'Bedsides' at the University of Florida and Shands Medical Hospital, Gainesville, Fl, USA

I returned to the University of Florida, to the Center for Arts in Medicine, in June 2016, to further engage in an intensive participation, focussing on 'bedsides' primarily, and the far reaching benefits of this activity.   

'Bedsides' is an arts in medicine healthcare activity originated by University of Florida, and Shands Medical Hospital, Gainesville, Fl.

In Arts in Medicine, and according to Jill Sonke, Director of the Center for Arts in Medicine, ‘we see health not simply as the absence of illness, but as a state of being which gives each of us the opportunity to live to our fullest potential. Through an interdisciplinary holistic and creative approach to health, we engage the arts as a means to optimize opportunities both locally and globally’.

Arts in Medicine works to support biomedical and nursing activities by assisting patients, at the 'bedside' or in waiting/reception rooms, in order to alleviate stress, and engages with the patient on a one-on-one basis through a range of arts activities. These can include drawing, painting, story telling, oral histories, photography, music, singing and movement, improvisation ‘improv’ theatre amongst others, at the 'bedside'.

Historically, rock art images were intended as healing, spiritual messages. It is also well known that art is used to express our humanity, the divine and the mysteries that shape our worlds. Animism is the belief that there is spirit in everything. The Egyptians had a very embedded system of biomedical medicine, which included animistic healing in the form of amulets, etc. Research shows that the idea of ‘hospitals’ can be directly attributed to Islam who lead the way between the 8th and 9th Century.

So what is it about the arts that may contribute to healing at the 'bedside'?

Healing can occur through active use of the mind in developing or focussing on imagery. Using images with an intention, and the use of the arts as a method of transcendence, can impact healing in a positive manner.

The pioneering work of Dr. Robert Adler (1975) and Dr. Candace Pert, is worth researching, as both investigated the role of what is happening in the mind, directly affects our body.

It’s worth mentioning that Leonardo da Vinci (famous artist) dissected the body, and by doing so, furthered the biomedical knowledge of doctors who learnt more about the body. Of importance, there is no point in our history, which does not recognize the arts as part of healing.

I have had personal experience of this 'bedside' activity, working as an artist, and know that the health benefits are insurmountable. The patient is transported, for a short period of time, into a creative world allowing, them to engage in their own creative 'spike'.

On my return, and thanks to Barbara Poulter, who is Cape Town based, and knowledgeable and active in breast cancer therapies and support, I met with two hospital staff members who both showed keenness in staging interactive art and health workshops with their cancer surviving outpatients. We (together with my twin sister Debby O'Connor, and my husband Bob Wells) staged about five or six very fun interactive sessions in 2015. It was refreshing to be part of such inspirational groups, and we have a common wish for this work to continue into the future, so as to be in line with over 60% of the hospitals in the USA and in the UK. I will publish some pictures from these events.

REPORT and Artist in Residence program- my plan to star burst it into SA hospitals

REPORT on my attendance at the 2014 Arts in Medicine Summer Intensive

July 7 -18

With the University of Florida and Shands Hospital, Gainesville, Florida. USA

Locations: Classrooms 133 and 451: UF Cancer & Genetics Research Complex (Genetics Institute), 2033 Mowry Road, UF.  CCRC: Criser Cancer Resource Center, Shands Cancer Hospital, 1515 SW Archer Road, room 1302.  McGuire G-13 and G-13: McGuire Theatre and Dance Pavilion, Museum Road & McCarty Drive, UF

I am deeply grateful to the DUT for making this experience possible for me. I not only enjoyed learning much about the intersections and applications of Arts in Medicine, but importantly, I got to terms with how the disciplines and practice of Art Therapy, and Arts in Medicine, have some outward similarities yet clearly differ in their quests, and in their outcomes.

