Alzheimur workshop

Music Score for a Lullaby

2080-03-26T19:02:00.000+01:00

The painting, Music Score for a Lullaby by Chelete Monereo, describes how a mother dreams of freedom for her daughter. She has composed a lullaby for her baby where she has planted seeds for the future. These seeds create a melody where love and an air of the ancestors characterise the rhythm against a world without limits and conditions.
Our memory is not simply a question of remembering “facts”. The memory of our lived experiences and relationships with our relatives runs through our veins. While the origins of our experiences are found in the interaction between the human being and the environment, this experience, however, only becomes apparent and is perceived when its value has been built upon another. That is, the conscious commitment between the new and the old is, the imagination.
And, the imagination is ours. It is capable of identifying threads that enable us to interweave fragments found in the field of the arts, culture and science, in order to make the life of the Alzheimers patients more joyful.

THE ARTIST'S REFLEXIONS

2009-09-29T19:39:00.001+02:00

Some time ago, I read for the first time the word “Alzheimers” in a magazine. It described a man with this disease (I think he was a retired lecturer) who could only carry out such things as to dress, walk around the house, play with his dog or take care of the garden, and he hummed some melodies. At the same moment as the musical rhythm was interrupted, he stood still, like lost, and the concentration he put into the task he had been doing, diminished. When his wife realised this situation, she started singing one of his songs and her husband was then able to pick up the hum and return to one his activities.
From my point of view, within the tragic context of similar illnesses, the situation seemed to have a mysterious, as well as, a poetic element.
Now, I have had a direct experience with patients affected by the Alzheimers disease at different stages.

Based on an exhibition of my paintings at the Museum of Fine Arts in Murcia, where the memory and remembrance formed part of the subject matter, AlzheimUr Foundation invited me to work with them.

They have brought forward memories from their vague and shadowed remembrances, caught them and fixed on to the white fabric using colours, stables, threads and knots… within their capacity.
It was impressive to find out the following day, that a man did not remember having done this task, but it was even more impressive to see that after looking at “his” fabric for a while, he focused his attention on a spot of a yellow colour. It made him smile and he said: “Ah yes, this is my road paving machine that I have been working on building roads.”

Or a woman, in front of a scribble that she had done some days earlier, to say with a dreaming voice: “this “is” my mother. She was so beautiful! Did I do this? With my mother everyone was happy and was laughing. She was so funny.” Then she narrated new memories, looking at the scribble with tenderness.

These stains and scribbles provide in some way, the key to the memory that became locked from the inside, with the slam of the door.

Physical? Mental? Stimulant? What a mystery!

Attendible? Improvable? Curable? What an admirable effort!

Chelete Monereo

EMOTIONS, MEMORY AND ALZHEIMER

2009-09-28T19:11:00.004+02:00

Our brain is a wonderful machine which is in a constant production. It creates images, colours, feelings, etc. All our perceptions belong to the nervous system and provide it nutrition. One image can provoke biological changes. It can generate the production of serotonin, adrenaline, noradrenaline … millions of molecules. Painting, music, writing (as a visual communication through symbols previously agreed on), are nothing more than a game that combines physical and chemical processes of the brain in order to see, listen and smell, and thus to gain memories and emotions. Neuroscientists are showing (by means of reporting directly from brain activities with techniques of the neuroimage), that by stimulating the fields of perception the chemical process in our brain is activated.

In the 19^th century, based on the studies of James and Lange, the proposition was raised that in our memory the different kinds of behaviour are recorded and they evoke according to the function of our felt emotions. Hence, an extraordinary and fascinating path opens up and where neuro-scientific investigations are contributing some light.

Antonio Damasio, an excellent neurologist and a researcher in the neurobiology of emotions and feelings, and a winner of the Prince of Asturias Awards for Technical and Scientific Research in 2005, wrote in his book Looking for Spinoza: “Emotions play out in the theatre of the body. Feelings play out in the theatre of the mind.” He adds that memory, emotions and the language, are factors that make the human organism and its brain to be unique and especial.

