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Programming for People with Dementia and Their Care Partners

at The Metropolitan Museum of Art
January 25, 2011

Introduction by:

Rebecca McGinnis, Access Coordinator, Metropolitan Museum of Art

Session Chair:
Georgia Krantz, Guggenheim Education Manager for Adult Interpretive Programs

Panelists:
Jennifer Kalter, Manager of School and Family Programs, American Folk Art Museum
Amir Parsa, Alzheimer's Project Manager, The Museum of Modern Art
Carolyn Healey, co-founder of Arts and Minds
Amy Trommer, Alzheimer's Association, NYC chapter
Lynn Jacobsen, Wife and Caregiver of a person with dementia
Ashley Mascon, Manager of Visitor Experience at the Rubin Museum of Art
Debra Jaffey, Community Access Programs, Metropolitan Museum


Georgia Krantz

I know that we are all incredibly excited to be here on this panel. We had some pre-meetings and the excitement was palpable. To speak together and with you to speak about People with dementia and their care partners.

I'm interested for many reasons. For one thing this population is underserved and extremely eager for more excellent programming like what is happening at the Metropolitan Museum, at the Museum of Modern Art, through Arts and Minds, through the Alzheimer's Association, and at institutions that are represented here today and represented by the audience. I know that there are a lot of people here with lots of experience and interest. We are delighted that you are here. We are really interested in sharing the importance and the need for this. We are also interested in considering useful tools for initiating and sustaining programming and talking about the challenges and the outcomes that we have observed and experienced in serving this community. The panel is made up of individuals representing arts institutions and organizations which are at very different stages of involvement with this community from Amir Parsa at the MOMA, very established at serving this community, all the way down to me, working for a museum very eager to get started but really just taking the first steps. We thought this would be an interesting mix, and a useful mix because it is an accurate reflection of the larger landscape of institutions and organizations serving this community, but also the kind of collaboration that is taking place between institutions and organizations at very different stages of involvement all seeking to serve this community to our best possible potential. That's why we have chosen to conduct this panel as an interactive conversation and not as a series of presentations, to reflect the collaboration and to model the kinds of discussions that are going on between people seeking to learn more about working with this community. Of course we will be inviting you to engage with us.

We will be focusing on three topics:
First, in very broad terms, what works in serving this community?
Second, what are effective approaches and techniques in interacting with a group around a work of art?
And third, how do we get plan, how do we conceptualize, how do we get started with programming and how do we present such initiatives as viable to the larger institutions we serve?

We will be spending 25 minutes discussing each topic. There will be 5 minutes at the end of sections 1 and 2 for questions and thoughts and 20 minutes at the end of section 3 for a more substantive reflection. I'm going to be keeping an eye on the clock to try to keep things moving forward. If we don't have time for your questions or thoughts after the first two sections, please do hold it for when we have a more lengthy conversation at the end. And just one last remark, this panel is focused of course on people with dementia and their care partners and many of the institutions here do serve these groups together. There is a growing interest in programming for just caregivers, of course not to neglect the people in their care, but to further serve them, through providing their caregivers with tools so that they can have a meaningful experience at the museums without us, without these programs. Amy Trommer is here from the Alzheimer's organization and she with her colleague, Nancy Henley, organizes a program called Greet Art which serves this purpose and with which all of us are involved to varying degrees and which I just think is a very beautiful example of the way people can come together and collaborate for the good of a common goal.

We are going to begin our conversation with brief introductions. I have already introduced myself.

Amir Parsa

I'm Amir Parsa, Museum of Modern Art. I've been at the museum now for 7 years and on this particular project for 4 ½, 5 years.

Karen Healey

I'm Karen Healey. I am a co-founder of Arts and Minds, along with my partner, Dr. Jamie Noble, here in the front row. This project is meant to extend this work beyond the larger museums, out into the community and to the smaller museums and make a piggyback of networks among health care and community organizations.

Lynn Jacobsen

I'm Lynn Jacobsen, wife of Emmanuel Jacobsen, who has dementia and was diagnosed roughly 9 to 10 years ago and this program, we've gone to all the museums, has been a lifesaver for me. I am here to provide the perspective of the caregiver.

Amy Trommer

Hi, my name is Amy Trommer, Alzheimer's Association, NYC chapter. I am a family caregiver trainer and I got into this work because my mother-in-law had dementia and despite being a health care professional, I didn't really understand how best to communicate with her, so I have designed training to improve the quality of life of caregivers and the people they care for. I have also had the pleasure of working with all the people on this panel as a part of Greet Art, which is a program solely for caregivers. It's a wonderful program.

Jennifer Kalter

I'm Jennifer Kalter at the American Folk Art Museum. I started a program for this population in 2008. It has grown a little bit and changed a little bit over the years. We've increased our numbers and are also working with the Alzheimer's Association, too, to add programs.

Ashley Mascon

I'm Ashley Mascon, Manager of Visitor Experience at the Rubin Museum of Art and I came to the Rubin Museum about a year and a half ago. As the Manager of Visitor Experience, I felt it was important for me to think about all visitors who come through the door. The museum is relatively young, compared to the other museums that are represented on the panel. We are still getting a sense of the need and learning from other institutions. So our programs are just getting underway and I'm here to represent that perspective.

Debra Jaffey,

My name is Debra Jaffey, I work here at the Met in Community Access Programs along with Rebecca McGinnis, who introduced the day today. We oversee programs for people with disabilities. And this January starts our fourth year of our Met Escapes programs which is our program designed for people with dementia and their caregivers.

GK: So, to get things started, I'm going to start off with a question and I would love to direct this question to you, Lynn, as the caregiver on the panel. What works, in serving this community? And as we discuss this question, I think it might be interesting also to consider a contextualizing question and that is, why is it important to serve these audiences and why should anybody care that we do?

LJ:Well, let me start with what works. What works is the staff. You can have great art on the walls and in your cases, but if you don't have the staff that is sensitive, caring, compassionate and knows how to communicate and interact with someone with dementia whose attention span can be from 5 seconds to 5 minutes to maybe 50 minutes, it wouldn't work. And speaking from my experience, I'm also a nurse, by the way, of observing my husband, getting him out of bed in the morning can be very challenging. But telling him "Today we are going to the museum for the program", that's an incentive to get out of that bed. Watching him within the program when he is stimulated and I mean stimulated both visually with the art 'cause he's always loved art, but by the questions, by the interactions. It is just a joy and a pleasure that at times can bring tears to my eyes, to see him intellectually be stimulated, join in a discussion, listen to other people, listen to the group discussion leader. And just be delighted He can't wait to participate, sometimes a little bit too eager. It's the staff and their knowing how to present questions, well, first I think select the work of art that's going to be discussed, give a little background, and then present provocative questions and involve the people and engaging them. That to me is the key to what works.

Why is it important? It's important to me as an individual, not just as a caregiver. I'm also a wife and I'm a person. And that is an hour and a half when I come to the museum where I stop being a caregiver. I am a person again. I too am stimulated. I too am thinking. I too am enjoying. I don't have to be watching my husband every 5 seconds that he's not getting into trouble or wandering off. Just to observe him and it gives me wonderful memories of the way he was. He has always been very intellectual and has always loved art and to see him enjoying it again is just a delight that I can't begin to form into words and to share with you. My goal in life, and I've told this to the other panelists, is that I want to be able to go to a museum every day of the week.

GK: And we want that too.

AT: I just wanted to say, I've been with the Alzheimer's Association for almost 3 years and I have conducted over 40 training sessions for caregivers. I feel that people with dementia and caregivers often share the same problems. There is a lot of isolation. There is a lot of depression. These programs allow people to be able to continue their relationships. It may not be the same relationship as it was before, but it is a relationship and they are able to build upon the relationship. And I think what is really important, I'm not going to read this piece to you, but maybe you saw a piece that was put out by NPR, about the emotions outlast the memories. Lots of times we think about going to an event and what do we remember about the event or what do we know about this piece of art. Why art is so wonderful, as well as music, is that people with dementia have an emotional response to a painting. It doesn't matter about the history, although it's a great thing to know about the history. But somebody can just see that piece of art and it can bring about an emotion from long ago about a vacation, about a person. There is no right or wrong. It's just really very much in the moment. And this is something that is so difficult for caregivers and the people they are caring for, because so often they are afraid to speak because they are afraid they will say something wrong. And this gives them the opportunity to say whatever they want, do whatever they want and to be able to be in the moment. And that's why these programs are so critical. And the fact that Alzheimer's disease and other dementias is a national healthcare crisis. Every 70 seconds somebody is diagnosed with dementia. And that is why we want to be able to expand this network of cultural offerings so people have activities and a sense of purpose and something to do.