In short, Art Therapy is about a clinical approach with distinct biomedical and mental health approaches. In Arts in Medicine, and according to Jill Sonke of the Center for Arts in Medicine, ‘we see health not simply as the absence of illness, but as a state of being which gives each of us the opportunity to live to our fullest potential. Through an interdisciplinary holistic and creative approach to health, we engage the arts as a means to optimize opportunities both locally and globally’. Arts in Medicine works to support biomedical and nursing activities by assisting patients, at the bedside or in waiting/reception rooms, in order to alleviate stress, and engages with the patient on a one-on-one basis through a range of arts activities. These can include drawing, painting, story telling, oral histories, photography, music, singing and movement, improvisation ‘improv’ theatre amongst others, at the bedside. In addition, projects can entail mural painting by patients, their families and nurses, photographic installations and healthy environment design.

Terminology, Prevalence and Professionalism: Distinctions and boundaries of Practice:

Arts and Health –encompasses all the disciplines that engage the arts for health. Under this topic fall two areas of practice, namely;

Arts Therapies – these are clinicians, who deal with emotions, set clinical goals and evaluate outcomes,

Arts in Medicine practitioners – these are creatives who engage in the arts in healthcare settings and fields to enhance health and wellness, and improve the healthcare environment. A common understanding is that patients, their families and nurses like to be heard.

Hospitals and Arts in Medicine programs

•         Artist in residence programs, environmental and art collections, performing arts, arts and education (credits for long stays), caring for caregivers, and volunteer art programs.
•         Artists in pediatric and adult oncology wards, and gerontology - recording oral histories of patients and their families.
•          ER rooms – music and art making, amongst others.

Historically, rock art images were intended as healing, spiritual messages. It is also well known that art is used to express our humanity, the divine and the mysteries that shape our worlds. Animism is the belief that there is spirit in everything. The Egyptians had a very embedded system of biomedical medicine, which included animistic healing in the form of amulets, etc. Research shows that the idea of ‘hospitals’ can be directed attributed to Islam who lead the way between the 8^th and 9^th Century.

So what is it about the arts that may contribute to healing?

Healing can occur through active use of the mind in developing or focussing on imagery. Using images with an intention, and the use of the arts as a method of transcendence, can all impact healing in a positive manner. In addition, and as I made use of in the Siyazama Project, with the use of the arts as metaphor or symbol showed clear evidence that indeed impacted health and healing.

The pioneering work of Dr. Robert Adler (1975) and Dr. Candace Pert, is worth researching, as both investigated the role of what’s happening in the mind directly affects our body.

It’s worth mentioning that Leonardo da Vinci (famous artist) dissected the body, and by doing so, furthered the biomedical knowledge of doctors who learnt more about the body. Of importance, there is no point in our history, which does not recognize the arts as part of healing.

Important readings:

Making Special (Ellen Dissanayake)

Flow (Csikszentminalyi – FLOW THEORY)

Psycho (Adler)

Self-Transcendence (Reed)

Stages of Creatvity (Wallas)

Stages of Ritual (Achterberg)

Four Bridges (Sonke and Brandman)

What is Art for? (Ellen Dissanayake)

Mans search for meaning (Victor Franklin)

Brain Dance   (Anne Green Gilbert - www.creativedance.org)

Rituals of Healing (Acheterberg, Dossey, and Kolkmeier)

Creative Arts Therapies (www.nccata.com)

Creative Aging (www.estanyc.org)

Dance for Parkinson Disease (www.danceforpd.com)

Run Lola Run (short film)

Flow Theory: Spurs relaxation response, more blood and oxygen going to organs and brain, sustained flight or fight causes illness. Flow state is the domain of the artist. In the Arts and Health origins for the 21^st Century, the hippies are believed to be the forebears of these sensibilities when they were searching for change, and seeking access for everybody to the arts. Research has reported clear evidence that music aids recovery in premature babies, trauma patients are encouraged to record stressful events in a diary, being in nature aids recovery and moving, dancing, singing, laughing and playing all improve health. In short, taking theatre off the stage, and straight to the bedside.