We know what the Alzheimers disease implies for the patient, family and the society, and the difficulty of facing, every day, a loved one who we see and considers us as strangers. But we also know that the patients, already advanced in the disease, are able to express their emotions responding to many stimulants and are able to, in a certain way, remember. What happens in their brain? A way to verify it is to make a research, to measure what can improve the lives of the patients when, with different artistic-emotional stimulants, we try to make them remember and with the help of their emotions to feel better.

The AlzheimUr Foundation’s commitment and one of its principal aims is to carry out a research. A research that is not limited to clinical studies, new medicine or genetics, but is also social. In other words, it is a question of “weaving together” a commitment, integration between patients and their relatives together with society and the activities that the Foundation carries out. The aim of the research, in this case qualitative, is to prove that these activities that derive from the arts and are linked in a direct way to the emotions, can benefit the patients due to making them remember, as well as improving the patients’ self-confidence, their quality of life and of that of their relatives.

With this first activity, we embark on an original and affluent line of research. It represents a great opportunity and comprises great possibilities. We count on the patients and their self-sacrificing families, on the wonderful richness of human emotions that many know how to express in the multiple aspects of the arts, on the institutions that have supported us, on the society, their values and on an excellent and enthusiastic team with a high degree of professionalism. Without all these bodies, it would be impossible to carry out this, or any other, undertaking.

CARMEN ANTÚNEZ, directress of the Dementia Unit at the University Hospital “Virgen de la Arrixaca” in Murcia and Medical directress of the Alzheimer Foundation.

REFLEXIONES DE LA NEUROPSICÓLOGAS

2009-09-27T19:27:00.000+02:00

1ª PARTE: MALETA DE LA MEMORIA.

El taller se llevó a cabo con dos grupos de pacientes diagnosticados de Enfermedad de Alzheimer GDS 4, y que asisten al Taller de Estimulación Cognitiva de la Unidad de Demencias del Hospital Virgen de la Arrixaca. A pesar de estar en el mismo estadio de la enfermedad, los grupos diferían en el grado de deterioro (GRUPO 1: Menor deterioro; GRUPO 2: Mayor deterioro).

La respuesta de los pacientes al taller fue muy positiva, ya que recordar el pasado constituye una actividad estimuladora que dignifica y gratifica al paciente.

Fue muy importante la colaboración de las familias, que en todo momento se mostraron involucradas en el proyecto, proporcionándonos los objetos personales de sus familiares.

En el desarrollo de las sesiones se destaca la capacidad de los objetos para evocar recuerdos de sus vivencias del pasado y las emociones asociadas.

En el GRUPO 1, los objetos presentados fueron reconocidos por los pacientes y fueron capaces de recordar episodios de sus vidas en los que estos estuvieron presentes. Sin embargo, en el GRUPO 2 hubo mayor dificultad para reconocerlos y asociarlos con su vida, por lo que fue necesaria la ayuda para orientar el recuerdo.

En general, Resultó más fácil cuando se trataba de un objeto utilizado por ellos en su pasado que cuando se utilizaba una representación actual del mismo (ej.: una paciente no reconocía un saltador de niña actual, que representaba una cuerda con la que ella jugaba de pequeña en su calle.) siendo más complicado en el grupo más deteriorado.

En la valoración de emociones tras el taller, predominan las emociones positivas en ambos grupos ante la presencia del objeto. También hay que decir que en muchas ocasiones se observó la ausencia de emoción, más predominante en el grupo 2.

En el desarrollo de esta primera parte los pacientes llevaron sus cajas de la memoria a casa entre sesión y sesión para poder enseñárselas a sus familiares y hablar sobre los objetos con ellos. Esta iniciativa careció de éxito ya que como los propios familiares informaron los pacientes ignoraron la caja en su domicilio.

2ª PARTE: EL PAÑUELO DEL RECUERDO.

Con respecto a la primera parte, esta segunda resultó de mayor dificultad para los pacientes dado que se trabajó con conceptos más abstractos. Al igual que en la primera parte se observaron diferencias entre ambos grupos.

