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Creative arts interventions for people living with dementia have been shown to improve mood, emotions, communication, and relationships for older people living with dementia and their care partners. Previous research demonstrates that TimeSlips, a creative storytelling intervention, provides a “failure-free” environment and an opportunity for individuals to use their imagination. Because it does not involve memory, people living with dementia are encouraged to contribute and interact, thus creating an environment that focuses on dignity and strengths rather than deficits. This case study explores the student facilitators’ experiences of running TimeSlips sessions in different levels of care. The two facilitators ran continuous sessions over six months – with an individual at home, group sessions in memory care, and group sessions in assisted living. The facilitators journaled about their experiences after each session and the same picture prompts were used across the different types of sessions. Each journal entry was coded by two independent researchers using grounded theory principles. Through the coding, it was clear that the facilitators needed to use different skills to engage participants in storytelling based on their level of care. Themes that emerged include joy of connection, playfulness, and engagement. In addition, specific skills are needed to accommodate some behaviors of people living with dementia (such as aggressive behavior toward others in the group) and how to distract from those behaviors to continue with the storytelling. The benefits and challenges of each modality and gaps that may need to be addressed for student facilitators will be discussed.

Subjective cognitive decline (SCD), defined as self-reported memory issues that have worsened over the past year, can be one of the first indications of Alzheimer’s disease and related dementias. SCD affects nearly 9% of Virginians aged 45 or older, and 31% of these individuals live alone. A practice-based intervention is essential to addressing the challenges associated with cognitive impairment. This study examined the effect of StrongerMemory program, which involves a series of cognitive exercises. The StrongerMemory program provides a 12-week curriculum designed to stimulate the brain’s prefrontal cortex, which governs the ability to retrieve memories. Participants are encouraged to spend 20 to 30 minutes a day reading aloud, writing or journaling and completing simple math problems. The Mason Gerontology Research Team investigated the pre- and post-cognitive outcomes among 43 participants who participated in the StrongerMemory program to determine the effectiveness of the program. The cognitive outcomes were evaluated using the Mini Montreal Cognitive Assessment 2.1 (Mini MoCA). The mean (SD) scores in Mini MoCA evaluated in the participants were 12.60 ± 2.1 (pre-test) and 13.53 ± 1.9 (post-test). The mean difference was statistically significant. Our results indicate that the StrongerMemory program is beneficial for cognition. The premise around the StrongerMemory program is that prior to a diagnosis or even with a diagnosis of mild cognitive impairment, a decline can be slowed and possibly prevented by participating in a program like StrongerMemory. The Mason Gerontology Research Team continues to evaluate the StrongerMemory program to examine its impact on SCD.

The Music & Memory intervention is a person-centered, non-pharmacologic intervention for people living with dementia. It is considered a personalized music intervention because the playlist comprises music genres that the individual prefers. Music has shown positive effects on behavioral and psychological symptoms of dementia. However, the findings from previous studies are often based on small sample sizes, insufficient descriptions of treatment fidelity, and lack of randomization. To address these issues, we began a randomized controlled trial implementing the Music & Memory intervention in nursing facilities in Virginia with support from the Centers for Medicare and Medicaid (CMS) Civil Money Penalty. We will present our research strategies as well as preliminary results suggesting that nursing facilities with higher occupancy rates are more likely to participate in this type of a program. In addition, study participants with dementia show positive emotional and behavioral reactions when listening to their favorite music.

TimeSlips is an award-winning, non-pharmacologic, creative storytelling intervention designed specifically for individuals living with dementia by Anne Basting. As part of the NextGen pilot program, George Mason University implemented TimeSlips at a dementia-specific adult day health care center with undergraduate and graduate students trained as facilitators. They worked with two different populations living with ADRD – an early-stage group and a moderate- to late-stage group. Students who participated reflected upon their experiences and noted that they learned so much about the importance of open-ended questions and accepting even one-word answers. One student stated: “This makes so much sense, as I have noticed participants take these open-ended questions and deliver beautifully unexpected and clever responses.” The implementation was different for these two groups, and our analysis of the content and process indicate that consistency and person-centeredness are key to participants’ expression of pride and joy in their accomplishments.

Research indicates that family caregivers of individuals living with dementia are at risk for high levels of stress, depression, physical health declines, and illness. The health and well-being of family caregivers is critically important to a long-term care system that is dependent on them to continue their caregiving role. In-depth individual and focus group interviews of 16 dementia caregivers were conducted to explore the emotional experiences of caregiving stress during transitions of individuals living with dementia to a higher level of care. Data were transcribed verbatim, checked for accuracy, and analyzed by at least two members of the research team. Line-by-line coding, memo writing, and constant comparative analyses were conducted until redundancy, when no new themes were discovered. Caregivers described various levels of feeling overwhelmed and symptom progression leading to the move to a nursing facility. Social isolation featured prominently, with caregivers describing a gradual erosion of their social network and socializing opportunities because of their caregiving responsibilities and the care recipient’s deteriorating symptoms. Caregivers described feeling isolated and stigmatized. One caregiver said, “…you’re being less invited, you’re being less involved. People don’t know how to deal with you…I don’t know if they become the pariah or I become the pariah.” At the same time, maintaining social connections and having help with caregiving featured prominently in the coping mechanisms described. The health of caregivers is equally as important as the person living with dementia, and programs, interventions, and resources should be a priority for supporting families through transitions.