In a projects beyond the hospital and titled ‘Vital Visionaries’, young medical students meet and work with older folks before they get sick. ‘Arts and the Military’ began as a project in order to assist soldiers returning from 2^nd World War and Vietnam. In all of these projects, patients are seen as whole and not broken.

Core Values in the Arts in Medicine fields:

·      Can improve health at key moments,

·      Whole person care,

·      Can transform healthcare environments to a place of beauty and healing,

·      Participant autonomy and participant choice (patients may say ‘no’)

·      Beneficence and nonmaleficence (do no harm)

·      Competence and capacity to excel

·      Creativity

·      Diversity

·      Inclusion

·      Integrity

·      Respect

·      Professionalism

Professional Pathways:

·      Practicing artist, artist in residence, guest artist, visiting artist, arts practitioner.

·      Arts Therapist (mental health professional)

·      Arts Program Coordinator (hospital based, community based, outside agency based)

·      Grant Writer

·      Healthcare/Healing environment design

·      Professional Caregiver

·      Educator

·      Researcher

·      Others

Artist in Residence (up to 20 hours per week)

·      Short term, long term

·      Volunteering

·      Exhibiting

·      Performing

“We help connect patients with the places within themselves that are still well” and we offer “therapy which is not considered therapeutic” Jenny Lee.

Authentic and sustainable self-care: Self-care for caregivers and the road to preventing compassion fatigue was a big topic. Recognizing compassion fatigue, in oneself, is important for burnout. Web site www.compassionfatigue.com  also warns of STS or Secondary Traumatic Stress and how to be resilient.

Ethical Dilemmas was another big topic for working in hospitals. One needs to develop ethical sensitivity, define dilemmas and options, refer at all times to professional standards, apply ethical principles to all situations, consult with supervisor and respected colleagues, deliberate and decide. Finally, always reflect on experience.

In a ‘Dancing for Life’ program, we danced and sang loudly with Parkinson patients. This was an absolute highlight for me! I also took part in a photo shoot with two very pregnant expectant mums at the bedside.  This taught me the importance of keeping all equipment sterile, and how imperative it is to wipe down everything between patients.

Program Planning based on the thinking of Ponsioen (1962) – who adds arts at all levels - and the work of Maslow were discussed. Using tools such as CDCynergy and MAPP were deemed most appropriate when planning for community health programs. Institutional Review Board (IRB) protocols needs to be adhered to. Evaluations are very necessary but not to be undertaken too soon.  Arts based methods in health research at the University of British Colombia is currently seen as the leader in this field of research. They encourage use of photo-voice and ethnography in gathering stories (Staricoff, 2004).

I attended a specialist Arts and Aging program with Rusti Brandman and I found this most enlightening. She spoke of the ‘graying of the population’ and how retirement planning is essential. Erik Erikson’s theory of the life cycle is important, as is the work of Jean Cohen whose work takes a close look into the four stages of post-midlife brain development.

Stage one: Midlife re-evaluation (35-65),

Stage two:  Liberation stage,

Stage three: Summing up – more synergy between left and right brain hemispheres,

Stage four: called ‘encore’ – celebration stage.

The funding of Arts in Medicine programs with the aging population is cheaper in the long run: it reduces dependence of patients (assists nurses to nurse), creates independence promotes gerontology (study of aging) and encourages reminiscence modeling. This work engages lifelong learning, social and civic engagement, sequential learning, which directly targets dementia. Reminiscence, imaginative storytelling, self-enquiry, skills building for sense of accomplishment, themes honoring presence of self are all great themes and they should all be cross generational interactions. Dance and singing, and the contemplative arts such as yoga (which encourages mindfulness) and breathing exercises can collectively, and directly, improve balance and memory.

