studies published on creating scrapbooks

with individuals who have dementia (Mizen, 2004). However,

the creation of scrapbooks with this population may be


beneficial in enhancing the well-being of the individual

who has dementia, help the family to better relate to their

loved one, and assist caregivers in developing empathy for

the patient. Photographs, family recipes, and stories may

be collected from family members that may be included in

the scrapbook (Allen, 2009).

Creating a scrapbook is a tangible way to preserve

family stories, legacies and celebrate life events (Kohut,

2011). Scrapbooks are an artistic creation that celebrates

life, love, and family from the perspective of the artist.

Photographs, cards, newspaper articles, and souvenirs can

be added to scrapbooks to “create a cherished document that

'tells a story of who we are while preserving our memories

for future generations'” (Kohut, 2011, p. 124). With the

help of a trained facilitator, a scrapbooking group can

help participants to focus on their strengths, develop

connections, learn healthy coping skills, discover ways to

combat stress, and gain support from other members of the

group (McCarthy & Sebaugh, 2011).

Summary

Older adults often experience losses in a variety of

areas that may include visual, hearing, and memory loss,

decrease in mobility, and independence, and death of family


members and friends (Stephenson, 2006). Relocation to an

assisted living facility or nursing home is also a common

event. For individuals ages 65-69 years old, the

prevalence of dementia is 1.4% to 1.6% and increases to 16%

to 25% for adults over the age of 85 (APA, 2000). Dementia

is an umbrella term used to describe a decline in mental

ability that interferes with activities of daily living

(alz.org, 2013). This includes having difficulties with

memory and other areas of executive functioning (APA,

2000). The most common type of dementia is Alzheimer's

disease, but there are also ten other types of dementia

(alz.org, 2013).

There are currently no therapeutic interventions that

will cure dementia, but they may help an individual with

dementia in reducing the effects the disease has on quality

of life and provide a sense of hope (Safar & Press, 2011).

There are a variety of interventions used to treat

dementia, including pharmaceutical drugs such as

cholinesterase inhibitors and memantine that are prescribed

to diminish cognitive symptoms (alz.org, 2013). However,

non-medication interventions that include creative

therapies such as drama, dance, music and movement

activities may provide enjoyment, enhance communication,


and promote self-expression (Rylatt, 2012). Cognitive

Stimulation Therapy (CST) is another successful

intervention that combines reminiscence therapy, reality

orientation and psychosocial therapies (Tuppen, 2012).

Art therapy is a non-medication intervention that can

help people in a variety of ways such as in developing

interpersonal skills, managing behavior, reducing stress

increasing self-esteem and self-awareness, and achieving

insight (American Art Therapy Association, 2013). Creative

expression can also improve mental and physical health and

boost the immune system (Hannemann, 2006). Reminiscence

and life review have been used with older adults and

terminally ill patients for over five decades (Stallings,

2010). Creating legacy projects is a family-based

intervention used with individuals at the end stage of life

(Allen, et al., 2008). Legacy projects can include making

a photo scrapbook, family cookbook, or typed or audio-taped

stories gathered from semi-structured interviews (Allen,

2009).

Scrapbooking as a therapeutic tool is only beginning

to be used in the mental health field, especially for

individuals who have dementia (McCarthy & Sebaugh, 2011).

Making scrapbooks is a way to preserve family stories,


legacies and celebrate life events in a tangible way

(Kohut, 2011). Creative therapies that include art making,

reminiscence, and legacy work such as scrapbooking, can

provide individuals who have dementia with a sense of

purpose and achievement, and help to relieve loneliness and

increase morale (MacGregor, 2006).


Appendix C

PERMISSION TO CONDUCT THE STUDY

Department of Art TherapySpringfield CollegeSpringfield, MA 01109

Dear_____________________,

I am in the process of completing my Master's degree in Clinical Art Therapy through a qualitative research project. This letter is to request your permission to conduct my research within your facility with residents who have dementia.

The purpose of this research study is to learn the possible benefits of using scrapbooking as an art therapy intervention for older adults who have been diagnosed with having dementia. Three to four residents from your facility will be selected for the current study. Participation in this research project will involve scrapbook-related art directives, observations during the art process, field notes, and photographs of the art work with no identifying factors. All potential participants will be given the opportunity to refuse to participate.

I would greatly appreciate the opportunity to work with you and your staff. I am enclosing a copy of the informed consent forms that your participating staff, residents and their legal guardians will be asked to fill out.

There is little research concerning the use of scrapbooking as an art therapy intervention for older adults who have dementia. Your willingness to support this project will add to the available body of knowledge.

Please feel free to contact me for any additional information that you might need. Thank you for your time and consideration. I look forward to hearing from you.

Sincerely,

Rebekah Mekler# 413-265-0148


Appendix D

INFORMED CONSENT

CONSENT TO PARTICIPATEVOLUNTARILY IN A RESEARCH INVESTIGATION


Dr. Leslie Abrams Rebekah Mekler Responsible Faculty Member Investigator's Name

Participant's name (please print) Date

PROJECT TITLE: Understanding the benefits of scrapbooking as an art therapy intervention for older adults with dementia.

Your ward is being asked to participate in a research study as described in this form below. All such research projects carried out within this department are governed by the regulations of both the Federal Government and Springfield College. These regulations require that the investigator obtain from you a signed agreement for your ward's participation in this project.

The purpose of this research study is to learn the possible benefits of using scrapbooking as an art therapy intervention for older adults who have been diagnosed with having dementia. Three to four participants from your ward's facility will be selected for the current study. Participation in this research project will involve scrapbook-related art directives, observations during the art process, and taking field notes. All potential participants and their legal guardians will be given the opportunity to refuse to participate. The methods used to collect information for this study are explained below.

You are encouraged to ask any questions at any time about the nature of the art directives and the methods that I am using. Your suggestions and concerns are important to me, and you can contact me at any time at # 413.265.0148.


I will be collecting data by making observations, taking photographs of the art work, and writing field notes regarding the setting, the participants, and activities or behaviors. The data will be used for academic purposes only.

I guarantee that the following conditions will be met:

1) Your ward's real name will not be in the written field notes; instead, your ward and any other person and place names in your ward's case will be given pseudonyms that will be used in all verbal and written records and reports.

2)You and your ward's participation in this study is voluntary; you have the right to withdraw from the study at any point, for any reason, and without any prejudice, and the information collected will be turned over to you.

Do you grant permission for your ward to be quoted directly?

Yes_______ No______

Do you grant permission for the research investigator to take eight photographs of your wards art work, one each week, with no identifying factors?

Yes_______ No_______

No known risks are associated with participation in the current study. Additional information can be obtained from the Office of Academic Affairs of Springfield College (# 413-748-3959) concerning pertinent questions about the current research study and an explanation of your ward's rights as a research participant.

I CERTIFY THAT I HAVE READ AND FULLY UNDERSTAND THE ABOVE PROJECT. ALL MY QUESTIONS HAVE BEEN ANSWERED TO MY SATISFACTION BY THE RESEARCHER. I WILLINGLY CONSENT TO MY WARD'S PARTICIPATION IN THIS STUDY.

___________________________________________________Signature of Legal Guardian Date


Appendix E

INFORMED CONSENT

CONSENT TO PARTICIPATE IN A RESEARCH INVESTIGATION


Dr. Leslie Abrams Rebekah Mekler Responsible Faculty Member Investigator's Name

Faculty Name (please print) Date

PROJECT TITLE: Understanding the benefits of scrapbooking as an art therapy intervention for older adults with dementia.

I am in the process of completing my Master's degree in Clinical Art Therapy through a qualitative research project. This letter is to request your permission to participate in my research study. I will be conducting my research at the community where you are employed, with residents who have dementia.

The purpose of this research study is to learn the possible benefits of using scrapbooking as an art therapy intervention for older adults who have been diagnosed with having dementia. Three to four residents from the community will be selected for the current study. Participation in this research project will involve scrapbook-related art directives, observations during the art process, photographs of the art work, and taking field notes. All potential participants and their legal guardians will be given the opportunity to refuse to participate. The methods used to collect information for this study are explained below.

