The Penelope Project: An Arts-Based Odyssey to Change Elder Care
222
The Penelope Project: An Arts-Based Odyssey to Change Elder Care
222eBook
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Overview
At Milwaukee’s Luther Manor, a team of artists from the University of Wisconsin’s theatre department and Sojourn Theatre Company, university students, staff, residents, and volunteers traded their bingo cards for copies of The Odyssey. They embarked on a two-year project to examine this ancient story from the perspective of the hero who never left home: Penelope, wife of Odysseus. Together, the team staged a play that engaged everyone and transcended the limits not just of old age and disability but also youth, institutional regulations, and disciplinary boundaries.
Inviting readers to see through the eyes of residents, students, artists, staff, family members, and experts in the fields of education, long-term care, and civically engaged arts practice, this book underscores the essential role of the arts and humanities in living richly. Waiting, as Penelope waited, need not be a time of loss and neglect. The Penelope Project boldly dreams of how to make late life a time of growth and learning. If you dream of improving people’s lives through creative endeavors, this book provides practical advice.
Product Details
| ISBN-13: | 9781609384142 |
|---|---|
| Publisher: | University of Iowa Press |
| Publication date: | 05/15/2016 |
| Series: | Humanities and Public Life |
| Sold by: | Barnes & Noble |
| Format: | eBook |
| Pages: | 222 |
| File size: | 13 MB |
| Note: | This product may take a few minutes to download. |
About the Author
Maureen Toweywas creative director for Arcade Fire on its Grammy award-winning album The Suburbs and directed tours for Ray LaMontagne, Esperanza Spalding, and tUnE-yArDs. She lives in New York City.
A resident of Milwaukee and Mexico City, Ellie Rose runs the nonprofit GeroStart Inc.
Read an Excerpt
The Penelope Project
An Arts-Based Odyssey to Change Elder Care
By Anne Basting, Maureen Towey, Ellie Rose
University of Iowa Press
Copyright © 2016 University of Iowa PressAll rights reserved.
ISBN: 978-1-60938-414-2
CHAPTER 1
THE CURRENT LANDSCAPE OF ACTIVITIES/PROGRAMMING IN LONG-TERM CARE
Kirsten M. Jacobs
As a child, I often found myself performing in nursing homes with my dance or violin classes. Whether I was playing "Twinkle, Twinkle" on my half-size violin or tap dancing on the linoleum floors, I was among the children who are often paraded through nursing home hallways in hopes of brightening the lives of those who live there.
I don't remember a lot about those visits, but I do remember feeling a bit uncomfortable and afraid. The smells, sights, and sounds were all unfamiliar and somewhat unpleasant to my childhood self. I remember what I now would describe as vacant looks on the faces of some of the older adults. And I remember the hospital-like space. The hallways were long and the lighting was harsh.
About twenty years later, I once again found myself being led down a nursing home hallway, but this time in Wauwatosa, Wisconsin, and the experience was very different. As an audience member of Finding Penelope, I had the chance to travel through the Luther Manor community and witness the magic of the Penelope Project collaboration.
To me, the Penelope Project is an example of the ways the aging-services field and long-term care activities have evolved in recent years. Fortunately, many nursing homes are very different than they were twenty or thirty years ago. The Penelope Project is one manifestation of that evolution.
CULTURE CHANGE
About the time my childhood self was performing in nursing homes, a grassroots movement to radically change long-term care was just emerging. That movement was dubbed the culture change movement and refers to a shift away from a medical model of care. Rather than spaces and days designed to accommodate the needs of an institution, nursing home environments and schedules (or lack of schedules) are designed to accommodate the lives of those who live and work there. The terms "culture change," "person-centered care," "person-directed," and "relationship-centered care" all refer to this transformation from a medical model to a more homelike model.
Culture change is a philosophy, but there are a host of practical implications, too. Long-term care settings (like nursing and assisted living communities) are changing language, routines, activities, physical design, dining, and bathing and care practices. For example, rather than scheduling breakfast at 8:00 a.m. and waking residents at 6:00 a.m., a person-centered approach invites residents to rise when they wake and to eat what they want, when they want. People are at the heart of the culture change movement, and the place they live is their home.
To ensure the daily experience of living in a long-term care community reflects residents' likes and dislikes, great effort is made to really know them. Staff members are encouraged to spend time with residents and understand the whole person, rather than just knowing a collection of diagnoses and care needs.
This came to life recently at one West Coast organization that recruited volunteers to sit with health center (nursing home) residents to document their stories, reflections, and anecdotes. The health center residents, many of whom had dementia, shared stories about travel, past jobs, and loves. The stories were carefully documented in the words of the elders. Then, one evening, volunteers performed the vignettes for a packed house of residents, family members, and community members. The residents who participated enjoyed the experience of being heard and celebrated while staff and community members all marveled at how many new things they learned about each resident.