Important on-line resources:

www.creativeaging.org

www.estanyc.org

www.timeslips.org

www.aftaarts.org

www.songwritingworks.org

www.danceexchange.org

Arts in Medicine from the clinical perspective:  Narrative medicine makes medicine and doctors more humanistic. Medical students tend to battle with the integration component of patients, both young and old. A fourth year medical student told us that his love of playing the guitar had rescued him from a very troubled upbringing. He believes he gives his patients ‘a voice’. Arts in Medicine practices promote humanism with its particular approach. The panel and feedback reports clearly state that the patients definitely do have better hospital experiences when engaging with Arts in Medicine approaches and activities. Its helps in self-care, too. Most believe that biomedicine is simply not enough. Of note, was the point about the costly and inadequate ‘end of life care’ experience with very sick aged folk, and how misleading this approach can be whilst in a medical facility. It is also highly expensive.

Important Readings:

Adolescence and Dying - Rebecca Brown

TED.MED

My grandfathers Blessing – Rachael Ramon

Teachers Everywhere – Rachael Ramon

In all of the above situations it is the nurses who tend to take the brunt of the patient caring work. Yet, there is evidence that nurses are now choosing to work at hospitals that have Arts in Medicine offerings, as opposed to those hospitals, which do not. This supports retention, and nurses can spend more time nursing.

In addition, we volunteered to take part in a 2 hour Pilot HPNP Public Health test that is intended to be rolled out as a form of Certification for this field eventually.

 My Presentation on the 10^th July 2014 at the Haan Museum in Gainesville, Fl:

I was invited to present on the latest insights into my work on the Siyazama Project and I titled my talk ‘ART, Aids and Education: Insights into the rural craft Siyazama Project

My immediate Intention:

I intend to get an ‘Artist in Residence’ program up and running at hospitals, here to begin with, in Cape Town. I am so lucky to have the backing of all the specialist folk from the University of Florida and Shands medical hospital, namely Jill Sonke and Jenny Lee, of the Center for Arts in Medicine, who are very willing to assist with this new project. I also have numerous contacts with regard artists, musicians and dancers all of whom may be willing to volunteer this work.  I have put in for funding through the DUT Faculty of Arts and Design, and also have some funding of my own which I may use to get the initial set-up undertaken. I have medical contacts in Cape Town through whom I am spearheading this idea at present

I would love to get some reaction from the DUT with regard their opinions to this work. I feel compelled to undertake this project as a starburst program that can easily be rolled out to all hospitals in the country.

Regards

Prof. Kate Wells

Email: kate@katewells.org

13th Annual Arts in Healthcare Summer Intensive at the University of Florida: July 7-18, 2014

Prof. Kate Wells is excited to be attending this program at the University of Florida in Gainesville, Fl, USA, in July 2014. The Arts in Healthcare Summer Intensive is a comprehensive training program for artists, caregivers, administrators, students, educators and others who wish to explore the roles of the arts in healthcare fields and settings.

The program includes workshops in the history, philosophy and physiology of art and healing, experiential workshops in the visual arts, music, dance, theatre and writing, workshops in compassion fatigue and self-care, facilitating the arts at the bedside, arts in healthcare program implementation, administration, and grant writing, research, and practical bedside arts experience with the Shands Arts in medicine program.

The intensive includes new online modules including Patient Safety, Understanding the Experience of Illness, Healthcare Culture, and Healthcare Communication.

Prof. Kate Wells to present her third Keynote in Bristol June 2013

Prof. Kate Wells, Research Professor at the Durban University of Technology, is to give her third Keynote address in Bristol at the Culture, Health and Wellbeing Conference between 24th- 26th June 2013. She has been invited to talk about her ongoing work in the Siyazama Project in South Africa. 

Of interest, Prof's Marsha Macdowell and Kurt Dewhurst, of Michigan State University Museum, in East Lansing, Michigan, were recently in Durban with Kate. Great news is that they will be returning to the USA with the beadwork collection of the Siyazama Project. This collection includes beaded jewellery, beaded cloth dolls and beaded tableaus. Whist in South Africa, they had an important meeting with UKZN Press, in Pietermaritzburg, and have been given the go-ahead to produce a further book on the project. This time it will be a 'coffee table glossy', which aims to reveal much about the tableau collection of Siyazama. Work will begin on this immediately.