En una primera sesión debían representar con pintura personas significativas para ellos en su infancia. En general, todos tuvieron dificultades para realizarla y necesitaron de la ayuda de las psicólogas.

La segunda sesión que representaba la juventud, se trabajó con el concepto de color para representar emociones. Se observó incapacidad por parte de los pacientes para comprender la tarea, lo que provocó en algunos casos respuestas de ansiedad e irritabilidad.

La tercera parte fue para ellos la más gratificante, en la que debían plasmar los sitios a los que habitualmente iban en el momento actual.

Lo que pudimos observar en esta segunda parte es que si bien el hecho de plasmar en un dibujo alguna escena de su vida provoca reacciones emocionales y asociaciones con otros recuerdos, esta creación pierde su valor como evocador de recuerdos en el momento que termina la sesión (más patente en el segundo grupo), ya que se les hace imposible recordar por que motivo hicieron eso y qué representaba.

Todos los pacientes quieren venir a los talleres, no quieren que terminen y muestran una gran alegría al interaccionar con el grupo de terapeutas y profesionales invitados que trabajan con ellos.

Begoña Martínez Herrada y Blanca García Torres. Unidad de Demencias. Hospital Universitario Virgen de la Arrixaca en Murcia.

Invitation to the exposition "El Arte de Entretelas" MuBAM, 21-27 september 2009

2009-09-20T17:02:00.005+02:00

Procedure

2009-01-30T17:51:00.002+01:00

The second Art and Culture Workshop as Therapy, “narrating memories”, differs from the first one, “the art of entretelas”, by focusing the study on cognitive stimulation and semantic memory. This intervention enjoyed the collaboration of José García Martínez, a journalist known for his daily column in one of the regional newspapers, and 12 students of illustration in the Faculty of Fine Arts at the University of Murcia. Each patient was appointed two students. The workshop spanned 7 sessions, 90 minutes each.

On the 26^th of January 2009, six patients (diagnosed with the Alzheimer disease with GDS 4) were invited with their families to Murcia’s Regional Library. The workshop started here, with the presentation of the story tale, The Wedding, written by José García Martínez and a show of the film, Crazy for a Whistle, directed and written by the same author. The journalist read the tale with a great expression; a tale, which took place in Murcia during one sunny spring and described how the Lemon and the Sardine fell in love with each other and finally got married on the “Day of the Sardine’s Funeral”. At the end of the story reading, the patients picked up the thread and continued a lively dialogue about the Region’s joyful Spring Festivals. We hoped the tale and the fantasy inherent in the film, Crazy for a Whistle, would evoke memories for the patients of their lived experiences.

After this presentation, the patients were taken on a guided tour around the library to reinforce their awareness of the place. The bright colours and generous spaces stacked with books would help them to remember what happened that afternoon.
In the following sessions, now at the Dementia Unit, the focus moved to the 12 illustrators. These collaborators were asked to make at least one drawing per session, as detailed as possible although without reaching into the field of abstraction. Using these drawings as a support, the patients would be able to narrate his/her memories and build up a “story”.

The first task for the patients was to remember the story, The Wedding, and identify a memory of a lived and a festive experience. This experience they described to the students who prepared their pencils and started making sketches of the broken sequence of events. The following three sessions focused on the ‘festive place’ (environment, landscape), ‘specific festivals’ (carriages, presents, the whistle…) and ‘gastronomy’ (sardines, lemon…).
At the beginning of every session, the students showed their sketches to the patients. This helped them to recall the situation and to continue the description in more detail. The exercise required the usage of descriptive terms to improve the drawing. At the end of the session, the patients evaluated the work of their collaborators, the level of details and resemblance to the memory.

The aim was to grasp the patient’s narrative description so that he/she could identify with it. In other words, in the hands of the illustrator the drawing paper became a tool for the patient to express his/her lived experience. This meant that the student had to be flexible in the way of transcribing the words on to the paper, whether using wooden colour pencils, watercolours or, in terms of the number of illustrations (min 1 and max 3).