You are encouraged to ask any questions at any time about the nature of the art directives and the methods that I am using. Your suggestions and concerns are important to me,


and you can contact me at any time at # 413.265.0148.

I will be collecting data by making observations and writing field notes regarding the setting, the participants, and activities or behaviors. This data will be used for academic purposes only.

Do you grant permission to be quoted directly?

Yes_______ No______

No known risks are associated with participation in the current study. Additional information can be obtained from the Office of Academic Affairs of Springfield College concerning pertinent questions about the current research study and an explanation of your rights as a research participant.

I CERTIFY THAT I HAVE READ AND FULLY UNDERSTAND THE ABOVE PROJECT. ALL MY QUESTIONS HAVE BEEN ANSWERED TO MY SATISFACTION BY THE RESEARCHER. I WILLINGLY CONSENT TO PARTICIPATION IN THIS STUDY.

___________________________________________________Signature of Faculty Member Date


APPENDIX F

WEEKLY GROUP DIRECTIVES

Script:

For the next eight weeks we will be working on making

a scrapbook that you will leave here each week. You will be

able to keep the scrapbook and take it home with you at the

end of the last session. This is to see if this is

something that you like and captivates your interest. Each

week there will be materials for you to use for your

scrapbook, including magazine pictures. You may also bring

your own pictures, memorabilia, and other materials if you

would like to use them for your scrapbook.

Weekly Directives:

Week one: What are your favorite hobbies? (music, art,

sports, favorite movies, books, songs etc)

Week two: What are your favorite places? (vacations,

trips, where you have lived etc.)

Week three: What are your favorite foods? (family recipes,

etc)

Week four: What are your favorite memories? (letters,

postcards, invitations, ticket stubs etc.)

Week five: What did you do for a living? (jobs, raising


kids, volunteering, military etc.)

Week six: Who is in your family? and/or Who are your

friends? (include photographs if possible)

Week seven: Life lessons, wisdom, favorite quotes.

(additional quotes will be provided)

Week eight: Finishing up and final embellishments.


APPENDIX G

WEEKLY GROUP TRANSCRIPTS

Week 1 Notes 2-12-14

-4 participants, all female: HP, FT, MS, and MR, are all

in wheelchairs, but can also utilize a walker.

-HP and FT live on OP (beginning to middle stages of

Alzheimer's

-MS and MR live on PW on a secure unit that also has

Hospice care(end stages of Alzheimer's)

-3 facilitators: AM, DC, and RM. RM is the researcher of

this study. (AM mentioned getting a fourth facilitator so

it will be one on one, for next week) have them sign

informed consent form

Today's theme: what are your favorite hobbies? (music,

art, sports, favorite movies, books, songs, etc.)

The participants interacted with each other and the

facilitators. There was a lot of laughter and joy while

looking through the magazine cut outs, and personal

photographs and memorabilia.

At end of session, I asked the participants if they would

like to share what they have been working on, and all

were willing to share with the group.

I entered the conference room at the assisted living


community at 2:55pm. It is a small room with a table and

eight chairs. On the table there was a box filled with

glue, markers, crayons, colored pencils, and scissors,

which were provided by the activities director, DC. There

was also a bag containing four scrapbooks, and two large

pads of square scrapbooking paper.

HP and FT entered the conference room first, and were

helped by staff from their wheelchairs into regular chairs.

Then MS entered the room and shortly after MR came, and

both participants were helped from their wheelchairs into

regular chairs. I introduced myself to each participant,

and they smiled, and told me their names. I then read the

pre-written script from my proposal to the participants,

which explains what the group was about and what we will be

doing. DC handed each participant a different type of

colorful scrap book that she had picked out at AC Moore.

The participants seemed pleased with their books, and

expressed gratitude and smiled. FT and MR each had boxes

that contained personal mementos that their family had

brought in to be used in their scrapbooks. I also provided

a large selection of pre-cut words and images that the

participants could choose from to include in their

scrapbooks.


FT, who was setting next to me, spontaneously began

telling me about herself and her life. Based on what she

was telling me, which was mostly about her deceased

husband, and the vacations that they used to take, I was

able to suggest some images and words that she might like

to include in her scrapbook. The images that I offered to

FT appeared to jog her memory about detailed descriptions

of trips that she had taken with her husband when she was

younger.

AM sat next to MS and assisted her in putting together

a couple of scrapbooking pages, while DC worked with both

MR and HP. All participants appeared engaged with the

scrapbooking project, and all were communicating with both

the staff members and occasionally with other participants.

HP spontaneously positively commented on FT scrapbooking

page, and then F.T. looked at HP page and also commented

positively.

The group was supposed to end at 4pm, but since

everyone was so involved with their scrapbooking, the group

ended running over to about 4:05 pm. I encouraged the

participants to share with the group what they had

accomplished during the session. All participants took

turns showing the group their images. AM also prompted the


participants to say why they chose the words and images

that they did. All participants were able to articulate

the reasoning behind their choices.

At the end of the group, I thanked the participants

and staff for participating in the first group, and that I

hope they enjoyed the experience, and look forward to

seeing them again next week. All participants expressed

that they enjoyed the group and also look forward to coming

next week.

FT

Images: 1st page: people fishing on a dock with lake and

mountains. People hiking. Airplane

Words: 1st page: All aboard

Quotes: AM: what made you pick an airplane? FT: because I

like to travel...between the time I retired and now,

because I didn't have money before, and I'm not rich, but

anyway. This one reminds me of hiking, and I am not a

hiker, but I've tried, and this reminds me of New Zealand,

for some reason (referring to an image of mountains and

people fishing on a lake). There are mountains, and someone

fishing. I'm not a fisher lady, but the scene reminded me

of that. AM: Have you been to New Zealand” FT: Yes, with

my husband. And this is a plane (referring to image) which


reminds me that we had to get on the plane to go. And it

reminds me of vacations, which I like. AM: that's a great

page!

MR

Images: 1st page: women exercising, a couple riding bikes by

the beach, two children sledding, photograph of self

holding up a tee-shirt

2nd page: bowling ball and pins, woman exercising, a couple

riding bikes by the beach, two children sledding, a woman

gardening, photograph of self dressed up as a clown

Words:

Inside cover: start every day full of life, always be

kinder than you feel

(1st page) family, love, paradise

(2nd page) forever young, amazing, imagination

Quotes: AM: why did you pick the word “family”? What does

that word mean to you? MR: A lot of these people miss their

family. AM: how about “paradise”? MR: well, I don't know

about that one...but its, ya know, the beach, waves, and

stuff like that. AM: How about the word “love”, what does

that mean to you? MR: I love my family.

MS

Images: 1st page: picture of a globe and books


2nd page: no images

Words:

1st page: mother, never settle for good enough, happy and

healthy, let the good life in, joy, freedom, smiles, family

fun, teach, smart

2nd page: completely inspired, care, hopeful, all about

you, set your soul free, artist, strong, give, living.

Quotes: AM: why did you pick the word “give”? MS: I don't

remember...well, because I like to give things to people

and help people. Why did you pick “strong”? Because I try

to act strong. Why did you pick “mother”? Because I still

think of my mother, her name was =Jane= Group: AM asked all

the participants to say their mothers names, which they

did. AM: why did you choose the word “freedom”? MS: well,

we had to work for freedom...everyone in the world should

work for freedom. AM: why did you choose the phrase “never

settle for good enough”? MS: that's what everyone should

keep working for, for things to be better....I try to...I'm

not always successful, but I try to. AM: That's what

tomorrow's for. That's what its all about, you just gotta

try.

HP:

-2 pages of scrapbook completed today


Images: (1st page) a man cooking, a woman gardening, people

dancing

(2nd page) a couple bathing on a boat, a child in bed with

parents beside her, a woman balancing things on her head

while standing on one foot

Words: (1st page) New York City, believe, smile, remember

(2nd page) ready for anything. there's a time and a place

for everything, even going wild.

Quotes: AM: HP, she put “New York City”...why? HP: Because

I love it! AM: how come you've got a violin? HP: because I

played the violin. AM” that's not an easy thing to play.