You know, it's interesting, you know, obviously we are a culture that is getting older. As I was just speaking with a woman from the Cloisters just before, one in two people over 80 get dementia. It's a situation of where we have to think about what is our world going to look like in the future. And how do we accommodate it so that it's not a crisis but that it's a part of how we bring people into our community.

GK: Amir, do you want to say something?

AP: One of the things that you were saying, Lynn, about the importance of the educator. In museum parlance we refer to people leading these groups as educators because it's actually very important for us to think of them as educators and for them to really not only be aware of communication facilitation strategies which are slightly different than, let's say, from a group of teenagers or a group of well adults or well older adults, because you do have to make adaptations. These educators are the most important ingredient in the success of these programs. I've done a lot of workshops all across the country at this point and across the world really, and I see that a lot of the preoccupations of docents and educators is what kind of artwork should I choose, what will I say about it. And that's slightly the wrong preoccupation because if the educator is aware, knows their theory, knows their history, and is rigorous with the way they go through an artwork , through a certain series of observations, descriptions, etc., then the work of art is actually less important than the person creating this conversation. And I know that might sound a little tabu, but it is really very very important. The power of the person is actually more important than the power of the art as we say. And we know this anecdotally, but we actually did a study with NYU Center for Brain a couple of years ago and they actually verified what you are saying through a study, that for the participant, the leader, the educator, was the most important ingredient in creating a great experience. It doesn't matter what you show if that person doesn't do it right. And not doing it right can mean multiple things, from not having a good attitude, to actually thinking that this is an art history lesson and saying "Pablo was born in this year and that year" and everybody gets lost. I just wanted to reiterate the importance of that point. You can really create a rigorous method and strategy to create a great experience for this population.

GK: I just wanted to say that in section 2 we're going to be talking about what these methods might be so we will definitely be coming back to your point and exploring it further.

LK: I just wanted to say, along that same vein, that there are some key differences but I don't think it's entirely different than what a lot of us are doing as educators with other populations so it is something we can learn and can easily incorporate into our educational programs.

I agree with all this and Amir is using the word experience and that's very much what we are after here, an experience with some coherence, and like Jennifer, I take a lot of what I use with school children and adults of all abilities to my work with this audience, but I find that this audience is primed in a way, that there is something about the disposition of the group that is prepared to be in the here and now. You don't get this with sixth graders. It's very lovely to be with a group of people who are prepared to devote their attention to a work of art, and I might modify that a bit, Amir. I think the choice is fairly important. The work of art is the locus for this experience and as someone mentioned earlier, music is a possibility as well as visual art, but visual art offers that here and now. It's not sequential. It's not moving. It's not changing. I suppose you could choose video art and then it would change. But I don't do that, or haven't yet. We can create this experience around that still object.

DJ: I just wanted to pick up something I think Amy had mentioned and then what Lynn started talking about, why do we do these programs, why are they important. We had a program recently and we just got some feedback from the wife of a person with dementia. The person with dementia came with a professional caregiver to the program and Christina actually spoke with the wife who told us that when they walked into the apartment that she didn't recognize them, that they were exuberant, that the experience isn't just the experience here, but that it carries on. We've heard that a lot and I think that's so powerful and something that we all have to keep in mind. It's not just about what we do here, but it's really about improving people's lives in the best that we can in an art museum.

AM: I just want to echo that. I just heard a story today where someone said we felt so wonderful when we were there and when we got home my husband was still in a good mood 2 hours later. And that's a wonderful thing to be able to reduce agitated behavior or angry behavior and to have that mood continue.

GK: Actually, how have your experiences reflected on what is being said here?

AM: Well, as I mentioned, we are relatively early in a program for people with Alzheimer's or dementia, but we have been working with the Alzheimer's Association on the Greet Art program and one of the things that has been wonderful for me, again, coming into the museum, the Rubin Museum of Art just turned 6 years old in October and it has always been a part of the conversation at the Rubin to think about all visitors. And again, we have a Visitor Experience Department for that purpose, but to be able to then go outside of the institution and partner with the Alzheimer's Association and attend other institutions' programs and observe and participate. I mean, I came to a program here at the Met and was a full participant in the program and was able to get a lot out of that experience for all the obvious reasons. So, I guess for me, I can speak more to the collaborative nature of this new world that is being created. In terms of the role of the educator, I would second what you said, Jennifer, that it's true with all populations that is a crucial component in the kind of experience that people have in a museum and with artwork. It's not necessarily in my mind that it has to be there every time. There are different ways to experience art, but certainly with this population it does seem like that's something that you want to keep in mind. I would love to hear, too, more about artwork selection because I do think that as programs are getting started that is potentially something that seems like it could be an overwhelming choice or a bit of a stumbling block.

AP: I just wanted to add one thing, too. I think one of the interesting things about museums is that they obviously are all very different but at the same time they share some things in common. They are all pretty clean. They are well lit. They are lit in particular ways, to facilitate a positive experience, by design. They're contained. There's a whole lot of parameters that go along with any museum that I think make it very inviting to families, to people with dementia and their caregivers because not only does it create a positive experience for a lot of the variety of the things that we have said, but also, and I'm not an expert on Alzheimer's disease itself, but a lot of the issues that come up with the disease like agitation, wandering, being sort of pre-disposed to overriding emotions. A lot of that dissipates within the museum setting or the cultural institution and more specifically within these group environments that are educationally contained, supportive, etc. It's almost as if museums exist, cultural institutions exist, and now we have this great use for them. Not that we hadn't used them well before, but more use for them.

LJ: I would just like to add to what's being said that the other unanticipated outcome of being involved in the various programs is the networking and socializing that my husband and I have been able to do with other couples. It happens that the husbands are the person with dementia and the wives are the caregivers. We go out for coffee. We see each other with great frequency and again we can socialize on different levels. After a while you do get tired of talking about your problems. You need to talk about other things, and other joys – the theater, the movies, the tv program, what's going on politically. And my husband is able to socialize with some of the men. So that has added a whole other dimension that is of tremendous importance to our lives and will continue to do so.

And just listening to those two examples, the strong connection for the social aspect of being in museums together with other people. There is a book that Louis Silverman recently wrote called "The Social Work of Museums". And it does seem there are all these stars aligning that make this make sense right now and it's just a matter of learning from each other and going through the steps and making it happen for people at this point.

One thing that I would like to add is that it's not only what the museum is as a space, but it's what it is not. It's not a clinical setting where I think people are meeting so often.

LJ: That is a very good point. As often as we go to the clinical setting, every 3 months or so, I don't pick up and meet other people the way that I socialize and network with other couples the way that we do. It's a different setting. The relationships are different, the atmosphere, the mood. I have told my husband's physician that the person that I see here, in this clinical setting, is different from the person that I experience in the museum. And I have used the museum setting specifically. I didn't say at home and we go to the theater practically every night. I said "in the museum" that is a different person. We go to ballet concerts, etc., etc., etc. You don't interact in those settings. You sit and you watch and you enjoy and he's again stimulated, but we can't discuss the play, we can't discuss the piece of music while we're listening to it, but we can do that and that is what happens in the museum when we go around. I don't know if you want to get into the sketching. We'll talk about that later.

I think also one other thing. These programs allow people sometimes, sometimes people are unable to differentiate who has dementia and who is the caregiver and that's really very very powerful. People get to be people. They're not the patient, they're not the caregiver. They're people, just experiencing a wonderful situation. And that's very powerful.

I think that's true. When other people in the galleries see these groups happening I don't think they have any sense that it's anything but a regular public tour and often times in the galleries other people join in and lots of different people join in the discussion.