In the sixth session, the students finished illustrating the patients’ narrations, achieving an exclamation: “Yes, it happened in this way”!

The seventh and last session, took place in Murcia’s Regional Library where the patients returned to present their narrations to the journalist, José García Martínez, using the illustrations as a guide. At the beginning of the presentation, the patients sat by their families. One by one, they were invited to go to the table of presentation where José greeted them and listened to their memories narrated. This time, the patients were the principal players of the event, recounting short tales to the invited audience: the families and the students of illustration, the medical team and university teachers, among others.

As a way to register the workshop, each illustration had its evaluation form to measure the degree of emotion. In addition, the patient was asked a set of questions corresponding to each theme to be illustrated. Moreover, the patient was evaluated and observed in each session in the context of clinical issues such as behaviour and emotional state. Before the initiation of the intervention and at the end of the workshop, the degree of participation and the patient’s interest during the process of the workshop was measured. Measuring indicators were used based on clinical reports and questionnaires about quality of life, degree of deterioration, emotional level, behaviour, mental state and the degree of satisfaction.

In order to continue observing possible changes experienced or development of the disease suffered by these patients, all the sessions were video recorded with sounds, as well as being photographed. It will thus be possible to measure and compare facts throughout the investigation, facts on verbal expression and on emotion.

Bibliography:

- José García Martínez (1999) El Casamiento. Fiestas de Primavera 1999. Ayuntamiento de Murcia. Caja Murcia.

A. Pelegrin, M.V. Sotomayor, A. Urdiales (2008) Pequeña memoria recobrada. Libros infantiles del exilio del 39. Ministerio de Educación, Politica Social y Deporte. Ediciones Gráficas Arial. Madrid.

-The MOMA Alzheimer’s Project: Making Art Accessible to People with Dementia. A Guide for Museums. The Museum of Modern Art. http://www.moma.org/education/alzheimers.

- “Nationality in Context” en Framework, n. 7 June 07. Special Nordic Issue.

- Worlds in a Box. Whitechapel Art Gallery, London, 1995. The South Bank Centre.

Narrating memories as therapy

2009-01-29T11:54:00.003+01:00

With this second Art and Culture Workshop as Therapy, the debate on Alzheimers is opened up towards experiments within the research where the act of “narrating memories” joins the scientific investigation.

Literature is a source of inspiration where imagination melds with reality. Citing Marcel Proust and his book, Remembrance of Things Past, the writer points out that only by experiencing, one can remember things past. In other words, reality takes shape in the memory alone. Situations and objects evoke man's memory as man takes notice of his environment. As an example, Proust described in his novel, how the imagination of the protagonist became reality at the moment of recalling different smells, colours and lines in the landscape on his walk with his grandfather.

One of the challenges of our workshop lies in the effort of observing, as a way to focus the memory. As a result of searching for a book of popular culture and one that did not demand special knowledge to be understood, the Alzheimers patients listened to the tale, The Wedding[1], in the same way as they would listen to a minstrel. Written by the journalist, José García Martínez, the story opens up to realities related to the traditional holidays in the Region of Murcia. They are important events that make links between the place, impressive religious symbols and scents of spring, gastronomic flavours and sounds of whistles blowing, as well as including actors from the past.

The Wedding

It all happened during the same day, the day of the “Sardine’s Funeral”. The story of The Wedding narrates how Lemon and Sardine got married during the Spring Holidays in Murcia.

“Once upon a time, a lemon lived in the Espinardo neighbourhood. Its name was Lemon. He spent all his time hanging on a branch over a little stream. He liked observing the flow of this small river, so fresh and clean. But, what he found really fascinating were the reflections the sun left on the water, as shiny as silver coins or the scales of a siren. Occasionally, the soft wind moved the branch and Lemon could almost kiss the surface of the passing water.