HP: No. You know why I gave it up? My professor said he's

still taking lessons. I said to my mother, that's it, I'm

not taking any more lessons. AM: you mean because he was

so old and still taking lessons? HM: That's right,

(laughing) and I quit my violin. But we are all musical in

my family, my son plays the accordion and the piano, and my

daughter used to play the organ. AM: wow, amazing! Tell me

why you picked this woman here? HP: Why did I pick her?

Because she's planting flowers. AM: yes she is planting

things, did you do that a lot? HP: No I didn't. AM: then

why did you pick that one? HP: I don't know, I just did,

she looked good. AM: What's on your next page? Why would


you pick the phrase “ready for anything”? Why? Tell me why?

HP: well, that's what makes life. AM: you got to be ready

for anything, right FT? FT: that's right! Good or bad!

-RM and AM: Good job everyone! AM: That was our first day

of scrapbooking, did you have fun? Group: yes! AM: Makes

you think a lot, doesn't it? MS did you enjoy this? MS:

yes. AM: we are going to be doing this for the next few

weeks, with a different topic every time, and when were

done you will each have your own beautiful book of things

that mean something to you.


-3 participants, all female: FT, MS, and MR (HP was absent)

-facilitators: AM DC, and RM

-last weeks group was cancelled due to a flu outbreak in

the assisted living community

-MS worked with AM, MR worked with DC, and RM with FT.

-we worked in the conference room as we did the first group

-each participant had a box of photographs, cards, and

other memorabilia that was brought to be used in scrapbooks

from family members

-at the end of the group, the facilitators presented the

participants scrapbooks and mostly spoke for the

participant as opposed to last session when one of the


staff invited the participants to share why they chose

specific words, pictures, photographs etc.

Today's theme: what are your favorite places? (vacations,

trips. Where you have lived, etc)

RM: (towards the end of the session) I'm wondering if for

the last few minutes we could all share a little bit about

what we did this week...who wants to go first?

MR

Images: 3rd page: 2 photographs of family members, picture

of sail boat and house by the ocean

4th page: 1 black and white photographs of family members,

1 black and white photograph of friends, picture of statue

of liberty, picture of a Ferris wheel

Words:

3rd page: celebrating, experience, rest, summer

4th page: beauty, friends, company, lucky

Quotes: DC: MR liked the ocean, she loved going on family

visits to the ocean, so these are all MR's children and

their spouses, and this is her Mom on vacation, and we

found this sailboat. And she thought going to the beach is,

like, celebrating, and what did you say? MR: experience DC:

and what did you say here? MS: rest DC: and you like to go

in the summertime. And then MR picked some of her travel


vacations she went on...and these are all good friends of

hers that she and her husband hung out with...so they were

friends with company, and she remembered as a youngster

going on Ferris wheels to New York city, and there is her

and her husband. And this is a house she really liked, she

just thought it was a nice house which would be cozy to

live in. FT: I recognize some of that. RM: those are

beautiful, thanks MR!

MS

Images:

3rd page: 4 pictures of buildings in Westfield, MA, picture

of a statue in Westfield, MA

4th page: 3 pictures of flowers, sailboat on a lake

Words:

3rd page: “family's, schools, and communities”, Westfield,

Massachusetts, home

4th page: “travel the world”, Maine!, beautiful, gifts

Quotes: AM: MS and I will go first... RM: ok great! AM: to

MS, “we are going to tell them why we picked the pictures

that we picked, ok? MS: ok . AM: so, MS is from Westfield,

right? MS: thats right! AM: to MS :what pictures of

Westfield do we have? MS: non-responsive (AM continued to

share with the group about the photographs of Westfield,


because she had previously went over them with MS's son).

AM: Here is a picture of the Westfield Atheneum, this is

the 1st congregational church in Westfield...MS had a set of

blank cards with the church right on it, so that is the

church, and that is the church. Group: beautiful! AM: And

one of her other places to be with her family was in...MS:

we used to go to Maine every year! AM: they used to go to

Maine every year, they had a cabin, by the lake, right? So,

this is a postcard of Maine FT: oh yeah, I know Maine

some...the early part of my life was New York state, and

then after I was married I lived in Massachusetts, but we

did take some trips up to Maine. AM: (to FT) because

=Jane's= parents were from Maine, right? FT: her parents

live up there. AM: that's right! AM: so these are some

flowers that MS's son =Tom= took pictures of in Maine, some

of her favorite flowers, and we decided we'd put a nice

sailboat because she does like that, and traveled the

world! And MS wanted to put “gifts” because these are all

gifts to her.

FT

Images: 2nd page: FT chose a black and white photograph of

her childhood home

3rd page: black and white photograph of FT lying in a field


of grass and flowers

Words: 2nd page: family, home

3rd page: summer

Quotes: FT: I never made anything like this... DC: are you

enjoying it? FT: I am enjoying it RM: good! AM: lets look

at FT's stuff. RM: let's show everyone what you did today!

So, on the first page, FT included a picture of the house

that she grew up in. Group: wow! RM: anything you want to

say about that house? FT: some of those are my grandmother,

my grandfather, and, ah, I'd have to get an Aunt or someone

to identify them, because I don't know...my mother and

father are dead, and so I would have to...someone had

stuffed all the junk that they didn't know what to do with

underneath the porch! And it showed in the picture! Group:

oh no! AM: Hey FT, were you born in that house? FT: yeah,

two brothers and a sister AM: all of you were born right

there in that house? FT: well, mother and father, that was

a country house in northern New York, 25 miles from Canada,

and, ah, what was I going to say? This happens to me often.

Anyway, it had to be enough bedrooms for everybody. So,

there is another house their my friends took me by there,

and I didn't think I'd ever want to go back because I

thought well, I feel badly, but I don't because you go from


one spot in your life to the next spot, and that's the way

its been. AM: and that's the way its supposed to be. DC:

yup! Who is that person laying in the grass like that? FT:

that was me!! DC: oh my goodness! Wow, FT lying in the

grass. FT: and I don't know where this is, where this was

taken. I have all kinds of strange pictures. RM: and she

thought of the word “summer” to go along with this picture.

FT: and then I went to Australia one time, and I got

another batch of pictures, they aren't here though,

because, I don't know why because...but that was a

beautiful trip. Group: I bet! FT: yeah, that was a trip of

a lifetime! DC: we're going to have to find some stuff from

Australia. FT: and its a shame to just let them (the

photographs) flutter around...this is a good idea! RM: I'm

so glad that you like it (scrapbooking) you have all kinds

of...everyone has all kinds of great pictures to include in

their scrapbooks.

RM: (at end of session) I just wanted to also mention that

the last week, week 8, we will have an opportunity to go

through all of the images that you put in and add things to

it, so if there are words that you feel you would like to

include that you didn't have time to do today... FT: you

could put a new page in? RM: yep, you can put a new page


in, and you can embellish what you already have done. And

next week, we are going to talk about favorite foods.

Group: ooh! MR: I hope you have lots of pictures of food!

RM: I do! And some people may have their own recipes. Thank

you all so much for participating.

Week 3 Notes 3-5-14

-4 participants, all female: FT, MS, MR and HP

-facilitators, all female: AM, DC, and RM

-we met in the conference room, as usual

-AM assisted MS on her scrapbook while DC assisted both MR

and HP. RM assisted FT.

-HP, MR, and FT did lots of reminiscing about the past,

family, foods, holidays, and told stories to the

facilitator working with them while they worked on the

scrapbooks.

-according to AM and MS, MS felt overwhelmed and

overstimulated and chose to leave the group about half way

through the session.

-Today's theme: What are your favorite foods? (family

recipes, etc)

-towards the end of session: RM: if we can just have a

couple of minutes and have everyone, maybe, pick one of

their favorite foods and say why they picked it?


-participants were encouraged to speak for themselves if

they felt comfortable, and able, and talk about their

scrapbooks.