And I think we are all very conscious that our programs are for people with dementia and their caregivers. It's really designed for both people. It's not just designed for the person with dementia and their caregiver is there in the background. We are very conscious of how important the program is for the caregiver and engaging everyone and creating a place where communication can happen between the dyads and among the whole group. And I think it's a very important thing to keep in mind.

GK: And, as you were saying before Debra, it allows for this to continue outside. Again I think that is something that everybody has suggested is very important in how we do this programming. It's not just about the museum. It's great to be in the museum, it's safe and interactive and people are interested, but that dynamic can move outside of the museum space. I feel like it's a great leveler. We do programs for people who are deaf and for people with low vision and blindness at the Guggenheim and my goal is to level everyone to bring them into the museum and to think about serving them in the same way that we serve other people and to learn from them and to take it outside like they do and to try to create a level of equal understanding and interaction so that we learn from each other and so that we don't ghettoize anyone. Which I think is a really beautiful reflection of what Amy is doing through Greet Art, the fact that we are all coming together and we can constantly talk to each other and learn from each other. It's incredibly powerful.

GK: Jennifer, did you have any experiences from Folk Art that you wanted to share around what are the things that work for you that hasn't been said here?

LK: I think when I first started thinking about doing these programs I had heard at MOMA another caregiver speaking about their experience at MOMA's programs and they wish they had more to go to. The question of why are we doing these programs, it seems like why would we not do these programs? If it's so easy to incorporate into our other educational programming it's not so different from what we are doing with other audiences and there's such a need for this type of programming out there, why would we not do it? Folk Art in particular seemed like a good fit because we are a small space and we don't have some of the logistical issues that some of the bigger museums have. We're not very busy all of the time. We have quieter spaces which can be nice for this population. We have a lot of narrative works of art in our collection that are coming from people's everyday experiences which lend themselves very naturally to open ended discussion. So those aspects of the Folk Art Museum seemed to make it a really good fit to me but also it seemed like a program that any institution could really…

GK: I think maybe we'll give it a few more minutes to the question and get the involvement of the audience. We have 5 or 10 minutes.

Sharon Vatsky (audience member): Because I concentrate at the Guggenheim on programs for youth and families, I am curious, although I have worked with adults, the nitty gritty, what do you consider in terms of things that you need for structuring an experience, the kinds of works that you gravitate to, how many works, how long an experience, do you use seating, touch objects, the kind of planning that goes into really thinking through an experience.

AP: Are we getting into that in the second part?

GK: I think we will be picking things apart. We can certainly begin to pick them apart because it will introduce the second piece, which would be fantastic. If anyone has anything off the top of their head that they want to throw out to Sharon, that would be great.

AM: I'll say something about Greet Art. This is the program that the Alzheimer's Association has for professional caregivers and family members who are caregiving. And one of the reasons that made so much sense for the Rubin was because at the time that I approached the Alzheimer's Association we didn't have the resources or the capacity to begin immediately offering programs for people with dementia and what's great about Greet Art is that it's empowering the caregiver. It almost functions logistically speaking like an educators open house. So you're passing along the techniques we use in the way that we talk with people about the art and the activities that we use and this kind of thing and you are bringing in people who may be new to your institution. You're welcoming them, showing them around and offering a gallery experience for them that they can then translate in their relationship with the person that they are caring for. So that seemed to be a really great first step and it was easily transferrable from some of our other programming and I don't know that you couldn't do it the other way around, but it also opened up the conversation that I'm now having with all of these people and other institutions because the design of Greet Art is to connect different institutions so that caregivers can go to different museums and cultural institutions every couple months.

Every month now.

GK: If I could just follow up on that briefly. The Guggenheim is doing Greet Art on February 23rd and I have absolutely no idea what this requires, but in my conversations with Amy and listening to you, I'm taking these little baby steps and collecting this information and again I'm not so sure I have a place at the museum to put everything down and figure out everything that has to happen on my own to put it into place. So, I would agree that this is a way to begin to explore, even if we don't have a means to "we're going to do this, this and this", and it's going to be all clean and done, which I think is interesting.

LK: I just wanted to say that I think it is a great way to get started, but it's not the only way to get started. We started in a very different way. I don't know if Greet Art was even happening when we first started our programs. It was just something that I decided that I wanted to do and we should do and didn't really have a lot of resources to do it, but through meeting with colleagues and other institutions and sharing experiences, that was another way to get involved and also through sessions with the Alzheimer's Association and figuring out how to put the feelers out there in other ways.

AT: I just want to add that the Greet Art program is to teach professional and family caregivers how to utilize art to stimulate conversations, just to clarify, if there are any questions about that. I agree with Jennifer. It can work either way. The Association is a full partner to everybody here on this panel. We will help to provide training. We will recruit people to come to these programs, to either my training sessions or to Nancy Henley's training sessions to train for home health aides. We will teach you how to understand best communication techniques. And as a museum professional, you will select the paintings and how long you will want to spend on each of these paintings.

GK: And how it works within each institution. We will do a few more nitty gritties, because I think Sharon's thinking even nittier and grittier.

AP: I'm glad you brought up the nitty gritty. It's essential. We are talking philosophically and theoretically, but I think we are all very much into the concrete and the pragmatic and the nitty gritty. I would say it's very similar to programs for children, teens, adults, etc. obviously with adaptations. So in terms of the number of works, if it's an hour, 4 or 5 works, again to spend 15, 20 minutes in front of one. A little bit more time before and a little bit more time after, so maybe it's an hour, an hour and a half program because people might be slower moving from gallery to gallery. I think it's in facilitation and communication strategies that it's slightly different. For museum educators, I'm guessing there are a lot of people here, I think there are two essential slides, if we were to do it in Powerpoint fashion. One is how is this group different from my teen group? Am I speaking slower or not? Am I repeating things? Would I allow the person and their caregiver talking to each other where I wouldn't with teenagers. And in terms of selection of artworks, I still maintain that you can select a great variety. There are a couple of types of artwork that I wouldn't go to, but you also don't need to or want to limit ourselves to a particular type, like lets say, representational or figurative. I think abstract works fine. Works from different media works fine. Multimedia works fine. But, I wouldn't select works hung salon style, because it's hard to focus, things of that nature. But, I think as museum educators, we can figure that out very fast. One of the things I say, which I think sometimes bothers people, is that it's not that big a deal. It's not that big a leap or an adaptation.

GK: I would also just add that the "Meet Me at MOMA" book and the resources that Amir has put out with his colleagues has all the nitty gritty in it. How do you get started, what are the questions that you ask, what are the materials that you need. It's just all laid out there brilliantly clearly.

GK: I was just hoping that Amy or Lynn could comment about how such a program is different from a conventional support group, which is akin more to an AA meeting, with a group setting and a leader, just to underscore when we get caught up in the pragmatic elements of it, perhaps there's just not one right answer.

LJ: I don't belong to any support group, but again using my clinical knowledge as a nurse and knowledge of support groups. This is altogether different because this is an interactive program and I participate very actively in the group and we are talking and focusing on the work of art and maybe the artist and what we see. Sometimes it's also about how does it make you feel. But it's very focused on that work of art and the things that other people see and you begin to broaden your comprehension of that particular work of art. And I sometimes say "Oh, I didn't see that. You know that person is right. That's a good idea". Altogether different. I just don't see it as a support group.
I just want to add an interesting little factor that we haven't mentioned. When we go to view these works of art, that at all the museums they provide us with seating. That's a small thing you may think. It's a very important thing. The thoughtfulness, number one, that I consider of the seats that are provided. I think the selection of the particular work. Many of the programs have a theme that they build on and they tell us how they develop the theme and how the works of art fit into the theme makes it so exciting. It puts the art again and the experience in a whole other dimension of sometimes getting you to think "Oh I didn't think of that. Oh that's interesting". And it gets your mind going. So it's that thinking, the stimulation. For me it's always the joy of the intellect – I'm a puzzle person – so it's the joy of the intellectual activity. I'm 74 years old and I need that intellectual stimulation. My husband is 81 and he too enjoys the intellectual stimulation, so I cannot overemphasize the intellectual stimulation component of the discussion. The work of art gets it going, but the contribution of the other members is also important.

GK: I think we have a few more questions.