One day, a sardine passed by on the path. Her name was Sardine. Lemon looked at her and realized she was the famous sardine of the “Sardine’s Funeral” and she was being escorted from the city, Molina de Segura, to the capital, Murcia. Lemon noticed that her expressions and her splendour were the same as those of the water canal and he fell in love with her…”

This is how the story begins, taking place in a landscape that we all know, namely, the fruit land. Bright colours, different smells, the textures of nature and the happiness inherent in watching the carriages, were elements able to provoke the patients’ imagination and enabled them to initiate a journey where the mind and the inspiration were free and without prejudice. The emotion would lead them towards the way to describe an experience, which, although subjective, is recognisable by us all. Even if they were narrations of fragile connections with reality, they were related with the same excitement as those recollections of lived and happy experiences that are fixed in our memory.

In fact, we can all be a narrator like the journalist, José García Martínez, who, committed to society, calls for reactions from his readers and listeners with his reflections. This is the repercussion the workshop has on all of us, to value the capacity of the medium of narrating to fix realities shaped in our memories, acting as a reflection of values, social and cultural ones.

Halldóra Arnardóttir, PhD in History of Art and Coordinator of the Art and Culture Workshops as Therapy, Fundación AlzheimUr.

[1]José García Martínez (1999) El Casamiento. Fiestas de Primavera 1999. Ayuntamiento de Murcia. Caja Murcia.

PROCEDURE

2008-11-02T19:20:00.000+01:00

The first Workshop of Arte and Culture as Therapy initiated from the art exhibition, “Entretelas”, the work of the painter Chelete Monereo in the Museum of Fine Arte in Murcia. The third of June 2008, 10 patients of Alzheimer visited the exhibition together with their families, the artist and medical team.

Using the exhibition as an inspiration and means to active conversation about memories linked to their personal belongings, with them the patients created Luggage of Memory. The activity began in their homes with their families and concluded with their medical in the Dementia Unit. For this, the patients and families gathered together objects charged with memories.

In the Dementia Unit, each patient was provided with a beautiful leather suitcase to keep his objects of memory. To make the task easier, the medical team prepared a guide of suggestions. In the process of organizing the belongings, the patients explained the collection to the neuropsychologists and fellow patients. Following that, Chelete was reincorporated to the workshop to work with the patients in the creation of the Scarves of Remembrance. The workshop, the art of “Entretelas” concludes with an exhibition of the Luggage of Memory and Scarf of Remembrance, together with a medical report recounting the experience.

The objects selected by the patients related to playing, the school, the working life, the family and friends. After having collected the objects and photographs from their homes, each patient brought them to the Unit to organise them in his/her Luggage of Memory. Placing them in the luggage, the patient worked on his/her memory explaining the situations embedded in the object, following the order of his/her childhood, youth and maturity during six sessions. Following a set of questions, the aim was to identify the emotion that was associated to the object and its setting.

In the Workshop of the Art of Entretelas, the luggage is used as a tool of expression, of a call from the profound memory of each patient. Thus, appeared memories of reunions with the family and friends, celebrations and work, presents from boyfriends and things that had followed them during their lifespan.

In order to protect and enfold these valuable objects, each patient elaborated a Scarf of Remembrance for his/her luggage. This scarf forms part of the narration about their life route seen through the objects. The patient’s period of life was maintained to work on the notion of time, the colours of life and on transcribing emotions through a non-verbal expression. Chelete suggested working with a long fabric that would represent the childhood, youth and maturity, just as they had followed describing their objects. They drew, wrote and fixed their memories on to the fabric of close relatives and friends and lived experiences. During three sessions, individually the patients cut a piece of the fabric according their sense for the time. In the first session the theme was the memory of their parents, children games and friends. The second sessions focused on good and bad experiences while the third session represented their daily life of the present. In the fourth session, the task was to unite the different parts of their lives and recover the memory of the situations that they had been drawing.

As a way to register the workshop, each object had its sheet of evaluation measuring the degree of emotion as well as the patient being asked a set of questions corresponding to each object. Furthermore, the patient was evaluated and observed in each session in the context of clinical issues such as behaviour and emotional state. Before the initiation of the intervention and at the end of the workshop, the degree of participation and the patient’s implication during its process was measured. Measuring indicators were used by means of clinical following-up and questionnaires of quality of life, degree of deterioration, emotional level, behaviour, mental state and the degree of satisfaction.