FT

Images: Eggs, soup, casserole, roast, and brownies

Words: “company's coming”

Quotes: RM: why don't you tell them why you chose, like,

eggs...what made you choose eggs? FT: eggs in the morning

for breakfast and you might have soup, and than casserole

for dinner. RM: and also you were saying to me that eggs

and some of these kinds of things you would eat because you

grew up on a farm, right? FT: well, I might, yes. RM: and

also, who used to make lots of cookies and cakes and

breads? FT: my mother used to make lots of cakes and

desserts, and bread and she does all of those things a

house wife does on a farm. AM: probably a lot more than a

housewife does not on a farm. RM: alright, thank you FT.

FT: (referring to images in her scrapbook done in prior

groups) ...and this is the house I was born in, but it

isn't there anymore because it burned. And this is me in

the grass. AM: very good FT, we love it.

MR

Images: 3rd page: pizza, hamburger, shrimp dinner, salad,


photo of MR with children and grandchildren celebrating her

birthday

Words: health, rejuvenate

Quotes: DC: MR, RM would like you to tell her why you

picked these foods, here you have hot dogs...RM: yeah, how

come you picked hotdogs, do you like hotdogs? MR: yeah. RM:

do they remind you of anything? MR: I didn't like toast

with jelly on it, but if I had French toast I liked it.

DC: and then she likes a glass of wine occasionally and she

loves lobster...and this is her and her sister, having a

cup of coffee. RM: oh, look at that! Its perfect to go in

there (the scrapbook). DC: she said she likes salad and

pizza and shrimp and hamburgers and what better way to

celebrate than with family while eating cake. Group: very

nice!

MS

Images: 5th page: ice cream cones, Hershey bar, oreo cookie

pie, cup of coffee, chicken

6th page: smoothie, potato chips, fruit, dinner plate

Words: 5th page: sweet, great morning, Mom's best recipes

6th page: simple, health

Quotes: MS: RM: do you remember working on your scrapbook

last week? MS: no, I don't remember it at all. RM: I am


wondering if there are any pictures in here (looking

through MS scrapbook) that you might remember...maybe not

because there aren't any of your personal photos in it yet.

But it looks like maybe you have been to Maine before? MS:

I traveled the world. RM: you traveled the world? MS: no, I

don't think so. RM: have you been to Maine? MS: I've been

to Maine, yes. RM: yeah, these are the images you picked

last week of Maine. MS: yes, Maine, these are all Maine.

RM: Have you ever lived there? MS: no response.

-MS stayed for about half of the scrapbook session where

she appeared confused, would shake her hands and make

noises. AM determined that MS was so overwhelmed and

overstimulated that she needed to leave the group for the

day. Therefore, I was not able to ask MS questions about

her scrapbook today.

HP

Images: 3rd page: shrimp, vegetables, photograph of HP with

her daughter

Words: 3rd page: luxury, moment

Quotes: DC: HP, you went to sister school? Catholic school?

HP: I wanted to be a nun. DC: you wanted to be a nun?! And

then you ended up falling in love and being married...so

much for being a nun of this and a nun of that! I couldn't


quite picture HP as a nun of this and a nun of that. HP:

oh, I wanted to be one real bad! DC: you like music, and

you like to dance, and that's why you told me you wanted

that picture (referring to an image in HP's scrapbook.)

HP: yes, I was a violin player. We were all musicians in my

family.

DC: (to HP) tell her what you picked. HP: I picked crab,

and I picked vegetable...DC: HP, hold on one second...MR:

(referring to an photograph of herself and a friend) she

was my good friend and we graduated from Mercy hospital

together, and =Jane= and I were friends for a long time.

Group: oh, thats nice. RM: alright, thank you for sharing

MR. OK, HP is going to share her's now, okay? HP: ok, I

have shrimp here, and strawberries, and I got carrots, and

I got celery and I got bread, and I got tomatoes and

cucumbers and string beans. DC: and who are you in the

picture with? I am in the picture with my daughter. DC: and

what else did you pick for food? HP: I picked lobster and

ice cream and soup and salad. AM: and what type of food

don't you like? HP: I like it all!

-RM: (at end of session) good job, all of you, your

scrapbooks are looking really great, your making a lot of

progress!



-4 participants, all female: HP, FT, MR, MS

-facilitators: AM, DC, and RM

-RM worked with FT

-AM worked with MS

-DC worked with MR and HP

Today's theme: what are your favorite memories? (letters,

postcards, invitations, ticket stubs, etc.)

FT

-repeated the story behind the black and white photos of

the Christmas tree decorating five or six times over the

course of the 1 hour scrapbooking session.

Images: 1st page: black and white photo of FT decorating

Christmas tree, black and white photo of FT with a friend

outside in snow

2nd page: black and white photo of FT holding skis in snow,

black and white photo of FT's husband and friend in front

of Christmas tree.

Words: 1st page: Christmas, winter, holidays

2nd page: holiday, Christmas tree

Quotes: RM: so, FT, we started with Christmas, do you want

to talk about these a little bit? FT: at Christmas time,

instead of having a lot of parties, we had a Christmas


decorating party. When I was working, somehow I never used

to fit the decorating in, so we would have a party, and

sometimes we'd have a little tree for the kids, and a

bigger tree for the bigger folks. And, ah, more holidays

here. I came from northern New York, about ten or 15 miles

from Canada. I went skiing there. DC: you used to ski FT?

FT: well, the old fashioned kind where you'd put the strap

over your toe, and you'd go downhill, and then you'd carry

your skis back up to the top again. DC: oh wow! AM: I

would have only done it once. FT: well, you can fall down,

and you carry the skis around and you get all kinds of

exercise. RM: very good exercise FT: and this is my

husband and a friend of mine FT: yeah, so the winter, and

the Christmas tree... RM: so the winter/Christmas theme,

and also we started to look at some of the images of

Florida, but we didn't put them down yet, so we're going to

work on that next week. AM: very nice FT! DC: yeah! FT:

Thank you! FT: this way you can do it without spilling it

on the rug (referring to a previous art activity). AM:

yeah, you like this project better, I know.

MR

got fixated on one photograph and couldn't recall who was

in it


-appeared bored

Images: 1st page: Black and white photo of MR in nurse

uniform, 3 recent photos of family, magazine cut out of

diamond rings, and orchid flower

2nd page: black and white photo of MR and husband, 3 recent

photos of grand kids and family

Words: 1st page: no words

2nd page: kids, holidays, growing up

Quotes: DC: MR picked...MR was a nurse, so we have the

picture of MS as a nurse...and here is MS husband and her

children, and her grandkids growing up. And she likes

flowers, and then she has memories of her and her husband

when he was in the military. And everyone getting together

for holidays, and all the grandchildren, and doing picnics,

and birthday parties, and Christmas, and all of them

sitting on the stairs, having their pictures taken. RM:

Nice! AM: Nice MR!

MS

-AM began working on MS's scrapbook before MS came into the

room, as MS was late arriving to group.

-MS used to be a quilter, so AM cut out strips of cloth and

put it behind photos

-after having a difficult week last session and needing to


leave the group due to over-stimulation, she returned this

week in good spirits, and said she enjoyed working on her

scrapbook.

Words: 1st page: protect, life

2nd page: kids, pets, raise a star student

Images: 1st page: 2 photos of family, one of family dog,

quilt scraps as borders of photos

2nd page: 3 family photos, quilt scraps as borders of photos

Quotes: AM: MS, why don't we go first! Ready, we're going

to tell everyone why we picked all this today. MS:

(laughing) uh huh. AM: so this is our favorite memory

page...who is this? MS: (says name of her husband and

daughter). RM: look at the quilt that you put on there! AM:

yeah all this quilting came from MS old quilting box. RM:

were you a quilter MS? MS: yeah AM: yeah, she used to make

clothes as well. AM: explaining who each family member is

in the photographs. AM: referring to a quote from a

magazine, “MS raised to star students” RM: Beautiful job,

thank you!

