Jef Smith explores the world of arts and creative activities in social care, and how to choose from the many options available.
It is very understandable that social care practitioners and managers should be worried about resources, but perhaps we should spare an occasional thought for other areas of public activity which are also suffering a funding crisis. Of course, we know about the health service, but what of roads, libraries, leisure centres and the other facilities which depend on hard-hit local authorities for their management and finance? Here too there are terrible dilemmas to be faced. Some of these services cannot look to the emotional appeal on which the welfare of older and disabled people can intermittently call, but many social care clients living in their own homes still want to be able to use such community facilities and are deprived by their decline.
Over recent years, such pressures have contributed to a move by arts providers to presenting their wares more actively to the vulnerable groups supported by social care services. Galleries hold classes for pensioners, concert halls offer concessions for over 60s, dramatists specifically set out to address issues of ageing and failing powers. Older people form a particularly important target for these sorts of promotions. Their daily lives often lack stimulation, particularly if they are living alone or are otherwise socially isolated. Though some older people have considerable purchasing power, many social care clients are too poor to pay much themselves. If creative activities, however, can be presented as a relevant contribution to enhancing lifestyles or tackling loneliness, or even as positively therapeutic, they may be eligible for public subsidies or attract charitable support or both.
NCF Arts Festival
Spotting this trend, the National Care Forum (NCF), a body representing a swathe of care providers, mounted its first “Arts Festival” in conjunction with its national managers’ conference last November. I went along to get a flavour of what is on offer and was overwhelmed by the variety and energy of the organisations pushing to exploit this still relatively untapped market. Among the products being promoted were bird watching, community singing, dance (in various forms), digital picture making, gardening, organised outings, museum visits, painting, theatre and music (again of all varieties).
For those lucky enough to attend NCF’s festival, there was a chance to meet representatives of this range of organisations and to taste their wares, albeit briefly, at first hand. Twenty or so stalls offered explanatory leaflets, sample materials and the chance to talk to those promoting their work, and then there was an opportunity to experience some of the activities personally. The resulting mingling of delegates dancing with scarfs, drawing on iPads, singing choruses, potting-up seedlings, banging percussion instruments, and engaging in sundry other games and distractions in quick succession certainly made for noisy fun, though the quieter experiences like reminiscence and stroking artefacts for sensory stimulation tended to get somewhat drowned out. The session provided of course only an approach to understanding how such activities would be experienced by elderly people, many of them also disabled and cognitively impaired, but active participation is always more immediate than simple description.
Many of the activities NCF showcased were targeted at the captive audience of a care home’s residents. The relationship of domiciliary care workers to the cultural lives of their clients is somewhat more marginal, but where home care agencies have the capacity to interpret their role as relating to the total life experience of the people they serve — as opposed to dashing in and out simply to assist with basic daily living tasks — this wider vision becomes relevant. Day centres, where isolated older people used to be offered such a broadening of their horizons, have all but disappeared under austerity, so the visits of home care workers and the wider lifestyle perspectives they may be able to access are even more central to vulnerable peoples’ wellbeing.
Publications to help
How, soberly, should managers assess the ambitious claims made for cultural activities and decide what would best suit their particular situation and residents? A document which some will find useful is Arts for Health and Wellbeing: an Evaluation Framework, published by Public Health England in conjunction with the University of Winchester and Aesop (Arts Enterprise with a Social Purpose). Its stated purpose is to “strengthen understanding of what works in specific contexts and enable realistic assessment and appropriate comparisons to be made between programmes”.
Unfortunately, what follows turns out to be more a guide for researchers than anything immediately accessible to workers in the field. “The reporting and evaluation tool” which is advocated lists the information essential to a systematic assessment of a project’s value under a score of headings each covering several questions, but few agencies will have the resources to work through such an exhaustive operation. What would surely be useful would be an organisation capable of carrying out an evaluation and publishing their findings independently. At present, the competing, inevitably subjective, claims of arts providing bodies present hard-pressed managers with a potentially overwhelming array of possibilities.
Count the costs
Of course, the costs of mounting cultural activities cannot be ignored whoever foots the bill. A few of the bodies presenting at the NCF event are supported by major trusts and some nationally rated organisations like Wigmore Hall or the Wallace Collection, see their work with older people, especially those with dementia, as an essential element in their outreach to the community so carry the expenses within their mainstream budgets. The majority, however, whether they are charities, social enterprises or commercial companies have to charge for their services. These may take the form of consultancy, staff training, materials such as boxes containing ideas and equipment, or people who make local visits to support the staff leading activities.
Who’s in charge?
Who within our often socially impoverished communities should own the issue of expanding the range of cultural activities available to older vulnerable people? Home care agencies may lack the resources to take on this role comprehensively, but they have much of the necessary knowledge of the potential clientele. If funding could be found, this might indeed be an interesting new marketing opportunity. Occupational Therapists (OTs) will naturally argue that OTs are professionally best placed to take a lead in such initiatives, but culture covers a wide range of interests and no one staff member, however well qualified and widely experienced can be expected to make informed judgments covering music, the visual arts, drama, dance and any number of creative crafts.
Fortunately, almost any staff group will throw up individuals with some expert knowledge or relevant life experiences. Nor should the clients themselves be ignored. Finding an older person with a gift and enabling them to display it, whether it be playing a musical instrument, reminiscing about experiences in a way which entertains or stimulates others, or demonstrating a skill which can be shared can be both empowering for the individual and culturally enhancing for others. Perhaps, the best advice to any facilitator is simply to look at what’s immediately to hand before engaging with ambitious external resources.
The organisations to whom NCF gave a platform — and many others too small or local to be able to afford to present themselves on such an occasion — have a great deal to offer. Accessing their contribution and seeking out what is available in their own area and within the community formed by the agency’s own staff, the families and carers of clients, and the clients themselves will require careful thought and sustained effort, not least because there are almost certainly associated costs, starting with the time involved. It takes imagination and sensitivity to assess what will most benefit specific individuals. “Culture” wrote the critic and poet TS Eliot in a famous essay, “may even be described simply as that which makes life worth living”.
Last reviewed 28 February 2017