In order to continue observing possible changes or development of the disease suffered by these patients, all the sessions were recorded in video with sounds as well as being photographed. Thus, it will be possible to measure and compare facts throughout the required time of the investigation, facts on language expression and on emotion.

Bibliography:

- “A través del armario”. Catalogue for the exhibition: Chelete Monereo, Entretelas in the Museum of Fine Arts in Murcia. 2008.

- “Nationality in Context” in Framework, n. 7 June 07. Special Nordic Issue.

-The MOMA Alzheimer’s Project: Making Art Accessible to People with Dementia. A Guide for Museums. The Museum of Modern Art. http://www.moma.org/education/alzheimers.

- Worlds in a Box. Whitechapel Art Gallery, London, 1995. The South Bank Centre.

A visit to the exhibition "Entretelas" in the Museum of Fine Arts

2008-06-03T10:35:00.003+02:00

Today, ten Alzheimers’ patients visited the exhibition together with their families, the artist and medical team. Using the exhibition as an inspiration and means to activate conversations about memories linked to their personal belongings, the patients will create a "Luggage of Memory". The activity begins in their homes with their families and concludes with their medical team in the Dementia Unit. The task involves gathering together objects charged with memories.

Editorial

2008-05-29T11:52:00.001+02:00

Workshop 1
The Art of “Entretelas”
COLLABORATION WITH CHELETE MONEREO, PAINTER
May-Dec. 2008

With this first Art and Culture Workshop as Therapy, the debate on Alzheimers is opened up towards new experiments within the research: the arts join the scientific investigation and the qualitative evaluation.
The aim of the AlzheimUr Foundation is, through different workshops, to commit the arts to become a tool for the scientific investigation carried out in the Dementia Unit at the University Hospital “Virgen de la Arrixaca” in Murcia.

In the arts, the senses are one of the basic tools utilized to address and work with reality. The artist’s vision and sensibility towards society make us conscious of the individual’s complexity and the different ways of looking at the world. The arts show the relativity of things and the subjectivity that surrounds the human being.
As reason enables us to identify concepts and discuss them, find coherence and contradiction within them, emotions are equally important in the development of the human being and structuring our minds. They enable us to take decisions, work with memory, attention, perception and imagination in our efforts of living together in society.
Scientific research has demonstrated that our memories reside more profoundly in our memory if the lived experiences have passed through the area of emotions. Therefore, one of the main objectives of this collaboration between the arts and the scientific investigation in the proposed Art and Culture Workshops is that the patients are stimulated and feel induced through their emotions to create a bridge between the past and the present.
This was the reason for converting the exhibition of the painter, Chelete Monereo, held at the Museum of Fine Arts in Murcia to be the starting point of the workshop.

“ENTRETELAS”
In her exhibition – “Entretelas” – the artist invites us to reflect on our perception of the past: at the life of our grandparents and great-grandparents. As a way of following the thread of connections, the artist converts the fabric into her own language. It is a material that offers, by means of interweaving, different meanings according to the generation. Thus, to provide space for interpretation, Chelete proposed “Entretelas” as the title for the exhibition. It is a play on words allowing for a more or less rigid or flexible meaning, according to the context. That is to say, “entretelas” can be understood as interfacing a rigid fabric, placed between the cloth and the lining in some parts of the dress, or clothing, to give it stiffness. Another way to understand the idea is “to be between fabrics”, a situation of being in the middle of many things. Interestingly, the two meanings give the impression of being present without being seen. A third meaning implies the desire to knit, in the sense of knitting together situations or ideas showing a reciprocal respect for one another.
With this idea of interweaving fabric, objects and fragments of memories, the Alzheimer patient, together with the artist, family and the medical team at the Dementia Unit, picks up the thread from his/her visit to the exhibition to lead him/her to the past in order to retain the memory of the present.

Halldóra Arnardóttir, PhD art historian and coordinator of the Art and Culture as Therapy Workshops.