HP:

-MS does not have any photographs or items from before

moving to assisted living community

-was involved in the scrapbooking process and chose, glued,


and pasted her own pictures, words, and images

Words: 1st page: song, unforgettable (* DC and HP sang the

song “Unforgettable” together during group session)

2nd page: ”you'll never walk alone”, and mom

Images: 1st page: 2 photos of HP participating at activities

at assisted living community, magazine pic of train,

magazine pic of a pool and palm trees

2nd page: HP wearing bunny ears, HP with man?, magazine pic

of hand holding a red flower, magazine pic of a red car

Quotes: DC: so, we got to get caught up (HP). AM: yeah, no

more sick days for you (HP) HP: oh boy, I was sick as a

dog. (Remembering that she was sick with the flu, which is

why she missed one of the scrapbooking groups. AM: I know

you were. DC: Ok, HP, you're going to tell them how you did

your book today. HP: Ok. DC: you did your book about what?

Memories, of what, when you once went on....? HP: the train

DC: and then on an unforgettable what? Vacation. HP: right,

and Atlantic City DC: yup, and you like to do gardening,

memories of gardening, and making your own wreath HP: yup

DC: ok, and then you picked this side, why did you pick

this side? HP: I picked me and =Dave= DC: and she picked

“you'll never walk along”, and she picked this because it

reminds her of her old car, and how she loves flowers, and


how Mom (referring to image of HP wearing bunny ears) was

just being silly. RM: aw, love it, very nice! Thank you HP!

At end of session, RM: Next week we are going to be talking

about what you did for a living, like raising kids,

volunteering, you know, things that kept you busy. Alright,

thank you everyone!


-4 participants, all female: HP, FT, MS, MR


Today's theme: What did you do for a living? (jobs, raising

kids, volunteering, military, etc.)

-DC and RM reflected on how positive the participants

appeared today. All participants were engaged, smiling,

reflecting on the past and present, initiating and

responding, and were verbal. DC said that the sunny and

warm weather today may have played a role in the positive

energy of the participants.

FT

-FT has no children or grandchildren. FT was able to

identify her grandparents, parents, aunts, uncles, and

husband in photographs.

-FT needed some redirecting back to the theme of “what did

you do for a living”. She would occasionally get side


tracked and repeat stories of Christmas with her family and

friends.

Images: 1st page: large photograph of FT from the past

2nd page: black and white photograph of FT' with her

graduating class from either high school or secretarial

school, FT's diploma from secretarial school

3rd page: FT and her husband's “Bachelor of Square Dancing”

diploma

Words: No words used besides what is on the diplomas

Quotes: RM: Do you want to go first today and share with

the group? FT: ok. RM: So, this is Fran's book, do you want

to say a little bit? Who is this? FT: yeah, that was was

when I graduated, I believe. AM: High school? HP: look how

pretty you were! Beautiful. Group: wow!! AM: beautiful,

FT! Yeah, I can see you in there! DC: Yeah, I still see her

face features. RM: So, this is your high school picture,

right? And this was your high school class? FT: there were

only eight or nine people in my graduating class, it was

kind of small.....I went to secretarial school, and this

might have been that because that's me right there. I

didn't know these pictures existed! FT: we used to be in a

square dancing class in Chicopee, and this is our diploma.

HP: where did you dance in West Springfield, because I


lived in West Springfield? FT: It was at the school, it was

always at the school, the high school. MS: Very nice! AM:

FT, MS likes your work!

HP

-HP was a baker.

Images:1st page: black and white photo of HP's kids, black

and white photo of HP and her husband, color photo of HP

modeling a dress, magazine photo of a mother holding a baby

2nd page: old photo of HP with her husband on their wedding

day, two old photographs of HP.

Words: 1st page: eye witness a miracle, fashion, beauty,

pets

2nd page: muffin, pie, box of sugar

2nd page: talk, good, experience, home

Quotes: DC: HP was a baker, she made cakes at home, but we

couldn't find that, but we found a couple other things.

What was important to HP was family, and these are her two

children. She lost thirty pounds and came in second place

in this dance in 1963. And that is her and her husband. And

she said that being a mother was a full time job but it was

a beauty, and she loved pets. And then here, we focused on

talk and food and sweets and home and you needed sugar to

make a lot of things. She was very busy exercising a lot,


so we made sure to put her exercising. And this is her at

the beach in her younger days. Group: oh wow!! DC: So she

said that she had much experience. And that was (Pointing

to a picture). HP: my two children DC: her two children's

first communion Group: very nice (clapping) RM: good job!

MR

-MR needed redirecting back to the topic of “what did you

do for a living”. MR also needed reminding of who was in

the pictures from her past.

Images: 1st page: black and white photo of MR with her

husband, 3 recent photos of MR's family (grandchildren)

2nd page: black and white photo of MR's husband, 2 family

photos, magazine image of a mother holding a baby

3rd page: photo of MR when younger, photo of MR's

grandchildren, magazine image of a woman exercising

Words: 1st page: kids, holidays, growing up

2nd page: share, healthy, goals, simple

3rd page: cookbook, saver, create, miracle

Quotes: DC: MR, as you know, was a nurse. The things

growing up in her life that were important to her were her

family, and her grandchildren, and they all had goals, and

it mattered to her that they were happy, and that they

shared things, right? And she said “life was simple”. And


here, she was having a cup of coffee. She said she was a

saver, she liked to create, that family can be a miracle,

and that she liked to cook, so we found a cookbook. RM:

nice job MR! DC: here she's having a cup of coffee with her

sister. AM: what was your sister's name? MR: =Susan= AM:

did you call her =Susie=? MR: =Susie=, and =Jenny=was my

older sister.

MS

-DC described MS as “witty, funny, and enthusiastic” today.

-MS was sharing a lot about her past and what she felt were

important lessons that she had learned in life. AM was

transcribing quotes from what MS was sharing today.

Images: 1st page: magazine image of little girl wearing

mothers dress shoes, magazine image of stack of colorful

books

2nd page: 2 awards from agricultural fair

Words:

1st page: kids, history, play, homework, help (AM

transcribed quotes of MS talking today)

2nd page: a piece of paper with a shamrock on it that says:

“ I pledge my head to clearer thinking, my heart to greater

loyalty, my hands to larger service, my health to better

living, for my club, my community, my country”.


Quotes: AM: MS was a teacher...what grade?... She was a

fourth grade teacher. Here is what MS said about being a

teacher. “ I felt like I was really helping the children to

learn. The fourth graders were excited to learn as long as

I made them anxious to experience learning” MS: we had a

lot of fun, we had time for fun and lots of time for work.

And if they didn't do their work, they lost their fun. AM:

She says here” teaching fourth grade was not all work and

no play, I had to keep there minds interested in what I

taught. It was never about me but always about them. I

always wanted to do something that helps others.” DC: ahhh,

very nice! AM: and what do we have here? What is this? MS:

my 4H pledge. AM: and these are just some prizes, the

Westfield young people's awards. RM: nice job MS!

-RM: (at end of session) So, we are actually going to have

group again tomorrow. Tomorrow we are going to be talking

about who is in your family. We can continue on for those

of you who have already started that, and also talk about

your friends, and pets, and so it should be another fun

class! AM: good, so we will be back again tomorrow guys!


-4 participants, all female: HP, FT, MS, MR



Today's theme: Who is in your family? and/or Who are your

friends (include photographs if possible)

RM: The theme is “who is your family?” this can

include..friend can be considered family too, pets, maybe

if you had a dog or a cat that felt like a family member.

So, I think everyone has pictures of their family members

still, right, that you can include in your scrapbook? AM:

I used a little too many, though. DC: I used a little too

many too. RM: That was my fault. AM: no it wasn't. RM: and

also, I put pictures of homes, you know, that might remind

you of a childhood or family home, and there should be

words and animal pictures too (spread out on the table)

FT

Images: 1st page: large black and white photograph of FT's

grandparents, aunts and uncles in front of the house that

FT grew up in.

2nd page: black and white photo of FT, her husband, and

family on her wedding day. Black and white photo of FT's

parents in back of wedding cake on FT wedding day. Magazine

cut out of two wedding rings.

Words: Clippings of FTt's engagement announcement and

wedding announcement from old newspaper. FT's wedding

invitation.


