"And the beat goes on……………….."
Day 3 - Arts and Aging / Arts and Healing Blog Forum
What kinds of research needs to be launched now so as to make the case for the value of the arts in aging and healing programs, and how can we involve the public in understanding and appreciating how the arts are making important contributions to both quality aging and healing? What do funders (public or private) need to know to be more receptive to supporting these efforts?
Maura O’Malley and Ed Friedman:
The growing body of research confirming the benefits of arts engagement for older adults confirms what we, as arts practitioners already know to be true – the arts are good for you. Good research is critical to successful fund raising. However – are there enough programs being implemented and sustained to provide a meaningful sample size? Additionally, research assessing the economic benefits for arts and community organizations that develop and offer creative aging programs could help spur more activity. The research, has to be made available and accessible (in plain language) to the general public.
In our experience, what moves people to understand and subsequently support creative aging programs – is the experience of witnessing and/or participating in them. To build public and professional awareness of the benefits of arts engagement, seed a critical mass of community based programs – make them visible, document them, disseminate them, talk about them. Start conversations everywhere and with everyone. A major public awareness campaign showcasing the transformative benefits for individual creative aging participants could be very powerful.
Participants in the NEA/NCCA Summit on Creativity and Aging, held in May 2015, focused heavily on the need for more research. Several studies have shown the positive impact on quality of life and health on older adults of choral, dance, and theater training programs. The world of science, however, requires that studies like these be these be replicated and conform to rigorous scientific review to be generally accepted. There’s much left to learn - we don’t know if a 10-week program is more beneficial than a 4-week program, for example.
The cost-effectiveness of these programs must be studied, documented and broadly shared. If singing, acting or dancing help stave off depression, falls, isolation, and decline, as early studies have shown, the societal savings will be enormous. Researchers in colleges and universities have an opportunity to partner with creative aging programs to create these studies.
Given that this is a new field, third-party evaluations of creative aging programs are also needed to document and validate program outcomes, refine successful practices, and improve future impact. These are expensive, and funders need to support them.
A caveat: Teaching artists who work with older adults see their students blossom and hear them say that these programs make their lives better, make them happier, and provide something important to look forward to. It can be frustrating for these artists and their program leaders to hear the call for scientific studies that define program benefits by health, rather than joy and meaning. It’s important to recognize, however, that we are building a new field and working to attract financial support at every level. Funders – private and public – are driven by provable outcomes. Perhaps the day will come when we won’t need more studies, but we’re not there yet.
The field needs both overall and discipline-specific arts investigations that offer solid evidence of effectiveness. When such research reaches a critical mass, public understanding should follow providing we all make an effort to get the results “out there.” At an NEA event last month, a fellow panelist compared the current arts/aging situation to early no-smoking campaigns. At first, such campaigns were largely ignored but as the evidence piled up, the situation changed completely.
When your primary outcomes are joy, a sense of purpose and a better quality of life, case studies that inspire us and appeal to our “humanness” combined with “boomer” market data is the place to start. When adding health outcomes to the case, conducting primary research that demonstrates cost savings and other societal benefits is imperative. A few breakthrough studies by credible research universities would make a huge difference.
Funders will also want to know where their investments will make the most difference. Many “boomers” will have discretionary income to spend but may not have access to opportunities or an understanding of their importance. Many “systems” will have resources to leverage and access to the aging population but will not see the arts as part of the solution and so on. Developing a systems framework for impact that is anchored in research and easily understood would be very helpful.
The best way for the public to understand and appreciate the arts is to experience it. That said, a well thought out and heavily funded national campaign using high profile boomers spreading the gospel of the arts might be the faster way to jumpstart the artful aging movement eg think.. don’t be a litter bug, don’t smoke, wear your seat belts.
Bottom line, some will need stories, some will need pictures, some will need diagrams, some will need experiences and others will simply need facts and figures or a combination of all of the above.
One of the things that comes to mind right away is the need for partners. Arts organizations, as providers, aren’t necessarily good researchers. The funders need to understand that aspect and acknowledge that it takes long term investment as well as large scale work to ensure reliable and meaningful results. Research projects that have a far reaching outlook are going to be more successful.
