Dementia and Art


Anne Watts, a 31-year-old composer and singer, has spent the past year turning nursing home residents into artists. She believes that her efforts help patients deal with the loss of self inherent in dementia.

Watts practices her unconventional therapy in conjunction with Meridian Healthcare, Inc., nursing homes in Baltimore. Rather than the more conventional art therapy programs found in other institutions, her approach has been to link individual artists from the community with single nursing home residents. The participants choose their own medium and control the artistic process.

According to an article in The Wall Street Journal (January 13), the results have been positive. Meridian’s director of Alzheimer Services notes that “most health-care workers underestimate the capacities of demented patients.” Watts’ nursing home artists, though suffering from varying degrees of dementia, have completed ceramics, collages, quilts, paintings and other art works.

The personal growth and expansion of horizons seems to have worked in both directions. One of the outside artists recruited to work with the demented elderly, multimedia artist Cathy Leaycraft, says that her first reaction to the nursing home project was that “I was horrified, thinking why would they want to be alive? But after a while, I saw they weren’t really ready to die yet, there were still things going on, spiritual kinds of things.”

Watts’ original idea grew out of her contact with nursing home resident John Englehart in 1986. Englehart was institutionalized in 1918, and diagnosed as retarded and schizophrenic. Heavily medicated with Thorazine, he had not spoken for fifteen years when Watts gave him a felt marker and a piece of paper. Englehart not only produced a detailed drawing, but also identified the subject of his art work as a “windmill.”

Over the next four years Englehart produced scores of drawings and paintings. He was critically acclaimed, and his works were sold at a one-man show in Baltimore. Englehart died two years ago at age 85.

Watts acknowledges that Englehart’s artistic awakening was very unusual. Nonetheless, it is the image of the man she initially described as “this horrifying, gnomish creature” that keeps her involved in the project. “It is scary for all of us,” says Watts, “to think of a future in a lonely place where we aren’t given the opportunity to do our work and where no one wants to hear what we have to say before we die.”

Q & A

Q: When is a nursing home resident determined to be incompetent so that a health care agent has power to make medical decisions? Who determines incompetency?

A: The Health Care Power of Attorney statute (A.R.S. §36-3221) is operative when the patient is “unable to make or communicate health care treatment decisions.” In most cases it is not necessary to have any formal determination of incompetence since the patient and agent will agree about care decisions. If there is disagreement, of course, the patient’s decision will prevail unless he or she is clearly incompetent. Even an incompetent patient should be consulted about health care decisions (for therapeutic reasons if not for legal reasons).

If no consensus can be reached the Court must decide the patient’s competence, based on medical testimony. The whole purpose of health care powers of attorney, however, is to avoid courts and lawyers as much as possible. In most cases, that goal should be easy to meet.

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