Quotes: HP: ok FT, lets see! RM: FT, do you want to tell

everyone about this picture? FT: I think that's my

grandfather and grandmother, and these are four aunts, not

bugs, and that house was built by my grandfather. AM: by

your grandfather? FT: well, at his direction...he wasn't a

carpenter necessarily, but he had it built, their were four

bedrooms upstairs, and a kitchen and a dining room and a

living room and another bedroom and a bathroom, way back

then! AM: how many acres? FT: on the farm? AM: yeah. FT:

well, that is probably something I knew and don't know

anymore. I don't know. AM: I can ask (name). FT: yeah, ask

her. RM: what about the next one? HP: look at all those

handsome men! DC: look it, she goes after the men

(laughing). AM: that's your wedding! FT: yep! RM: so she

has her wedding invitation, wedding announcements,

engagement announcements, this is an actual photo of... FT:

yes, this is my husband, that is his brother, that was a

good friend of his, that is my brother, and here are

=Steve= and I here. His name was =Mike= but he encouraged

everyone to call him =Steve=. AM: was that his middle name,

or he just chose that? FT: well I think he kind of chose it

and encouraged his friends to call him (name). Oh, and

that's my mother and father there. RM: and was that your


wedding? FT: I think it might have been. HP: that is

wonderful! AM: I can't believe you still had the cut outs

from the newspaper of your marriage announcement, that is

awesome!

MR

Images: 1st page: 2 photos of MR's children and

grandchildren. Magazine cut out of a living room, and

magazine cut out of a golden retriever.

Words: 1st page: support, health, goodness

Quotes: DC: Hey MR? Do you want to show them what you did

today? MR did...here we talked about family, so this is her

daughter and husband with their three grandkids, and MR

said they had a dog growing up, but this was as close as we

could find. And with family, she always hoped for support,

and she said that living room kind of reminded her of the

living room like she used to live. And that is her daughter

and her husband and her granddaughter down on the bottom.

And MR put in her group “love” for her granddaughter right

here, and her son used to be in basketball, so we found a

basketball player, so we figured we'd say stories about it.

And then she has her great-granddaughter down here, so we

put “inspired”, her great-granddaughter is extraordinary,

and she of course loves flowers, and when she saw Mickey


Mouse, she had to have him! Group: awww! RM: very nice MR!

MS

Images: 1st page: 5 images of birds that MS had cut out of

magazines many years ago

2nd page: 2 magazine pictures of birds, card with a light

house

Words: 1st page: no words

2nd page: Hand written note that says “ Mom, I still

remember the multitudes of lady slippers in our yard in the

springtime...(MS)”

Quotes: AM: MS, let's tell them what we did today, ready?

Tell them what we did today. MS: what did we do? AM: we

made bird pages Group: oh, that's beautiful! Gorgeous!

(referring to bird pictures). AM: When we were looking at

all of these clippings over the week, MS said “I used to

clip out stuff all the time” and her son sent her a folder

of a whole of stuff she used to clip out so we used it.

Here is her monogram (said MS initials). AM: read card from

son (see above). DC: That's nice MS! AM: and she loves

cardinals, and they say that when you see a cardinal it is

someone coming back to say hello, so keep that in mind when

you see a cardinal that it is someone saying hi. RM: and I

like the fact that you had cut those out so long ago, and


it is perfect, perfect for this project. Nice work!

HP:

Images: 1st page: black and white photo of HP and husband.

Color photo of HP. Magazine pictures of a fish and 2 owls

2nd page: black and white photo of HP, colored photo of HP

and child, colored photo of HP daughter?

Words: 1st page: perfect, amazing, time is precious

2nd page: good, time, grow

Quotes: HP: I'm 97 and I'm willing to go out AM: (to HP,

referring to MS) You could be her Mom! (to MS) look at her,

she could be your Mom! She's 97, your not even 80. DC: HP,

I'm going to be 56 HP: you're a baby, for God's sakes. AM:

HP, I'm 33 HP: you're full of baloney! AM: I am, I was born

in 1980. Group: laughing. AM: how old are you RM? RM: I

will never tell. AM: are you serious? Group: how old are

you? RM: guess, take a guess. AM: 26 RM I'm 33 AM: me too!

We're the same age. AM: do you really not tell people how

old you are? HP: you're only as old as you feel HP: you

know, when people are entertaining here, they will always

come up to me and ask me, would you mind telling me how old

you are? When I tell them, they say “you're kidding”

(laughing) AM: really, why would you lie at 97? DC: she

even goes as far as to say to the handsome men when the


come in “ do you want to know how old I am? I'm available!

Group: laughing HP: you are only as old as you feel, and I

don't feel that old.

DC: OK, HP, why don't I hold it up and you tell them about

your picture here, OK? Who is this? HP: that is my husband

and I. DC: OK, and why did you put this here? Because you

guys are, what? Love birds! So, then there is a picture of

you fishing...how long was that fish? 18 inches long! HP:

18 inches long. I did a lot of fishing, caught a lot of

fish. DC: There she is with her granddaughter...and HP used

to raise Beagles, and there is her daughter and her son,

and how they were growing. Group: nice (clapping). RM:

yeah, very nice!

-End of group. RM: Next week we will be talking about life

lessons, wisdom, favorite quotes. So, its going to be a

good opportunity for you to share the things that you have

learned in your life. HP: oooh! DC: What have you learned

in your life? We got to start thinking about them and

writing them down now! DC: yep, never give up at one

marriage or two marriages, go for three (to HP, who has

been married three times). AM: you know what I'd say? Never

get married! HP: I'd never get married again. Group: no?

HP: Not at 97! RM: you never know! DC: I know people who've


gotten married at 100! HP: Oh my God! AM: OK! Class

dismissed! AM: Oh, MS, HP wants to know if you'd get

remarried at 97? MS: Would I? No! AM: Me neither! DC: would

you? (to RM) RM: I don't know, I would have to see at 97.

AM: yeah, we don't know, Bill Gates could propose when

we're that old. DC: Donald Trump too! But he'd have to cut

his hair first.

Week 7 Notes 4-2-14

-4 participants, all female: FT, MS, MR (HP did not attend

today's group)


Today's theme: Life lessons, wisdom, favorite quotes

(additional quotes provided)

FT

Images: 5th page: Old music written by FT's father-in law.

(FT showed and expressed a lot of pride regarding the

music. RM took notes and will type up quotes for FT to

display in scrapbook next to the music.)

Chosen quotes: 1st Page: “Friends are the joy of life”. 2nd

page: “There is only one happiness in this life, to love

and be loved”-George Sand. 3rd page: “The only true wisdom

is knowing you know nothing”-Socrates. 4th page: “No one is

in control of your happiness but you; therefore you have


the power to change anything about yourself and your life

that you want to change”- Barbara de Angelis. “Count your

age by friends not years. Count your life by smiles, not

tears”-John Lennon.

Quotes: Regarding the song that FT's father-in-law

composed: “Songs for Sale was the name of the program on

the radio. This music and lyrics was written by my father

in law (A.J.T). He was German and came over by ship with

dreams to seek better things in this country. He entered a

contest to write songs and won the contest with “To be with

you”. We heard him on the radio one evening...we didn't

have television yet. We were thrilled because he worked so

hard doing what he wanted to do. We were so pleased that he

won! -FT. RM: are you ready FT? Do you want to read it?

FT: Reads chosen quotes (above) out loud. FT: I have to

explain this a little (regarding music written by father-

in-law). My father-in-law was German, and he and his family

came to this country many years ago with no money, and all

of these things reminded me of him, because my husband and

I lived with him in MA for awhile, and we didn't have a lot

of money, so we shared one room, well, a regular house on

(name of street) in MA. Here are sayings that reminded me

of him. (reads chosen quotes). Group: oh wow! Clapping.


Great! Good job!

MR

Chosen quotes/ words: 1st page: “Hope, dream, wish, live,

laugh, love, repeat”. “Keep love in your heart. A life with

out it is like a sunless garden when the flowers are dead.

The consciousness of loving and being loved brings a warmth

and richness to life that nothing else can bring”. Oscar

Wilde. (MR added, always take time to smell the flowers!)

