Consent and creative engagement

For the past year and a half I have been leading an art club at one of my local nursing homes. Some of the people in the group are at different stages of dementia. I work with the care assistants to deliver an engaging activity for the residents to enjoy. The quality of engagement varies from session to session, sometimes people are sleeping or unwell. Sometimes people don’t feel like participating or they have visitors. This requires me to be flexible, open and understanding to support this long-term, sustainable practice.

Everyone is invited to participate but I have a regular small group of people I work with. I work on different floors in the home so this means I work with different people. Something happened recently that really made me think about how I work with people who have dementia, what participation means and the importance of consent.

I was working with a group of ladies on a floor I hadn’t visited before, one lady was sat smiling and looked like she was wanting to participate. She said she loved dogs and talked about one she had in the past. We looked at a picture of a collie dog and we drew the outline together using carbon paper. I was working my way round the group and she would stop drawing until I came round again. I thought it was because sometimes people struggle to direct the line when drawing, or holding the pencil can be difficult. But after we had painted the fur and grass, I got a pencil for the eyes and placed it in her hand and she said in a really clear voice ‘I don’t like being made to do things. My grandfather used to make us do this and it made me have enough. My grandmother was blind and we had to look after her and he always made us do this sort of stuff…even at school, I didn’t like doing it’.

I thanked her for sharing her feelings and I told her I was grateful for what she said. We had nearly completed a picture of something I thought she wanted to do, but there was something about the experience that triggered some emotions in her. Sometimes there are moments of lucidity during creative acts, where people with dementia say interesting and insightful things. I’m aware that what people experience differs, and I feel that people suffering from the disease of dementia have a fragmented reality that is different to mine. I was once with a lady who was greatly affected by the disease, but she was willing to hold the paintbrush or pencil and have a go. We had all kinds of abstract conversations and then suddenly while she was painting she said ‘I used to paint a lot when I was younger. I asked her what paint she used, she said ‘acrylic’ and she was describing techniques she had used. She then returned to her previous state when I visited again. I imagine it like a window, I’m sat with someone, waiting for them to look through it at the same time so you can have a communication about what you’re both looking at. But this communication can be stuck in a loop or can be a memory. If you are sensitive, it’s possible to see how the memory is relevant to the present context. So going back to my earlier experience of the lady saying she had been made to draw and paint by her grandad, she opened the window to tell me how she felt about what she was experiencing in the present, through a memory of the past.

It's made me feel more sensitive to the power dynamic of engaging with people. I had participated on a online safeguarding training event provided by Curious Minds in Manchester. (www.curiousminds.org.uk) It was really interesting and it made me think about what this means in relation to what I do. Everything I do is about an hour long, there is a lot of preparation and there isn’t always enough time to get through things in larger groups, but despite this, I need to be sensitive to how and why people participate in what I do. I’m sharing Shirleys painting of her dog that she may not have wanted to paint after all. I’m grateful for her honesty and she signed her painting for me. It’s now in my studio to remind me to make space for sensitive considerations in my practice.

The Unwanted Dog