I'm not an educator. I'm a geriatric care manager. The words that struck me were "It makes me feel like a normal experience". The reason I'm here is that because I'm frequently frustrated by hearing what my families are saying about the day programs for people with dementia and how they feel like their relatives are treated like they are children and I have observed the programs and I can't disagree with them. So, I'm here because I'm excited to see if there is something else out there. In terms of why do these programs, I hate to do this, but if you are talking about the health insurance, it would be very obvious, you could really build a case as you were saying, the tremendous impact on the health of these people and the people taking care of them. There's a big issue there I think.

This is really just a comment, not a question. I do outreach programs at adult day care centers and we talk about what works. To me, one of the things that really makes a difference is providing a safe environment for people to take risks, to give them the time to process and to think and to expound and then validating what they say. I don't think there's anything like a person who's compromised being validated constantly for their contribution.

Can I just second that for all museum visitors? Because I think I completely agree with what you are saying. I as I'm thinking about what you are saying, I would hope that is true for anybody, that we all need safe spaces to take that risk. And as daunting as that may seem, that's not all that different from what we are already doing in museums, hopefully.

I'm wondering if you've seen a difference in the impact of your various programs between people who were sort of sophisticates and had experience with art and those that don't have a museum-going experience, either the person with dementia or the caregiver.

AT: I'll take that. We have had people who are art lovers and people who have never stepped foot in a museum come to these programs and almost universally we get the same kind of reaction because it's about emotion. That's why we originally started Greet Art to include professional caregivers as well because a lot of times professional caregivers have never ever, they may have lived in the city their entire lives, but have never stepped foot inside a museum. I can say that one of the first programs we did at MOMA that professional caregiver went and immediately got a membership to the museum. It was amazing. It was truly amazing. This is another winning situation for the museums. Besides this, you are attracting additional audiences who may never have come in to a museum and then people come back and bring their family members as well. But I don't think it makes a difference whatsoever. That's been my impression.

AP: It's a great question though and it's probably one of those studies, that somebody down the line could really take on. Because hypothetically it could go either way because you could think, well people who've always gone will go back to the experience. It's powerful. It's intellectually stimulating. But then you see people who have never gone, specifically because of the disease, and because now it opens up new venues, new avenues. It's a new experience. It could kind of go either way. I would think that people who have the experience of going to the museum already would be readier to take that first step, to go the first time. But that's very interesting. There's no way for us to verify that, because we don't ask "have you ever been?" or "have you not been?", but it could be a very interesting study.

There's another element of that where the sophisticated person who has a lot of experience with museum going and art making and art viewing could potentially be put off by the group experience. For this reason we all work very hard to cultivate the right tone, for one thing, which a lot of people have already spoken to, but also to operate at a very high level, which is not to say that the most basic comment is unwelcome, because that is what we all want, the first thing we want people to say is the most obvious, the most basic thing. "Tell me what you see" "What is in front of you?" "Let's understand what are we looking at." So I could imagine that people who are used to looking at art on their own could potentially be frustrated with the situation, so it's something to be aware of.

GK: But I do feel like educators are very aware of the kinds of differences in the audiences that come in, just with any audience. I know at the Guggenheim we always tried to gear ourselves towards trying to accommodate that variety of people who come and are sitting in the same group. This person has never been to a museum and this person has written a dissertation on Picasso. The skill and the key is to try to again allow for all of that to unfold in the discussion, that is touching on everybody's level of experience and also just modeling on the fact that it's great to listen to a person who's never been in a museum to talk again about Picasso. "Wow, I've never seen that before." I've seen that a thousand times. "Have you ever seen that?" "Jesus, I've never seen that." We've all experienced that.

We are a little bit over time. Can we take one more and then we can move on to Section Two. So if anybody who hasn't had their question answered, please hold them and we can get to them at the end.

These are also nitty gritty questions, so maybe we can use them to transition to the next section. I'm Alison Day. I'm an educator at the Brooklyn Museum. I have three educator-ish questions that are all related. The first question is when you are facilitating a conversation, do you use more frequently open-ended questioning or more directed questioning? The second question is, in addition to facilitating conversations do you use more sensory experiences, such as touch, sound, smell? The third is, we've mentioned a little bit, works that you lean towards, such as those that might have narrative content, or works that you tend not to go to, because they might be hung inappropriately. If there are any other general guidelines like that to offer us, that would be very helpful.

Part Two

GK: Alison, that is the perfect introduction to Part Two. Lets just go ahead and take those questions as a means to launch into the second part, which is how do we do this around works of art? Maybe we can talk about a specific example, the nuances of why something may or may not work. Thank you, Alison. It's nice to meet you. Who would like to start?

AM: I'll jump in here. Again, the Rubin Museum of Art, for those of you who don't know, is a museum of Himalayan art. Jennifer, you mentioned that narrative often works well with this population. I come almost from the opposite end. A lot of our work, there are people who think it's all about the narrative. You have to make sure that people know exactly what this artwork means, because it's religious art. It's Himalayan Buddhism and Hinduism, primarily in our collection. So, for me it's been an interesting conversation within the institution, to open it up. It's something that our education department has been working on for years, using those open ended questions is definitely what we err on. We do that as much as we can with other types of programs, with other types of audiences, but particularly with this audience, really opening it up, and letting it be okay that there are various interpretations. And 9 times out of 10 what ends up happening, and this happened with our Greet Art program in the fall, that generally people are getting at the essence of the work, even when it's a particularly religious symbolic tanka painting, they are getting at the general sense of the peaceful nature or wrathful nature, this kind of thing. So even, when we have to make the argument for it's okay to ask these open ended questions and see where these conversation goes, at the end of the day it all works out just fine.

GK: And actually, when you are doing your programming, getting to one of Alison's other questions, are there kinds of works that you prefer to use over others or do you feel like everything is free game, or have you found that some work better than others?

AM: I've been thinking a lot about this question of artwork selection, not just for this kind of programming, but for programming in general. I think we can talk about anything, and have an interesting conversation, but I do think that art offers something special. And the specialness of it varies, depending not just on the population, but on you, on what you're drawn to. I find that the artwork that I select oftentimes is artwork that inspires me, that excites me. I don't start the conversation by saying "here's why I love this art", but I know that that passion is in what I'm saying and in the conversation and the way the conversation goes, that it carries on throughout. So oftentimes that's the guiding force for me and I do think about the artwork selection. I am very thoughtful in that process for any tour that I am leading, or training that I am leading or something, but I also don't fret over it. I make the selection and sometimes I go with intuition and sometimes it's because, as an example for the Greet Art program, I selected one painting that had two figures that were in relationship to each other in some way that I thought that would be interesting to talk about in some way. So, not to fret about it, but to be thoughtful.

GK: Can I just push this one step further, because I think it has to do with the thoughts that people are having. I've been to the Rubin and seen some really amazing, really frightening works. Would you feel free to choose a work, I mean really those things are beautiful emotionally, but very off-putting emotionally. Is that something that might be less successful for an audience than those beautiful utopian where everything is sunshine?

AM: I'll give you the short answer, which is no, I probably would not choose them for this audience or for a very young kindergarten, first grade, second grade. But, other audiences, it opens up a great opportunity to talk about why is it frightening, what it is actually symbolic of? But the short answer is, for this audience, probably not.

AP: I want to answer your questions very directly, and anybody who asks the education-ish questions is great in my book. So, in terms of the question open-ended vs. directed, I think you are kind of doing both, in that when you ask somebody "What are you seeing here?" "Can you describe some of the things?" it's kind of directed, but at the same time you keep it open-ended. I think the change, the difference, we would go, let's say from that question, if no one is answering, we sense that it's dormant, it's not happening, we might go to a choice question "Does this painting, does this scene evoke spring or summer?" And at the very ultimate, this almost never happens, but I would go to a yes no question, without feeling bad, without feeling I was breaking the tabus of museum education, I would say "does this evoke spring?" because it's a catalyst for conversation and what ultimately matters is that conversation and have the whole program in mind, second work, third work, etc.

Second question - I think you guys do a lot of touch. I think in our galleries, it's just the nature of our museum and galleries and laws and sort of policies, we don't do touch and we don't do drawings, because it can get kind of complicated at this point with this audience, but given the nature of a museum and the educators, etc. I think that doing touch and having certain types of objects or doing it later in a studio space but combining it with a view in a gallery can work wonderfully also.