2nd page: “Today is a good day to be happy”. 3rd page: “ “How

far you go in life depends on your being tender with the

young, compassionate with the aged, sympathetic with the

striving, and tolerant of the weak and strong. Because some

day in life you will have been all of these” -George

Washington Carver. “May you live every day of your life”-

Jonathan Swift. (MR added, “If you're healthy, have your

family, if your loved, it makes life complete”). Words:

absolutely. embrace the day. Healthy. 4th page: “No matter

what age you are, or what your circumstances might be, you

are special, and you still have something unique to offer.

Your life, because of who you are, has meaning”.- Barbara

de Angelis (MR added: “you all are so very special to me.

You are my family and you all are very special and unique,

love, MR”.) 5th page: “Love with the deepest part of your


soul.”

Quotes: MR: Read out loud to the group the quotes that she

chose and wrote (see above). RM: Oh MR, that's beautiful!

DC: good job! Group: clapping

MS

Chosen quotes/ words: 1st page: (MS had saved this poem from

a long time ago because it is one of her “all time favorite

quotes”). “ For the new year, a short course in human

relations: The six most important words: "I admit I made a

mistake." The five most important words: "You did a good

job." The four most important words: "What is your

opinion." The three most important words: "If you please."

The two most important words: "Thank you," The one most

important word: "We" The least most important word: "I"

-Author unknown. “ Life is meaningless only if you allow it

to be. We each have the power to give life meaning, to make

our bodies, our time , our words in to instruments of love

and hope” - Thomas Head. “When I hear someone say “life is

hard”, I am tempted to ask “compared to what?”. To

(children's names) “Always, always, do unto others. Love

Mom.”-MS.

Quotes: AM: MS, read this to everyone. MS cut this out in

the 1970's! MS: read out loud to the group: the “6 most


important words”. Group: very nice! Profound! MS:

(continues to read her chosen quotes, but has trouble

seeing it) Am: do you want me to read it? MS: yes AM:

continues reading MS chosen quotes. AM: oh, there is one

more funny one...one that made her giggle said “a joyful

heart is content in all things”. The reason it made MS

giggle is because MS said: “this is only true if that heart

is truly content”. Group: laughing, so true!


-4 participants, all female: HP, MR, MS, FT


Today's theme: Finishing up and final embellishments.

-Beginning of group: RM: This is our last scrapbooking

group today. So, today is going to be kind of

relaxed...there may be things that you haven't gotten to

put in your scrapbook, so now is a good time to add them.

DC: so we can add anything we want? RM: yes, anything you

want! If you are looking for words or pictures, I have them

in those envelopes...any kind of embellishments that you

want to make...and at the end, maybe we can just kind of

reflect on the group and how it was for everyone. DC:

sounds good to me!

HP


-HP did not attend week 7 group, so she and DC got caught

up by finding quotes to add to her scrapbook.

Images:2nd page: photo of HP. 3rd Page: photo of HP

Chosen quotes: 1st page: “Live, laugh, love.” 2nd page: “We

all have our own life to pursue, our own kind of dream to

be weaving. And we all have some power to make wishes come

true, as long as we keep believing”- Lousia May Alcott.

“When someone loves you, the way they say your name is

different. You know that your name is safe in their mouth”-

Jess C. Scott

3rd Page: “There are only two ways to live your life. One as

though nothing is a miracle. The other is as everything is

a miracle” -Albert Einstein

4th page: Live a joyful life!

Quotes: HP hand wrote a letter to her children included in

on the last page of her scrapbook: “ To (name of daughter

and son), I love you dearly, I miss you (son), but I know

you are busy and I love you with all my heart. My

(daughter), I love you dearly, you have done so much for me

and I love you with all my heart. Remember all the great

times we had, all the laughs. (Son), the accordion,

(daughter), the organ and violin were all music to my ears.

I love you, “Mom” xxoo.


DC: HP was out last week, but what we did was we made up a

page from last week of all the sayings that HP found that

she liked, and she has a couple pictures of her and her two

kids, and of course she loves flowers, and what we did was,

“live laugh and love”, we saved this page blank because we

have some pictures of her husband that are going to go in

there. Then we found another saying with a cute Polish

picture of HP because she says she's Polish. And there's

another one, and we saved these two for her daughter who

said she will be bringing in more pictures. Group: very

nice, clapping. DC: HP, did you enjoy doing this? HP: I

enjoyed it very much! RM: oh good, I'm so glad!

FT

-FT's long term memory is very good and can recall past

events and people in great detail. Her short term memory

is not good and she repeats the same story over and over.

-DC says that she “never has seen FT talk as much as she

did in scrapbook group”.

-FT chose a background and added the quote about her

father-in-law's music next to the music sheet. She then

told RM that she felt she was finished with her scrapbook

and felt good about what she had done. RM and FT looked

through the scrapbook together and admired FT's work and


all of her accomplishments.

Images: FT added her High school graduation program because

there was an empty page in the book that needed to be

filled.

Words: none

Quotes: RM: Ok FT, should we share with the group the last

couple things that we did? Do you want to give the group a

little explanation of what this is? FT: My father-in-law

used to write songs, and why did he write songs? Because he

wanted to be rich like other people. Anyway, he wrote a

song and submitted it to a radio station way back a long

time ago, and he submitted this son “To be with you” and he

won first prize! Group: oh wow! FT: but that did not

include, of course, printing, which was expensive, and so

he didn't do that, but anyway, it was on the program “Songs

for sale” by (father-in-law's name), and then there is an

explanation of it over here...its a shame he wasn't able to

go further, but that was a dream of his. He was born of a

family, a very poor family, who were immigrants from

Germany, and they came to this country. So to him,

something like that was really success, and I think he

thought because they printed it for him he would go on

further, but he did not happen to do that, but he had


pleasure doing that. I know this was way back before

television, and here we were, back in =Boston=, MA, and we

were all with our heads stuck to the radio, listening, and

we could hardly hear anything, but here was my father-in-

law telling them about his dream on the radio! Group: wow!

Ooh! AM: he was famous! FT: yeah, that, but, he had to have

the money to have it published, and recorded, and all of

that, which takes money that he didn't have. But, we always

felt quite proud of him, there we were, all of us stuffed

in the living room with our heads in the speaker of the

radio, and we could hardly hear it, and he goes on to

describe why he wanted to do it and everything. We were

trying to stop him, but he was going to tell! Group:

laughing AM: what a good memory! DC: very good! RM: thank

you! Did you enjoy doing the scrapbooking FT? FT: I like to

do this... I didn't realize what it was all about when I

came here...I did not realize...scrapbooks...I just never

did, but I have enjoyed it. RM: good, I'm so glad to hear

it! AM: and now its yours! RM: yep, its all yours now!

Group: clapping.

MR

-DC said that MR did not want to come to scrapbook group

today.


-MR did not initiate and was not very responsive today and

would repeat the same thing over and over. -MR was fixated

on her father dying when she was 7 years old.

-When DC handed MR a pen, she started writing and became

very engaged in writing to her children.

Images: none

Words: Letter MR wrote: “To my children, my whole life has

been filled with much love. You all are so very special to

me. Somewhere over the rainbow is where you will find me. I

love you all very much. All of my children and

grandchildren, you've been a very special part of my life.

Love, Mom, grandma, daughter, friend, granddaughter.

Quotes: DC: MR, I found, was very successful today. MR

wanted to write something to her children, and at first, I

wrote it for her, but then when I gave her the pen, she

wrote it herself, so we started it “To my children” (see

above). And we saved a couple pages in case her kids want

to add something. RM: that's lovely! Thank you! DC: MR, did

you enjoy doing this? MR: Oh, I did!

MS

-MS told AM, while looking at a photo of herself, that she

had a “fat face”. AM informed RM that MS has “struggled

with an eating disorder and self esteem issues her whole


life”.

-MS long-term memory was not good today, and neither was

her short term memory.

-MS had a lot of trouble hearing today.

Words: none

Images: 1st page: puffins. Dog. Son's husband with dog. 2nd

page: pictures of quilt patterns.