As evidenced by the story above, the field of "activities" (social and physical programming in long-term care) has benefitted immensely from the person-centered effort to know the people who live in nursing homes. But it's not difficult to conjure images of traditional activities programs of the past. Admittedly some nursing homes continue to plan and facilitate activities just as they did twenty years ago. In those settings, residents participate in regimented activities like bingo, birthday parties, and coffee talk. Those activities may not reflect resident preferences or interests and are often very predictable. The old paradigm assumes less capacity and keeps residents in the role of recipient rather than participant. Elders receive care and entertainment but often aren't invited to contribute, engage, or interact.
As the approach to activities in long-term care evolves, new terminology is being used to describe the daily life of the organization. Some organizations have replaced the word "activities" with "life enrichment," "wellness," "quality of life," or "life engagement." Life enrichment is currently the most common alternative to "activities," but all the terms are intended to suggest more meaningful engagement and a higher level of participation on the part of the elders.
In long-term care settings that embrace culture change, life enrichment is a way of life rather than just a program. Elders are invited to participate in daily tasks, just as they did in their own homes. So rather than special event preparation happening behind the scenes, elders might envision the event, make the decorations, prepare some of the food, and welcome the guests.
In 2006, the Centers for Medicare and Medicaid Services (CMS), the federal body that governs activities in nursing homes, affirmed the importance of culture change. CMS implemented new guidelines that state that "the facility must provide for an ongoing program of activities designed to meet, in accordance with the comprehensive assessment, the interests and the physical, mental, and psychosocial well-being of each resident" (DHHS 2006). Suddenly, nursing homes were required to tailor their activities programs to the residents living within their community. With this, activities programs that hadn't yet implemented person-centered care had to make a change. Culture change is still implemented to varying degrees across the country, but the shift in regulations pushed most organizations to think more intentionally about the ways they implement person-centered care within the nursing home environment (and often beyond).
WELLNESS
Over the past ten years, providers of aging services are increasingly striving to find ways to help both residents and employees achieve overall wellness. Many variables influenced this trend, including health care reform and a national conversation about prevention of chronic diseases and about overall well-being.
While every organization defines wellness differently, the concept generally incorporates the following dimensions: emotional, intellectual, physical, vocational, social, and spiritual. Wellness is about achieving holistic well-being for every individual. Traditionally, a nursing home might have focused primarily on physical health by administering medications, offering a healthy diet, and encouraging occasional exercise. An organization that embraces a wellness model focuses on every dimension of wellness, understanding that they are all intrinsically connected. Each element is considered equally as important as the next.
Some organizations are blending the dimensions of wellness into existing activities programs, while others are completely replacing activities with a holistic wellness program. There's huge variation from one organization to the next, but most programs strive to help elders achieve individual well-being, regardless of age or physical limitations. That means that all individuals, including those living in long-term care or approaching the end of their lives, are assumed to have the capacity to learn and grow in all dimensions of life.
The Penelope Project invited residents to participate in discussion groups, movement exercises, visual art making, music making, and storytelling. Together, the project addressed every element of holistic wellness. Engaging with other residents, university students, actors, and community members addressed social and emotional wellness. Participating in movement exercises enhanced physical well-being. Learning about the Odyssey through discussion groups, storytelling, and other projects provided opportunities for intellectual growth. Preparing for the Finding Penelope production by helping with set design contributed to vocational wellness. Aspects of the play, like the chorus' "Welcome Dance" ("My heart is open to you, my soul/spirit welcomes you"), illustrated that spiritual well-being doesn't happen only in Bible study. The Penelope Project is one of many examples of long-term care settings finding big ways to incorporate all the dimensions of wellness into the daily lives of those who live there.
ARTS AND CREATIVITY
Arts and crafts have traditionally been a part of long-term care activities, but organizations now go well beyond an occasional craft project. With steadily growing evidence to support the value of the arts and creativity in the lives of elders, long-term care organizations are incorporating varied opportunities into their life enrichment programs.
One East Coast organization opened its building to the greater community by offering a space for professional artists and musicians to store their supplies and instruments in exchange for conducting art classes for residents. In other organizations, residents participate in dance classes that incorporate storytelling and poetry. Some organizations use the techniques of improvisation to both train staff and engage elders. Whether it is storytelling, dancing, or art-making, long-term care settings are striving to make the arts accessible to all residents, including those with physical or cognitive limitations.
GOING FORWARD
The factors that influenced recent changes in long-term care settings are quite intermeshed. The culture change movement started in the 1980s and picked up significant momentum in the mid-1990s. About the same time, the National Endowment for the Arts and National Endowment for the Humanities sponsored a micro-conference on aging, which is said to mark the beginning of the dialogue on arts and aging. Simultaneously, the idea of active aging was emerging. The concept of active aging has been modified by aging-services providers to encompass holistic wellness for all people, not just younger elders living independently. Culture change, wellness, and the arts have all significantly influenced each other and the current landscape of activities in long-term care.