Kate is also writing a Chapter for a new book by Oxford University Press also within the arts in health realm.

Linda and the Smithsonian Folklife Festival in Washington July 2012

What a wonderful adventure I have been on with the “Orphan Tower”! We were invited to attend the 46^th Smithsonian Folklife Festival in Washington DC and the Tower was part of the “Common Threads “exhibit which had pride of place on the National Mall.

 It was the most amazing experience looking to the South and seeing the Washington Memorial and to the North, the Stately Capitol buildings- all on our front lawns!! An awe inspiring image I will remember forever! Flanked on both sides by the some of the most beautiful, interesting Museums in the world – we were in very impressive company!

The festival program included “The creativity in Crisis : Unfolding the AIDS Memorial Quilt”. It was a deeply moving looking out over the hundreds of quilts laid out every day, as memorials to those loved ones who had died of AIDS.  For two weeks, we had the names of people who had succumbed to this disease, called out in their memory. The names echoed around the Mall, and thousands of names rang out for the entire two weeks of the show, a constant reminder of the devastating loss of life that AIDS has caused. We all took time to read a page of names, and it was a very humbling feeling acknowledging someone’s child, lover, friend or partner who had gone, but was not going to be forgotten.

The “Orphan Tower “ created huge interest. On seeing the Tower, visitors initial happy reactions were often jolted into shock, sadness or quiet contemplation, once it became evident that the bright little dolls represented orphans. We, in South Africa, have become almost numb to the staggering statistics but for the visitors it was shocking and disturbing.

The visitors loved to see Lobolile, and Beauty, as they created the beautiful dolls, and the children were thrilled to be included and allowed to bead their own little bracelets and necklaces, with the guidance of the two women. The products were so appreciated by everyone, and the Market place allowed for a steady flow of product sales throughout the exhibition.

One of the biggest challenges was the heat wave. The USA had not experienced such temperatures since 1895. The temperatures were over 40 degrees every day and the humiture was excessive. I had never experienced such intense weather before, and being outdoors all day was quite draining. Our fabulous volunteers kept the ice water flowing, and the copious liters of water kept us all hydrated. The best way to cool down was to spend lunch breaks wandering through air conditioned galleries. Just fabulous!

The heat buildup was so intense it had to break, and break it did! A hectic storm broke one night, and with the same intensity as a mini hurricane, it swept through the festival flattening all but one or two of the tents!!! The little orphan dolls were found scattered far and wide as the Tower had crashed down with the tent. Fortunately, the Barrow’s engineers had constructed a very sound structure, and we managed to patch it up as best we could. The festival was speedily built up again and the show could go on!

I have returned with precious memories! I met interesting people from all cultures. I spent wonderful times with the women from the Kesikamma project. They were such a great team to be part of.  David Gere and his team from UCLA were hugely supportive and caring. His photographic workshop, “Through Positive Eyes “was inspiring and spending time with them all was very special. The highlight was the documentary filmed in the “Common Threads” exhibition Space.  We were interviewed along with David Gere, and I believe the documentary will have many possibilities for viewing throughout the USA.

The Smithsonian team was incredible. Big thanks to Arlene and Emma and the whole team who supported and helped us all.  Kurt and Marsha from Michigan State University were a huge part of the success of the festival and I am deeply grateful for all their help and care. 

The “Orphan Tower “ went onto an exhibit at  the World AIDS conference in Washington, and is now going to be travelling from Michigan State University Museum to other Universities around the US.

David Gere being interviewed on site, in front of the Tower, at the Festival

Beauty Ndlovu from Siyazama Project was with Linda in Washington

Linda working hard on keeping the Tower in shape! 

As Linda has said "the dolls are spreading the message in true Siyazama style “!  

A huge BIG thank you to Linda for being a real doll and for working so hard for Siyazama Project! Thank you Linda from all in Siyazama Project :)