And then the last one, I can tell you very specifically what I wouldn't go to and that is one, hung salon style, and two, as important as a work might be in the collection, and people in the museums we've been to "But this is the most important work in the museum", except that it's between two elevator doors or it's downstairs and you think "Why is the most important work in the museum . . ." , but that's where it was, or in the basement, in a corner, where it's humid and dark. So, the logistical considerations when choosing the work; humidity, light, whether there is lots of passage, etc.

Number 3, I would not choose work that by definition, is meant to disorient you. Let's say, multi-channel video work that wants to challenge your perception of reality. With this particular audience, you've got to stay away from that. I'm serious, because it would work very well. It would disorient them. But the question of the work that is troubling, I once had a grand disagreement, not with Amy, but Amy was present, with somebody at the Alzheimer's Association, about the choice of the representational content. Of course you don't want to pick anything that could potentially be traumatic, but what exactly is that, how exactly will you choose? I was in Denver and there was a representation of a Native American person carrying the head, or the scalp of a person. I'm not going to go into the colonialist perception, but I wouldn't pick that. It's so amazing that you are here, Lynn, because one of the experiences that stays with me because when we were, as a group, in front of a painting of Diego Rivera, a completely colorful, festive atmosphere, and he was completely traumatized because he associated the color red with the priests and "Why are they taking that child away?" So, how can you project what will come as traumatic when the perception of the people is very much different from ours? So, would I pick the one you wouldn't pick? Maybe, maybe not. I would just go with what you are saying. If it's a question of how would people respond, just picking what you are comfortable with. You have a great range of choices. Don't make life hard for yourself by picking something that's very risky. And the last thing, and I promise I'll wrap it up for me. This question of representational, narrative vs. abstract. I think a nice mix is fine. It really depends on the skills of the educator and creating responses, etc. Now, would you pick 5 monochromes in one tour? No. Maybe at the end of 6 years or something like that, but not really. But, a healthy mix is fine, I think people respond, even cognitively speaking. We were about to do studies that thought about how much freedom of interpretation of what we call an abstract work might have and thus allow for great discussions. I'm very much into works that are representational enough yet extremely ambiguous so that there is a grand freedom of interpretation. But I think anything works outside of those if you are comfortable with it.

I would also like to add that given what we know about the emotional carryover at the study that Amy cited earlier, if you want to try something out that you think might be questionable, don't let it be the last picture. Put it in the middle somewhere, and end on a high note, because you want everybody going out happy and feeling good 2 hours later.

LJ: I want to pick up on what Amir pointed out. One of the things that I noticed with my husband is that you never know the reaction in advance of how he is going to go. And I'll give you an illustration. Recently we were in Santa Fe, New Mexico and we went to the Indian Museum to see what you and I would call rugs, weavings, wall hangings and, as you know, in native art they originally used to use what the Nazis adopted as the swastika and I was with a friend of mine who is also a nurse and she immediately became alarmed and said "Gee, isn't this going to upset Manny?" Well, he was looking at it and admiring them for what they were, works of art. He did not pick up on the swastika. Why is it that I am focusing on that? Because, every morning when he wakes up, the first words out of his mouth are "Hitler killed the Jews". He was in Danzig and escaped Hitler. So, he's lived to tell the story. That has a lot of meaning for him, but when he saw it in the work of art, in that context it was perfectly fine. At that moment that he saw that, what set him off on that particular painting? I have no idea. He's seen Diego Rivera and we've been to Mexico a zillion times and we go to the museums and he loves Diego Rivera's art. But he's very empathetic and sympathetic towards to the struggling peasant. But, you don't know, is my point. You just don't know.

Jennifer, I'd love to hear from you about this, also.

LK: I just wanted to say that the bottom line is that you have to be flexible, because you never know exactly how people are going to react to something. Having said that, there are many times I feel that a lot of narrative art works very well. There was a time that I was here observing the program and there was a participant that comes to the Folk Art Museum regularly and is always very quiet at the Folk Art Museum and doesn't participate much but at the program here the facilitator took them to a large Jackson Pollack upstairs and I thought "Oh my gosh, Bob's definitely not going to relate to this work of art" and he was so vocal. He had so much to say about that particular work of art. It just made me realize you never know how people are going to respond, so always have some backup projects in your selection for the day in case something upsets someone or doesn't work.

GK: Jennifer, have you ever gone to a work and it's just not working and you just immediately got up and move?

AP: Jennifer never moves. She just stays there, no matter what. She makes it work.

GK: No, just say that something is clearly not working and you haven't spent a lot of time there and you just decided that you know I think it's better to just move on instead of continue this plodding.

LK: Definitely. I feel like that happened last week for me actually. We were at a piece. It was a sculpture in the middle of the gallery and I think it was too hard to focus for a lot of the group and people were not really getting into the conversation, so I transitioned that depended on the dyads together and decided to do that instead of moving on to another work of art.

DJ: And here at the Met we have such a range in our collection, so there is so much to choose from so in the last 3 years of our programs we have gone all over the museum. I don't think there are any rules that we go by. There is something to narrative work where people can identify and it can spark long ago memories in people that they can identify with. But, saying that, too, I think there is also a benefit to looking at things that is less familiar to everyone in your audience, for a lack of a better term, more obscure works of art - the nonwestern, maybe in our Oceanic galleries, where everyone, you're kind of evening the playing field and everyone is not familiar with it and everyone can respond without anyone having a lot of prior knowledge.

I'd like to also address the issue of handling materials and sketching that you brought up. Here at the Met we use that a lot. I think all of the educators incorporate sketching into our gallery tours. We make the point, of course, that we are not trying to copy what is in front of us. It's introduced in a very gentle way as a way to notice, to respond. We have a wide range in one small group of people who are nonverbal to people who recently diagnosed. So, sketching allows for quiet time for everyone to have their own experience and perhaps a nonverbal person can now respond and react in a different way to a work of art that's nonverbal. We also have handling materials that relate to works of art that we are showing. We always make sure there is a connection, a reason. It's not just "touch this" because we want you to have a tactile experience, but making connection to the work of art. We have very simple things. We're looking at a tapestry and trying to understand what it is. It's not hard, it's not like a painting, and to actually have a soft faux tapestry or talk about the process of art making and we have the materials in the bag that people can pass it around and it allows, for often as things are passing around, to have dyads interact with each other and to say a few words to each other. It also creates conversation among the group. It's another way of allowing people to have an experience and maybe bringing out people that may not be in the discussion.

GK: Carolyn, do you have anything to add to this?

CH:You know this is an audience who we see repeatedly and we come to know. So, Shanta and I, Shanta Scott from the Studio Museum in Harlem, and I plan our sessions together and we often find ourselves saying to each other "You know, Mr. Wickem is going to have something to say about this." It's an opportunity actually to make choices that will draw people out, if you know someone who is particularly keen on history or you know they lived in Harlem in 1968. You can really tailor things in such a way. In terms of bringing people out in the conversation, our participants really do this for themselves, especially as they become more and more comfortable. You know we can always rely on Lynn, to get things going and to bring other people into the conversation.

I love this idea that it creates a community. These people begin to know each other and so we can actually choose work for them.

LJ: One of things I appreciate very much. My husband has declined over time in his ability to do the sketching and the drawing, except, thank goodness again for the staff. When they encourage him and help him. Particularly he loves making collages. When they come over and it's one on one, not doing it for him. They will say "Manny, where would you like to place this? You place this and I'll put the glue on." That encouragement and helping him along is extremely important. All the pieces, any little line or squiggle, I take home the piece. Sometimes I frame them. I put them up on the wall. I now have a memory book, because there are so many of them. I started a memory book for him. I date them, the museum where it was done. And he's very proud of that. That's extremely, extremely important. He looks and says "That's my picture, that's my painting. I did that. That's my work of art." That is extremely important, in that there is somebody there to encourage him. What does that do for me? I can go ahead and do it. By the way, I never sketched in my life before I started this program 3 years ago. At the Studio Museum, Sarah, she's there. Through her guiding us, I did a portrait of my husband that is now on the wall in the dining room and every day he can point at that and say "That's me. That's my portrait."

