Early-onset dementia patients tackle symptoms through 'clinical art'

Early-onset dementia patients are facing their symptoms head-on through a "clinical art" program to stimulate their brains at the Nagisa Warakuen facility for the elderly in Tokyo's Edogawa Ward.

"Ashitaba Art" is a monthly program that the facility began holding roughly two years ago that challenges dementia patients who began developing symptoms before the age of 65 to maintain their current mental functions through creating works of art.

At a meeting of the group on April 18, instructor and clinical artist Kanako Obata, 36, led the roughly 10 participants in creating "bamboo shoot"-themed sculptures. Participants first held a bamboo shoot in their hands, paying close attention to the shape and the feel of the object, even being prompted by Obata to smell the shoot, all to stimulate their brains through their five senses. She also asked the participants for examples of dishes made with bamboo shoots. At the suggestion of "sashimi," Obata promptly answered, "Wow, fancy!" to the smiles of the participating family members of the patients and other facility workers.

The artwork itself was made from newspapers rolled up to form the shape of a bamboo shoot before being decorated with bits of traditional Japanese handmade paper. Staff kindly guided a woman who did not understand the process and was just tracing the brush meant for glue over the materials.

Seventy-four-year-old Gen Ito of Katsushika Ward has been participating in the event since the very first meeting with his wife, who has early-onset dementia. He said his wife also attends the daytime nursing care service provided by Nagisa Warakuen called "Ashitaba" three times a week. "Ashitataba Art is an activity that we have spent time cultivating. As a family member, I want to help keep it lively," Ito commented.

In addition to creating sculptures, clinical art also includes a wide variety of programs, like listening to the sound of rain while painting on panes of glass or imagining what it's like inside dirt while painting on a flower pot. The effectiveness of the treatment on dementia is still being researched, but according to Obata, "Art is just a tool. Having fun and smiling is what's most important."

About an hour later, the bamboo shoots of various shapes and colors have been completed. Obata goes around the room to offer compliments about each individual piece. Participants then share their thoughts and praise with each other, and by the end of the session, everyone has a satisfied expression on their face.

The activities that patients with dementia are able to carry out slowly decrease with the progression of the disease, and for many people, their self-confidence decreases as well. Through spending time enjoying themselves with their peers, the treatment is thought to offer comfort and encouragement for patients with low self-esteem. "Even if they forget that they made the piece, how they felt while making it definitely still remains," Obata said.

According to a nationwide survey carried out by the Ministry of Health, Labor and Welfare in 2009, an estimated 38,000 people have early-onset dementia. Compared with the more than 4.6 million people aged 65 and over suffering from dementia, there are a smaller number of early-onset patients, and the reality is that there is a lack of facilities and programs to support and meet their needs.

The causes and symptoms are the same as the dementia that occurs in those 65 and above, but the average age for the onset of symptoms is 51 years old, and there are even cases of those in the prime of their lives being affected. Because of the age factor, while they may feel changes in their body, they often put off going to the doctor and are forced into early retirement, many ending up unable to support themselves financially. Because they still have their physical strength, their struggle to find a place to feel comfortable at or a reason to live is an issue that needs to be addressed.

"There needs to be more effort put into deepening knowledge about early-onset dementia among nursing care workers," said Nagisa Warakuen regional director Megumi Ikeda. In the 2009 fiscal year, Nagisa Warakuen began its "Ashitaba" daytime nursing care service as a Tokyo Metropolitan Government pilot program. Even after the pilot service ended, the facility continued to offer care on its own, and has had participants such as a man on a leave of absence from work and a woman in the middle of childrearing.

"Our staff were worried about how we should treat those patients whose bodies were healthy but whose dementia was advancing," Ikeda said, looking back on the Ashitaba program. As for "Ashitaba Art," Ikeda said that she can see improvements in patients' concentration and communication abilities. Realizing that support for family members was also indispensable, the facility established a family association in 2012.

"Ashitaba Art" will hold its first exhibition on May 3 and 4 at Tower Hall Funabori in Edogawa Ward. The exhibition will run from 12 p.m. to 6 p.m. on May 3, and 9 a.m. to 5 p.m. on May 4, with chances to experience the art-making process on both days. Juntendo University Medical School research associate Akiko Furuta, a dementia researcher, will also hold a seminar from 2 p.m. on May 4. Admission is free. For more information, contact Nagisa Warakuen at 03-3675-1201 (Japanese only).