Making meaning, creating connection: a taxonomy of arts interventions for people with dementia

Background Arts interventions – music, dance, theatre, literature, visual and digital arts – can successfully enhance the care, wellbeing and quality of life for people living with dementia. The multi-disciplinary field of the arts and dementia combines perspectives from humanities and science paradigms, therefore researching arts interventions is highly complex. Consequently, the current evidence base for the arts and dementia has a number of limitations relating to the description, theoretical explanation, communication and simplification of arts interventions. Taxonomy is the science of classification, and is used to label and describe the world around us. By producing a taxonomy of arts interventions for people with dementia, this research aims to address some of the current evidence base limitations by: describing the component parts of an arts intervention; explaining how arts interventions ‘work’ for people with dementia and produce their effects; improving multi-disciplinary communication amongst arts and dementia stakeholders; mapping and simplifying the complex field of the arts and dementia. By developing a common language of classification, this research hopes to support artists and practitioners, carers and care staff, people with dementia, funders and commissioners, researchers and academics. Methods Using a primarily qualitative framework derived from taxonomy and realist methodology, this research comprised a literature review, discussion groups, a case study of music therapy undertaken in Denmark involving observations, interviews and focus groups, and a three phase Delphi questionnaire study. These multiple stages of data collection and analysis incorporated the lived expert experience of carers, care staff, therapists, practitioners, academics, artists, arts managers and people with dementia. Results The taxonomy of arts interventions for people with dementia proposed here has twelve dimensions: Principles, Art form, Complementary arts, Arts activity, Artistic elements, Artistic materials, Arts approaches, Intervention context, Arts location, Competencies, Arts facilitators, Artistic focus. Principles are the component parts that characterise arts interventions for people with dementia. Eight were identified: Engagement, Humanity, Selfhood, Involvement, Expression, Connection, Possibility, Transformation. This common language can describe unique experiences. Arts interventions can also be classified and theorised according to their relative contexts, mechanisms, outcomes, benefits and processes. Discussion The dimensions of arts interventions are inter-related. Arts interventions are typically composed of multiple elements from across or within the dimensions. Consequently, arts interventions can be classified generally, but delivered according to individual needs and preferences to ensure they remain person-centred. The taxonomy can be adapted to suit different audiences for accessible dissemination. The proposed taxonomy is comparable to other arts and health frameworks. Conclusion It is possible to define multiple dimensions of arts interventions for people with dementia, including their guiding principles, and to describe their processes, outcomes and potential benefits. This research offers an empirical understanding for how arts interventions work in theory and in practice. The taxonomy helps to make meaning and create connection – for those working in the field, and for those taking part in arts interventions. However, there are limitations to the interpretation of the arts and dementia presented by this taxonomy. Consequently, it is a foundational model that requires further testing. Responses from the wider arts and dementia community are therefore encouraged. Ideas for future research to support this are outlined