It's there in the flyer. No, Manny's isn't there.

AT: I think using a variety of techniques is wonderful, because sometimes people are unable to speak but they will respond to the touch. And like Lynn said, that Manny can't do the sketching, but somebody else will be able to respond to that. So, mixing that up. And modeling those techniques that are being used in the museum, but they can also use them at home, too. All of the museums have images on their websites that you can download at home, so that if somebody can't get out and come to the museum they can use some of these same techniques at home and to be able to form this relationship at home, too.

DJ: The Met offers three different formats. We have gallery tours, kind of traditional gallery conversations. We also have just artmaking in the studio. We always connect it to something in our collection and we project images in the classroom but then we do the artmaking based on that. We are also lucky enough to have a touch collection here of small accessioned works of art that are actually behind those doors. We traditionally use that for people with visual impairments, but have widened its use and we find it very successful with this audience. That provides kind of a menu of choices. There are some people who come to all of them, but some people who feel more comfortable knowing they are just going to be in a room today and sitting down and that's what they can handle and that's what they want do.

AP: I was just going to bring up another nitty gritty-ish question that I think comes up a lot is the amount of information, the historical points and points about the artist, etc. I think it's a question that comes up a lot, especially given the cognitive changes in this audience. I know that there's a lot of debate and discussion in education and museum education in general, about this - how do you give it, how much do you give, etc. I think it's important to note, I think with this particular audience you definitely don't want to overwhelm anyone with any information at all, not that when you overwhelm anyone else that they don't actually remember or internalize it. But you definitely don't want to do that because they can really get overwhelmed. But to have 3 or 4 major pieces of information and then distribute throughout the conversation, given the course of the conversation, so you have it in your mind and it's customized based on the conversation, but it's definitely not all at the beginning. "Seurat was a pointillist and he did this technique and so on. " So, you have those points in mind and you distribute them. And then I would say that a very important factor to consider is what everybody here is really saying, is that the storytelling, the conversations, the shared experiences, the connections, are probably more important, right, than the information that you are giving. Not that the information is not important, because it's a delicate balance. It has to be a meaningful, powerful experience that respects the person and allows the person to make connections to their lives, etc. But the storytelling and the connecting and the interaction between people is really really important so I wouldn't diffuse it. I wouldn't put a clamper on it, or however you say it, because you need to say more about Seurat or Picasso or whoever it might be. That balance is delicate but is something to consider.

I think that's one of the hardest things, is to kind of gauge your audience at the beginning of a program and see where people are. You have to figure that out at the beginning, so that you don't overwhelm them and so that you don't bore them. I had someone in the program a couple of weeks ago, one of the participants who had Alzheimer's, who every time I asked a question said "You're the expert. You tell me. Why are you asking me?" So, you have to figure out at the beginning where people are. And I think that's one of the most difficult parts.

GK: I think we should take a few questions and Amy, maybe you can insert your . . .

AT: I was just going to say that I think it's complicated in that it's a balance between the caregiver's needs and the person with dementia's needs and what you said before, which was very important, Lynn, was that you want intellectual stimulation and the person with dementia may not be able to hear all these things and so I think it's really important how the educator presents it and this whole panel presents it in a beautiful way. It's a skill.

Audience member: I have another practical question from a different aspect and that's that there are very specific needs of a patient with Alzheimer's disease that may affect their sensibility to programming. Whenever a patient is late to our programming, especially when they come independent of their caregivers, those who are in the early stages of the disease, we immediately become worried that something's happened to them on the way to the program, rather than just that they are just running late. So, there are things like transportation that we become concerned about, reminders. Having been to the programs at the MOMA and the Met and our programs there's a very different makeup of audiences that come to these programs. Here they tend to be very well connected patient and caregiver dyads and even triads with professional caregivers involved, whereas with our program, oftentimes the caregiver will meet the patient at the program and these other issues come up. I'm wondering how each of you have tried to tackle these concerns. The ideas that have come to mind include Access-a-ride and coordinated transportation. But, obviously that becomes very expensive.

Audience member: In relation to that, I was curious. It's hard for me to visualize, not having been to these programs, but having people I want to bring to these programs, how big are they? Are they small programs? Are they big programs?

DJ: Maybe I'll address that easy question first. At the Met, they're quite big for our programs. We usually have 4, now 5, educators teaching on a given day. Each educator will take 5 dyads, about 10 people is what we kind of schedule for and then usually not everyone shows up, so an educator will have anywhere between 4 and 8 or maybe 10 people, so technically we can accommodate about 50 people on a gallery tour program. For artmaking we have a relatively large studio, maybe about 40 people. We set it up in a way to make it more intimate. We learned the hard way kind of initially how to do the set-up for an artmaking activity for 40 people. We call them pods. We create small tables. We have 8 people around a table with one teacher and lots of volunteers kind of facilitating. Much smaller for the touch collection which takes place in this room. We have maybe 4 pods set up, spread out as far as we can to have an educator with a small group of people facilitating that experience. As far as the issues you brought up, we do issue reminders for this audience, either a call or e-mail. We don't get involved in transportation. We know that people who rely on Access-a-ride have lots of problems. I think that's what we can do.

AP: I think you bring up something very interesting. I think we are lucky that we live in New York because people can take public transportation, even though of course for many reasons they also can't. One of the things we have encountered in other parts of the country where you have to drive, for example, because there are longer distances, maybe because there is one museum, where this becomes central. So they have found different types of solutions. Maybe they make a partnership with another community organizations. That organization has a van or a potential transportation where they can do that. We have said that we can't get into the transportation issue. There can't be a MOMA van going around the city, picking up people. Why not? Not our decision. We send reminders. We really try to stay in touch with people. We try to address these potential issues with the creation of other types of programming. We have programs on site and on site we have our gallery discussion programs, we have artmaking programs, slightly different because they are really courses, almost 4 or 6 week sessions with the same people who sign up for them and then they go through a really meaningful profound studio type program. It's just the logistics of our museum where it's difficult to go from the studio classroom to the galleries, etc. We also have programs for groups from care organizations to come so that any group can call in and say "Hey we want to come" and they very often have their own transportation and since they are coming together they will find a solution potentially for that one field trip. So it's not just families pre-registering for something like Meet Me at MOMA. It's also groups coming to MOMA as a group and we are lucky enough to be able to accommodate all groups that have asked for this.
And the other way we are try to address this is to go out into the community so we have a huge outreach program that's really gone on for decades, in effect, without knowing that we are also creating programs for older adults with all sorts of cognitive abilities, so we have educators, freelance educators, sometimes full time staff to, say, go out into a day center or into a care center. And now more and more we are trying to do potentially online or distance learning, rethink distance learning. That might be in the future a little bit. But, a lot of organizations now have those capacities for video conferencing or online courses or things of this nature, so that's something to look into.

LJ: I just want to add to talk about the issue from a slightly different point of view and that is my husband and I often go to the museum on our own. Like I say, we like to be at the museum every day of the week. This has happened twice at the Met. When we come I have become so absorbed in what I am looking at that I forget about my husband and he has wandered off. Your guards, your security people, be attentive to that kind of situation. Because both times, I guess we found him, was it through security? I know the second time that it happened I immediately went to security and there he was. I had alerted security that he had wandered off and they put the word out and he was found. So, that's something else to consider, is your security guards, that people may wander off and they may not know.

DJ: I just wanted to add to that too. Everyone wears a nametag and it says Met Escapes, kind of for this issue. It identifies everyone and the program is on the day sheet so that security would know. It's a way of ensuring safety.

GK: I think there are some other questions?

Audience member: Are there specific days of the week or times that are recommended for the audience and is the audience used to programs that are funded, or paying admission for the programs?

LK: In terms of the time of day and the days of the week, we have been working cooperatively in order to spread the program over the month, so that Arts and Minds is not happening on the same day as Folk Art Expression. We are hoping that will continue as more and more museums offer programming. We have been leaning towards the afternoon. I'm not sure why.

AT: It's a better time for people with dementia. Early in the morning is difficult to get up and get ready. Generally after lunch is a good time. People are not as fatigued. I think most of the programs are in the afternoon.