Some programs, although successful, are simply too small to scale, and don’t hold up in a research based manner. So collaboration between organizations to create a bigger research pool can be useful in those situations.
Also, more research that compares variables is important. For instance, some basic questions that need more backing is what can provide older adults with the most independence and the most engagement in the arts? If someone is living at home vs. a care facility, can we find a parallel between their work in arts and if they are cognitively stronger? How do social settings affect this growth?
We have found a very interesting TedEd video on YouTube titled “How playing an instrument benefits your brain”. This 5 minute video has been particularly effective with funders in conveying some complex neuroscience about Music and brain function in a simple and entertaining way.
Research with a big R, a little r and most Importantly with a D – Research and Development
How much research in arts, aging and health is enough? Again, with the expanding demographics and the growing needs for products and services “enough” only belongs to project specific work. Members of this panel are much more versed than me in the “Big R” research that includes control and experimental group with random assignments and large enough sample sizes. Since Gene Cohen’s seminal study on The Impact of Community Based Arts Programs on the Health of Older Adults in 2007, many new studies have been developed. Funding is flowing from the National Institutes of Health with encouragement from the National Endowment for the Art’s Interagency Task Force. These studies from the researchers included in this Blogathon are finding solid ground within related health and education sectors to form deeper partnerships that can help give way to collaborative work.
“Little r” research is what I am finding is happening on a more consistent basis. This is outcomes research that ties arts interventions into the ongoing assessment of host organizations in health, education and social services. Though not akin to the million dollar research grant, this work moves our field forward. When we can work in a library, long term care, or educational facility to improve their specific goals and objectives as well as ours, programs become sustainable. For example, NCCA maintains a team of artists at the DC VAMC Community Living Center (CLC) to build sustainable models in long-term care. The outcomes of this NCCA Healing Arts in the Military project are tied to the goals and objectives of the VA’s patient centered care, patient satisfaction and staff satisfaction assessments. Being sure that our work at the CLC is congruent means that the NCCA artists are an important part of the care team and the administration’s strategic plan.
Finally, in the Blue Ocean of program and product development, research endeavors need to go hand in hand with development. We joke about working in a vacuum or as lone artists – the old ivory tower adage comes to mind. Nothing could be farther from reality than this work in arts, aging and health. In this work, a team incorporating interprofessional collaboration is key to success, along with keeping the end user central. Therefore, advisory committees, focus groups, beta testing and optimized research with a “big R” makes for success. Recently, John Zeisel from Hearthstone shared with me a theatre program that his organization is developing. He founded the program on research conducted through a NIH grant. The program had been designed to go to scale in a virtual format with Hearthstone planning to sell it through subscriptions to large assistant living systems. Earned income from this product and services will be substantial. The Cleveland Institute of Art almost stumbled onto product development, finding that their distance learning program for high schools, which is well grounded in arts education best practices, was a good fit with modifications to migrate to long term care facilities through subscriptions. NCCA developed the artists training guide and the new caregiver resource guide through focus groups and beta testing with interprofessional teams and end-user guided development. Research and Development efforts need to be practiced to maximize every program or project design.
Funders need to know that our programs, products and services have evidence that the outcomes will be excellent while consistently meeting the goals and objectives of the end user, the partnering agencies, and our own organization goals. Research at its best creates a common language and leverages assets for the greater good.
Recently, Aroha Philanthropies brought together 60 individuals engaged in direct service and philanthropy to creative aging programs across the country. The summit was an amazing gathering of arts and aging leaders and foundation and public agencies engaged in this work. The day started with a presentation on Ageism led by Ashton Applewhite, a Knight Fellow, New York Times Fellow and Columbia Journalism School Age Boom Fellow. Applewhite challenged us to recognize not only the effects of ageism, but its pervasiveness within our society and even among all of us in the room.
This is where conversations and research needs to begin: we need to acknowledge our own fears, misconceptions and internalized ageism.
From there, our research should focus on a number of arenas:
- Continuing to collect quantifiable data regarding the long term impact of arts participation by older adults.
- Identifying and highlighting best practices in both the aging and arts industries to showcase both innovative and traditional methods of arts engagement.
- Building on the research of Dr. Gene Cohen and others which demonstrates the benefits of arts engagement to the health of older individuals, and bringing this conversation more directly to the medical industry.