It began as a thought that gave rise to a question: Assuming artistic expression stimulates the mind, body, and spirit, how might an art program be designed to meet the needs not only of high-functioning long term care residents, but those with cognitive and physical impairments?

And so began a conversation during the care planning process that grew into a pilot project that eventually blossomed into Middlesboro Nursing and Rehabilitation Facility’s Artistic Enrichment Program, winner of the Kentucky Association of Health Care Facilities’ 2013 Innovation in Care Award.

Developed by Activities Director Christy Bean and Assistant Director Charmaine Moore in November 2010, the well-designed therapeutic program aims to reach all residents at the facility.

Focus On Individuality

The objective is not only to provide fun activities through art, but to focus on the creative journey individuals, regardless of ability, undergo during the artistic process. Goals aren’t set, they’re individually met. No expectations or boundaries are placed on residents, because the intent of the program is not to create “fine art,” but to create art by fine people.

The center’s artistic enrichment program requires its activities staff to invent projects that encourage creativity; stimulate memories, emotions, and imagination; foster self-expression; reduce stress and dementia-related behaviors; and provide the sense of personal achievement and independence that leads to increased communication, confidence, and healing in residents spanning the spectrum of cognitive and physical ability.

One way the activities staff achieve this is by encouraging residents to work with a variety of mediums that allow for success, not frustration and failure. Thus, residents with reduced cognitive function who are unable to follow simple directions, or “stay within the lines,” so to speak, are still able to tap into their own creativity by using paint mixed in spray bottles, a process that results in unique and colorful abstract paintings. They might hold blow-dryers, which necessitate less manual dexterity, to melt crayons on canvas to make colorful collages, or use celery stalks as paint stamps to create rose bouquets.

Tissue paper can be used to make stained glass and chalk or oil to create pastel drawings. Male residents particularly enjoy using hammers and nails to stamp antique cars on solid sheets of aluminum. Higher-functioning residents pursue ongoing projects that can take four weeks to complete. As in a regular art class, they learn techniques such as line, shading, and depth.

Activities directors do not need to be artists to generate unique projects. Pinterest offers a wealth of ideas, as does the work of famous artists easily accessed on websites and Google. Moore, for example, showed residents paintings by Georgia O’Keefe, whose abstracts capture the emotion and power of natural objects (most notably, flowers and barren Southwestern landscapes). Residents then turned their eyes on the landscapes of their own experience to convey their own abstract art.

Activities Enhance Skills

Soon the center’s occupational therapist recognized that artistic enrichment projects can help residents improve fine motor skills, hand-to-eye coordination, sequencing, dexterity, and powers of attention in a fun and rewarding way. Stroke patients benefit from the opportunity to strengthen their non-dominant sides or hands through adaptive equipment.

There have been many “ah-ha” moments, reassuring activities staff that their vision for the program has been realized. One involved a 98-year-old resident, whose only family, her son, resides in California. Because he is able to visit only twice a year, she spends much of her time thinking of ways to make his visit all the more special. Enter the Artistic Enrichment Program, which allowed her to spend months in her room painting a beautifully shaded horse to give her son as a gift. When he arrived, she felt not only the joy that comes from time spent with family but the thrill of accomplishment.

Program Expands To Community

But the Artistic Enrichment Program’s target audience is not confined to residents only. Family members, volunteers, and staff also participate, as do members of the larger community.

For example, art students from nearby Lincoln Memorial University, in Harrogate, Tenn., have assisted Middlesboro Nursing residents with various projects, an outreach initiative that has proven to be an entertaining social event for residents, and an eye-opening and educational experience for young adults who leave the facility with new-found awareness that art is ageless.

The local Girl Scout troop visits the facility to learn about art from the residents and earn special badges for their participation. And in the evenings, employee children come to the center to work on art projects with residents.

The program also serves as a unique marketing tool for the facility. When prospective residents and their families arrive for tours, they find resident artwork displayed throughout the building, either in showcases or in photos streaming across the Activity Department’s Smart TV bulletin board.

Photographs of artwork and articles about the program also appear in Middlesboro Nursing’s newsletter and on the Activity Connection website. The walls of Administrator Alice Maddox’s office display professionally framed resident artwork as well. The message signaled to visitors is loud and clear: The minds, emotions, spirits, and imaginations of residents can thrive here.

Consumers Take Notice

Thanks to the innovative program, Middlesboro resident artists have become celebrities in the larger community, too. When a local young woman sought donations for an auction to be held to raise relief money for tornado victims in Missouri and Oklahoma, residents got busy. Their artwork was so well-received that the residents have since established a Community Benefit Fund financed primarily with sales of resident art projects.

“Future projects include an art show at the local mall and hosting an art class with an area church that teaches community art classes,” Bean says.

Ultimately, Middlesboro’s Artistic Enrichment Program can serve as a source of inspiration for activities staff at other long term care facilities. “Art provides the perfect venue for communication and expression, fun and smiles,” says Bean. “There should be no boundaries restricting residents with cognitive impairments from participating in art programs, or limitations when it comes to the tools they can use for creativity and expression.”

A successful art program does not require an actual artist on staff, Bean says. With research and InternetAlice Maddox access, all facilities can access tools and project ideas. “Art enrichment requires no talent, but allows residents to uncover the emotions that help them to tap into their imaginations. The result is improved communication skills, increased confidence, and, ultimately, healing.”

Alice Maddox is administrator of Middlesboro Nursing and Rehabilitation Facility in Middlesboro, Ky. She would like to thank Elizabeth Lamont, PhD, for assistance in editing this article.