LJ: It takes two hours to get my husband ready and get out. I really appreciate, the programs here start at 11::00 and I am so grateful that everything takes place at 11:00 forward.

LK: I think also taking into consideration what your galleries are like at your institutions. Afternoons at Folk Art Museum are quieter. We don't have school groups then. And we can't do programs when the galleries are closed. We want to do program when we have quiet galleries.

AT: That's rather important.

Sharon Vatsky (audience): I just want to go back to the issue of transportation. At the risk of sounding like an ungrateful guest. You all are from Manhattan institutions. I know for my former colleagues at the Brooklyn Museum, or for programs where I have worked in southern Westchester or the northwest Bronx it's a very difficult problem and my suggestion is for people who are considering programs, is to look at elder care programs that may have transportation. They may be using their vans for Meals on Wheels and they may have certain timeslots when those vans are available when they could put them to use to transport people to your institutions.

I just want to agree with you but I just want to say that although we are very lucky to be able to have most of these programs that are in Manhattan, we are looking to expand into the other boroughs and have been recently contacted by several community based organizations in the Brooklyn area who want to be able to use their vans as another means of transportation.

Audience member: I actually just wanted to ask the panel about diversity within your participant groups, caregiver and people with dementia and maybe some of the challenges that are coming up. I know I used to work with the Alzheimer's Association and I know that for various reasons it was harder to reach the Asian population and it's sometimes harder to reach the African American population. I want to see if that was reflected in the participants and how you do your outreach to address those issues.

CH:I'll say that Arts and Minds was started partly to address this very issue. Jamie Noble is a neurologist with a clinical practice at Harlem Hospital and he wanted to bring something that would serve his patient population more directly. So when he asked me to work with him I went to the Studio Museum who also wanted to diversify their audience and reach out to older New Yorkers. To create grater diversity is part of the reason why we exist.

AT: And I think that's really important. I would say that the population coming through the Association is much more diversified in the last two years than it was previously, I think it is important to have smaller museums in different areas to be participating in these programs to be able to draw in a more diversified population.

AP: One of the ways that we have tried is that we have had partnerships with community organizations all over the city, not for this particular audience, but with community organizations in general who serve all sorts of people, from young teens to older adults to family groups, etc. We've made an effort to make them aware of this program. We have people who work in that area who as they are working with different populations at those organizations I've also given flyers and reminders and tried to continue that outreach. We are also capable and willing to do programs in Spanish language, so we try to communicate that. We occasionally get a group that comes. We have never had a situation where there are so many people who are only speaking Spanish for a Meet Me at MOMA program where we would do that, but we are willing and able to do that. So, within our resources I think we try all possible avenues to really reach different places. Of course more can be done I think in general. It's a global, I mean global within the city, effort meaning for all of our Alzheimer's Association chapters, community organizations. In general it's sometimes hard to…
I think it's a museum think. Museums in general have struggled with trying to show the pertinence of museums. I think it may begin there, a lot of people, from all walks of life, don't necessarily, non-museum goers they sometimes rightfully wonder what museums can have, etc. I think from a museum perspective we strive to make it relevant in our social circles. But we try, I think to do as much as we can.

GK: Is there a question in the back?

Audience member: Alzheimers, of course, is a continuum. I'm mostly hearing, I think, about early stage stuff. From my experience as a caregiver, museums at an early stage, that was just wonderful, a real lifesaver. But now that I'm dealing with probably late middle stage, art doesn't work at all. I just wonder what kind of elasticity your programs have to move with the progression of the disease. Of course there comes a point where nothing you can do in an art institution setting can help. There's a lot of play in the Alzheimer's continuum.

AT: I don't really look at people as stages. I look at people as people. Every person who has the disease is different because the brain is impacted differently. But I have seen people and I also think, what defines a successful experience? You're talking a lot about having a conversation. But I have seen people who in the middle phases or further out on the continuum of the disease who respond to color and that evokes a powerful emotion. They may not be able to participate in a conversation or they may just be sitting there touching an object. But I think that in different parts of the illness, obviously, in the last stages of the illness it's going to be difficult to bring somebody into the museum. But, I think you might still be able to download something and you never know what kind of emotion you are going to get from somebody at any part of the illness. I've seen people who you would think they have not communicated or even just sitting there silently looking at something can create some an emotion or relationship. It's hard to put that someone into a peg as being an early stage because you know if you read the material and you might say "Oh my god, that person is a middle stage but look, they had a fantastic experience here at the museum." So, I think you have to view each person differently and see what their response is. The other thing that I want to add and I say on a regular basis is, what do you define as a successful interaction? That person is out. That is what I view as a successful interaction. That person is here at the museum, they are out, they are not home in front of the television set, so I think that's what is really important. It doesn't mean you have to stay an hour at the museum. You don't have to make it all the way through. If you can have that relationship and that situation, that's a good thing.

Audience member: Hi. I am wondering in terms, sort of along the lines of diversity, if any of your institutions are doing any programs to encourage cross-generational interaction, bringing in young people interacting with people who have Alzheimer's, dementia, or just interacting with older people in general.

AP: Just in general we have in the past, not specifically with this particular program. We have Grandparents Day. We have multi-generational programs, one-time events, multi-time events, again with a lot of our partnerships with community organizations. Given the limited resources that we have, because all of us are actually very limited, to be honest. The short answer is yes. We don't have a particular program with a name that is multigenerational at this point. There is actually rumblings and thoughts about doing something like that. We've really done those types of things, whether it's one time, offsite or onsite, a big event or a small event. We've really done it. When you think about some of these programs they are multi-generational in that the caregivers are sons and daughters. We've had groups come with their sons and daughters and their grandkids in some of our regular programs so we encourage it, and of course, how multi is multi-generational. There is room for doing a program with a particular name.

LK: We are in the process also of planning a program with one of our participants' grandchildren and doing a reading program partnering the Folk Art Professionals program with the grandaughter's middle school, and having someone from that school come in and doing some reading articles on the program. So, we'll see how that goes.

I just wanted to respond a little bit to the person, if you don't mind, who was asking about working with people who are less cognitively able. When I first started to do the outreach programs I used to have a mix of people and I would ask of 10 people 6 of them would be verbal and I did some experimenting with people who were much less verbal and I found that I would do hands on things much more. And maybe we only worked with vocabulary words something from the picture, and what words would you use to describe it. And people would come up with hard or soft and one man said nothing the whole time he said the color blue, which was an appropriate response. And in terms of how do you know if people are responding, there was a man who looked like he was asleep the whole time. Towards the end he looked up and he responded. He looked like he was sound asleep.

AP: It's like academics, sometimes in the end they surprise you.

And if you make eye contact with somebody or if their eyes follow what you are doing, and if you have a mixed group, sometimes it doesn't work but sometimes it does and you know that it's successful.

You know, I've observed the groups at MOMA and I've seen that a lot. You just feel like after an hour and nobody is really responding. How do I really know if they are responding. It may be an invisible response. Maybe they will go home and I'll never know about it and I think that's great.

LJ: I just want to add that we've been involved in this program going on 3 years with the various museums and we visit my husband's neurologist roughly every 3 months. For the past at least one year after each visit the neurologist has mentioned "You know, he seems to be better than the last time he was here" or "He's stable." What that means, I'm not sure, but he hasn't gotten worse in that respect. I live with him 24/7. I may see other observations, which I'm also. . .But from his examination, he always comments. We have been with this neurologist from the first, from the diagnosis, about 9 years, so he has watched him quite closely over time. In the earlier road, when we first went, he was in a clinical trial and they did extensive evaluation. Now he's no longer in a clinical trial. It's just these clinical visits. That's where the situation is at the present time. I just live day to day and hope for the best.

GK: We are now in the final reflection period and we never got to Section 3. Section 3 was How Do We Plan, How Do We Conceptualize, How Do We Get Started and I do feel there was some progress about that. I just want to say we're not going to formally broach that. So, please, if you have questions. This is a wonderful conversation and I didn't want to interrupt that. If you have questions about that also, we have a lot of wonderful people here. Ashley has got started, Jennifer has got started, I haven't really gotten started. I just wanted to mention that.