3rd page: Note from AM to MS: Dear MS, It has been so fun

and amazing working on this memory book with you! You are a

strong and beautiful woman. I love you! Love, AM. The quote

on card: Hope you know the reason why you're thought about

so much...its just that every thought of you is warmed by

friendships touch!

Quotes: AM: MS, we're going to show everybody the last two

pages, OK? MS: what? AM: we're going to show them. MS:

what? AM: look at me, we are going to show everyone the

last pages, ok? AM: MS loved birds, and a long long time

ago, she cut out all of these magazine pictures and cards

and calendars of birds, and her son gave them to me a few

weeks ago. I'm talking 20 years ago (that she cut them

out). So, here are some Puffins, and who's that? MS: who's

that? AM: that's a dog named (dog's name), that kept MS

company. Group: cute! Ooh! Cute dog! AM: This is (name),


that's her son's partner and their dog when it was a little

baby. MS used to quilt and make patterns and do all sorts

of sewing and knitting, and this came from one of the

pattern books that she had...and this piece right here came

from a bag of old scraps of fabric that she had for years,

so we just put it in there. RM: beautiful! Yeah! MS, can I

just ask...did you like doing the scrapbook? AM: MS, did

you have fun making this book? MS: yes, it was fun! RM:

good, I'm really glad to hear that. What did you enjoy?

AM: what will you do with this book? MS, I don't know, I

will probably look at it every day and smile. Group: good!

Alright! RM: thank you so much for doing it, I really

enjoyed having you in the group! MS: oh, your welcome! I

like this group a lot!

RM: (at end of group), Every week, I looked forward to

this, I just really loved being with all of you, and

watching you participate, and look through old photos, and

then look at your book the next week and were “oh, this is

what I did”. You all did amazing, amazing work, and, ah,

yeah, thank you! Yeah! AM: a caregiver for FT was here

today and she said what a wonderful thing this is, because

when she comes in almost every day, FT talks about the book

and asks about the book and its made her family members,


even, very happy, and kind of anxious to see the finished

product. RM: oh, wow! DC: HP's daughter was asking me

yesterday when she can see the book, and I said tomorrow is

the last day, and she said “I can not wait”. RM: oh good! I

mean, they are beautiful! They are just amazing, all of you

did amazing work! So, I think the last thing is if I can

just take pictures of the last pages that we did today....

AM: and I think we have to thank RM and give her a round of

applause, because it was all her idea! Group: clapping. RM:

thank you so much! AM: good job everyone! AM: what we'll do

is, we will take everyone back because she has to take

pictures. DC: yeah, she has to take pictures, and I will

bring the books up after.


BIBLIOGRAPHY

Allen, R. S., Hilgeman, M. M., Ege, M. A., Shuster, J. L.,

& Burgio, L. D. (2008). Legacy activities as

interventions approaching the end of life. Journal of

Palliative Medicine, 11(7), 1029-1038.

Allen, R. S. (2009). The legacy project intervention to

enhance meaningful family interactions: Case examples.

Clinical Gerontologist, 32, 164-176. doi:

10.1080/0731711082677005

American Art Therapy Association. (2013). Retrieved October

4, 2013 from website: http://www.americanarttherapy

association.org

Alzheimer's Association. (2013). Types of dementia.

Retrieved from: http://www.alz.org/dementia/types-of

dementia.asp

American Psychiatric Association. (2000). Diagnostic and

statistical manual of mental disorders (4th ed., text

rev.). Washington, DC: Author

Buron, B. (2010). Life history collages. Effects on nursing

home staff caring for residents with dementia. Journal of

Gerontological Nursing, 36(12) 38-48.

Davidson, J. U., & Robinson, B. J. (2008). Scrapbooking and

journaling interventions for chronic illness: A


triangulated investigation of approaches in the treatment

of PTSD. The Kansas Nurse, 83(3), 6-11.

Hanneman, B. T. (2006). Creativity with dementia patients.

Gerontology, 52, 59-65. doi:10.1159/000089827

Harrison-Dening, K. (2013). Dementia: Diagnosis and early

interventions. British Journal of Neuroscience Nursing,

9(3), 131-137.

Karns, J. T. (2002). Scrapbooking during traumatic and

transitional events. Journal of Clinical Activities,

Assignments & Handouts in Psychotherapy Practice, 2(3)

39-47.

Kohut, M. (2011). Making art from memories: Honoring

deceased loved ones through a scrapbooking bereavement

group. Art Therapy, 28(3) 123-131. doi:

http://dx.doi.org.ezproxy.spfldcol.edu/10.1080/07421656.2

011.599731

MacGregor, A. (2006). Implementing the creative care

project. Nursing and Residential Care, 8(3), 131-133.

Merriam, S. B. (2009). Qualitative Research. A guide to

design and implementation. San Francisco: Jossey-Bass

McCarthy, P. G., & Sebaugh, J. G. (2011). Therapeutic

scrapbooking: A technique to promote positive coping and

emotional strength in parents of pediatric oncology


patients. Journal of Psychosocial Oncology, 29, 215-230.

doi: http://dx.doi.org/10.1080/07347332.2010.548443

Mizen, M. B. (2004). Scrapbook photo albums are therapeutic

for Alzheimer's patients. Creative Memories. 1-4.

doi: http://www.creativememories.com/AlzheimersAlbum.PDF

Orell, M., Woods, B., & Spector, A. (2012). Should we use

individual cognitive stimulation therapy to improve

cognitive function in people with dementia? British

Medical Journal, 334, 46-47

Oxford University Press (2013).

http://www.oxforddictionaries.comus/definition/american_e

nglish/mood

Puyenbroeck, J. V, & Maes, B. (2006). Program development

of reminiscence group work for ageing people with

intellectual disabilities. Journal of Intellectual &

Developmental Disability, 31(3), 139-147.

doi:10.1080/13668250600862988

Rylatt, P. (2012). The benefits of creative therapy for

people with dementia. Nursing Standard, 26(33), 42-47.

doi: 10.1159/000089827

Safar, L. T., Press, D. Z. (2011). Art and the brain:

Effects of dementia on art production in art therapy. Art

Therapy: Journal of the American Art Therapy Association,


28(3), 96-103. doi:

http://dx.doi.org.ezproxy.spfldcol.edu/

10.10.1080/07421656.2011.599734

Seifert, L. S., Drennan, B. M., Baker, K. B. (2001).

Compositional elements in the art of individuals with

Alzheimer's-type dementia. Activities, Adaptation &

Aging, 25(3/4), 95-106. doi: 10.300/JO16v25n03_07

Sorbi, S., Hort, J., Erkinjuntti, T., Fladby, T., Gainotti,

G., Gurvit, H., Scheltens, P. (2012). EFNS-ENS guidelines

on the diagnosis and management of disorders associated

with dementia. European Journal of Neurology, 19, 1159-

1179. doi:10.1111?j.1468-1331.2012.03784

Spector, A., Gardner, C., & Orell, M. (2011). The impact of

cognitive stimulation therapy groups on people with

dementia: Views from participants, their carers, and

group facilitators. Aging & Mental Health, 15(8), 945-

949. doi:10.1080/13607863.2011.586622

Stallings, J. W. (2010). Collage as a therapeutic modality

for reminiscence in patients with dementia. Art Therapy,

27(3), 136-140. doi:10.1080/07421656.2010.10129667

Stephenson, R. C. (2006). Promoting self-expression through

art therapy. Generations 30(1), 24-26.

doi:10.1080/01609513.2011.60311


Stewart, E. G. (2004). Art therapy and neuroscience blend:

Working with patients who have dementia. Art Therapy,

21(3), 148-155. doi:

http://dx.doi.org/10.1080/07421656.2004.10129499

Tuppen, J. (2012). The benefits of groups that provide

cognitive stimulation for people with dementia. Nursing

Older People, 24(10), 20-24.

Yasuda, K., Kuwabara, K., Kuwahara, N., Abe, S., &

Tetsutani, N. (2009). Effectiveness of personalized

reminiscence photo videos for individuals with dementia.

Neuropsychological Rehabilitation, 19(4), 603-619

doi:10.1080/09602010802586216

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