The United States is now in the midst of a huge demographic shift. In 2011, the first baby boomer turned sixty-five years old. While each generation of elders has brought new strengths, preferences, and expectations, the sheer number of those in the baby boom generation (those born between 1946 and 1964) will dramatically change the field of aging. Already, long-term care providers have noticed that younger elders often expect a higher level of involvement within the organization than previous generations. We can't predict exactly how the influx of baby boomers will influence the way activities are delivered in long-term care, but it's likely that boomers will continue to value health, physical activity, and personal gratification through vocation and independence.
As the field of aging continues to evolve, there's more work to be done. Most organizations acknowledge that culture change is an ongoing process. As new generations of elders and employees enter the world of long-term care, the culture of each organization must continue to evolve. Similarly, organizations are just embarking on the path of wellness. If holistic well-being is the goal, the entire organization must embrace every dimension. So, resident well-being can't be achieved if employee well-being isn't also achieved. And none of these things can happen in isolation. One or two staff people, or even a small team of staff people, can't be responsible for creating a culture of wellness and engagement — it must be in the DNA of the organization.
PENELOPE
I hope the Penelope Project sets the stage for more internal and external collaboration in long-term care. The most remarkable things that are happening in the aging-services field are not happening without the expertise, influence, and participation of the greater community. As aging-services providers invite artists, teachers, lawyers, computer programmers, gardeners, children, youth, and other elders into their communities, the experience of aging will improve for everyone.
As I meandered down the Luther Manor hallways, witnessing Finding Penelope as an audience member, I was filled with an overwhelming sense of hope. As organizations like Luther Manor, and those I've referenced above, continue to expand the definition of activities or life enrichment in long-term care, life in a nursing home will continue to improve for those who live and work there. Happily, it's clear to me that we are moving further and further away from my childhood experience of tap dancing my way through nursing homes.
CHAPTER 2SOCIAL/CIVIC PRACTICE IN THE THEATRE
Michael Rohd
Currently, within institutional theatre organizations, community partnerships are most frequently developed to implement programming that surrounds the productions that appear on their main stage or stages. That programming exists to deepen the vision of the artists. Institutions sometimes retain partners beyond singular projects, returning to them for help on other projects when content seems aligned with the partner's constituency or mission. These partnerships are valuable; they can effectively build new relationships around meaningful, shared interests, and they help arts organizations broaden the scope of their presence in their local communities. But too commonly, they operate more like a monologue than a dialogue. The initiating impulse — the voice that puts out the call, so to speak — is the artist. The non-arts partner has a choice — the partner can listen, respond, or not. But rarely does the invitation to conversation, to co-creation, come from the partner.
In the current arts landscape, ideas of engagement, participation, and institution/audience relationship are seen as keys to both innovation and survival. There is a growing number of research studies and funding opportunities focused on audiences, community, and context — which is an indicator that energy is aligning for deep investigation and a commitment to advancement in these practices. The array of engagement approaches in professional theatre today takes many of its core impulses and tactics from the pioneering, community-based, often politically motivated artists of the 1960s and 1970s, through contemporary location-based ensembles and the most current branding, public relations, and interactivity/participation experts in the social media, business, and design sectors. The core impulses on this continuum are widely varied in underlying philosophy and goals. For us at Sojourn Theatre, the Penelope Project falls on a very specific point of a spectrum we use to consider cross-disciplinary engaged practice.
On this spectrum, performance that is considered to be social practice(a term that originally comes from the world of visual and installation art) initiates with artists' desire to explore/create a conceptual event or series of moments they design. The design and/or execution of the performance may engage non-artists in any number of ways: it may leverage non-arts partners and community resources; it may intend to specifically impact the social or civic life of the context in which it occurs in measurable ways; or it may intend to exist as an aesthetic interruption from which impact is to be derived in an open, interpretive manner. But alongside whatever social or civic needs the project addresses, the leading impulse and guiding energy is from the artist.
In performances that are considered to be civic practice, artists use the assets of their crafts in response to the goals of non-arts partners as discovered through ongoing dialogue. The impulse of what to make comes out of the relationship, not an artist-driven proposal. We find civic practice and social practice to be distinct modes of engaged activity, with civic practice aiming to help establish an area of artistic practice framed by intention and process. For much of Sojourn Theatre's fifteen years, we have made theatre work that functions more on the social practice continuum than the civic practice one. This is the case for Penelope. But, in the work of the project, in the learning we have experienced, in our relationship with Anne Basting, spots on the spectrum have blurred. They have overlapped and even reset. The prioritization of needs amidst an ever evolving partnership have led to a process where aspects of the work have clearly been determined by artist vision, but aspects have also clearly been guided by student, resident, and staff needs.
(Continues...)
Excerpted from The Penelope Project by Anne Basting, Maureen Towey, Ellie Rose. Copyright © 2016 University of Iowa Press. Excerpted by permission of University of Iowa Press.
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