Audience member:Hi. I'm Barbara Johnson and I am an educator at the Cathedral of St. John the Divine. I was wondering if anyone had any suggestions or recommendations for a museum that might not be focusing on art. My environment is religious. It does have artwork. It's also historic. I know there are institutions here that also have a science focus as well. I wonder if anyone has any piece of advice for doesn't have that typical gallery experience.

I know the Cathedral of St. John the Divine very well and you can use it in much the way we use museum spaces. You can choose a bay, you can use a series of bays, go to the back, behind the apse. The spatial issues which Jennifer alluded to are definitely important considerations and that's going to influence your work. Jennifer was talking about it in terms, I think she was talking about a sculpture in the middle of the gallery rather than placed against the wall and people were having a problem engaging with it. Was that true? It was sort of a focus issue. There are also sort of spatial, orientation and navigation issues. We spend a lot of time getting people settled in their chairs because they have to do too much. They have to put down their chairs, then get to the right side of it to sit down and then be looking at the work of art. That's something that's going to come into play in your space. But other than that, I think you can proceed in much the same way. You may have to carve out smaller pieces. Let's say you want to talk about the Gothic arch. You see how people react. Can they take in the whole nave. I know you have ways to break that down, so you can do that. I think it will be very successful.

I was struck earlier by Debra's comment also about when you go into the lab, you would need to create intimate spaces within the lab. So I think this is just a follow-up on this reply, how do you make a big thing a little bit more manageable for people who maybe aren't comfortable taking in a giant thing.

AP: I just think in general, I think it's interesting to realize that in creating programs, in imagining programs you really want to be customize, think of the space, be imaginative, be playful, to actually reject any type of cookie cutter and template mentality, while taking into account the fact that some of these methods, some of these strategies, really work well, have been tried and tested. But that's there's a wide range of possibilities. Maybe you come up with something in St. John the Divine that may potentially come back to everyone and say, wow, they did that because of that space, but it can work well for anyone. Just as we realized that some of these methods and strategies work well for all types of audiences and maybe different approaches can work. Some things that are really well established. You don't really want to give too much information. Apart from that, being imaginative in actually the creation of these programs can be very exciting and you can adapt a lot of these ideas.

Audience member: I have a question. I've been very excited listening to all of you speak and I've been thinking about how ways I can incorporate this at the Cloisters. I think in terms of the artwork and the gardens I have already got several things going. I'm anxious about some of the logistics. When you said about setting up chairs, we use folding stools at the Cloisters. Will that work?

Yes.

How about a couple of steps, is that going to be a challenge? I wasn't thinking about wheelchairs, but I noticed with my father with Alzheimer's I noticed there is a spatial navigation issue.

In every program we have at least one person in a wheelchair.

You need help. You need support, lots of volunteers with each group. It's never just an educator by themselves. Our programs take place in the museum for the most part. We've done a couple of Monday programs, but so we're dealing with the crowds, taking the elevators, carrying the stools. We don't have the participants carry the stools at all. It has to be heavily supported. That's a good thing to bring up. You have to assume there you're going to have wheelchair users with this audience, so you always have to think about physical barriers, especially at the Cloisters.

I think you have a lot of spaces that you could use, that would be really exciting, the gardens.

AT: I think it would be fantastic, especially with the gardens. That is one area that we would love to get into as well, because gardens, again, evokes that emotion. We just did a ballroom dancing thing yesterday. So I think it would be wonderful if we could figure out the logistic piece. But I don't think you want to make it more difficult for yourself, because what everybody said here is true. You need that support. So, identifying the space that makes it less complicated is best.

Audience member: Are there any key pre-visit questions to ask people who register for these types of programs?

DJ: We have a form, if you are calling for the first time, it's usually the caregiver. There is a series of questions that we ask, basic information. We ask people's ages, where they are in the illness, if it is Alzheimer's or another type of dementia. Something we started asking recently, as an outcome of the program and learning things during the program, is people's former professions because that is nice to know and it sometimes comes out in discussions. They are looking at sparks of memory about what they used to do for a living. That is something that is nice to ask. Christina, did you want to add to that?

A good question to ask is about assisted listening devices. Because a lot of older people have hearing loss or have difficulty focusing so that's something that we ask and many people do say "Oh yeah, my dad does have a hard time hearing" and so that way we make sure they are in a group using assisting listening devices and Lynn is one of the people using them.

DJ: And we ask about how people they feel about crowds, to get a sense, a red flag that they are not good with crowds. A tendency to wander. We ask kind of those questions. And the sheet that we take with this information we share with our educators so that they can be primed and aware of the issues and be aware of the person's former profession, if that comes up and can work it in the conversation.

We also do put in about hobbies or other things. We recently found out that someone was head of the Japanese Woodblock Society or something. That is a good to know when we go to Asian Arts, that we have an expert among us.

Audience member: Sorry to be trouble, but I was wondering if you could return to my question about funding trends. We all need money.

LK: We don't have any at all. We are still exploring options. We would like to have funding, but one of the exciting things is that it doesn't have to cost a lot of money. We're not charging admission. Our programs are completely free. And there's staff time, obviously. But, other than that, it's not a very expensive program to run. That doesn't mean we don't seek out funding. But as far as getting started, I think it's something that can get done with very little money.

AT: At the Association we have received a small grant, a very small grant, from a family foundation to be able to assist in some ways. We are doing a special program at the Folk Art Museum with a quiltmaker to work with people with dementia who's going to do some quilting with them. But this is something that we are continuing to look at, additional funders and build successes to raise money to hopefully support some of the other programs we are doing.

Have all the programs we have been talking about free?

AP: All our programs are free, offsite, onsite, Meet Me at MOMA, groups. Everything is free. Jennifer really touched on it. It depends what your costs are. I think at the Met, here, Jennifer and other museums, the costs are really the educators, but at most museums across the country is docents, volunteer docents. If the museum is closed it's the security guard. If it's open there's nothing. It's really just staff time and the outreach effort. Of course if you want grand outreach, if you want to do 16 programs a month then it becomes more expensive and so then you would have to look at funding. It all depends on your logistics, on the space, on who's working. I don't know if it's a museum, if it's not a museum. It just depends on the scale. It all depends on your logistics. I completely agree that you can start with very minimal spending. It's just that fulltime person just teaches.

One of the things I've been thinking about, too, in terms of funding, because of course we don't have funding, either. Or just getting started. But I'm looking for ways within the institution to piggyback with other things on publicity. So working with the outreach that is already happening, obviously, to senior centers and that kind of thing. But also thinking in terms of exhibition and if there is any special publicity that is going to go out for programs associated with the exhibition, but also to come up with programs specifically for people with Alzheimer's, thematically, so that it can get out on the flyer. So, thinking about it from that perspective, too.

Audience member: On that note, I wonder if you all might talk about how you first gained access to the audience. What steps you took initially to advertise to get people in the door.

AP: You're right next door, so . . .

LK: People are great. The Met was great. MOMA was great. Other institutions advertising our programs to their public that was already coming. We have had so many people. I don't know if you can take everyone calls at your institutions. We get overflow for people and they have been given our name at the Folk Arts Museum which was really nice. The Alzheimer's Association, of course, has been great about putting our information on their website. And then just putting the program in our regular public programs flyer and adding it to our website, adding it to our publications.

GK: I think if you start a program you won't have a problem getting people coming to it. We are all here and we will help publicize programs. We have a big mailing list at this point. We send our flyers to doctor's offices where they are posted. There are all the other things that Jennifer mentioned as well. So we are all happy to help you get started. I just wanted to say that, as we are finishing up here, we obviously didn't get to everything. We are always happy at the Met if people are interested in this and thinking about starting programs we are very happy to have observers and to continue the conversation. I just wanted to say that.

And following up on that, everybody who is here has their card up on the table. Please take our cards and use us as you need us. We are all happy to at least communicate from the point of view of the experience that we do or do not have.

AM: Can I mention one more thing on that point, too. If you are thinking about how to have a conversation with your institutions, that's another thing that I am open to talking with you about. Because I think that's one thing that we didn't touch on as much and getting the support from within your institutions can sometimes be a challenge. Although the Rubin has been really great, but I know that is something that we are all thinking about, too.

GK: Sorry to cut things off everyone, but at 5:00 our recording stops. Thanks to everyone on our panel.