Author: leydenacademy

We are getting older and more diverse, and that brings challenges. We cannot solve these challenges through healthcare alone. We also need municipalities, schools, companies, housing associations and older people themselves to achieve an age-friendly society. This requires cross-domain collaboration. But how can we achieve that?

An investigative look
On April 25, researchers Tineke Abma and Barbara Groot from Leyden Academy on Vitality and Ageing, and Mariëlle Schuurman from Leiden University Medical Centre (all based in the Netherlands) presented the dynamic knowledge synthesis of local networks related elderly care. This synthesis was created in collaboration with stakeholders from 110 local networks and on behalf of ZonMw. The aim was to provide the professionals in the networks with tools to look at their own practice with an investigative view and to further develop the collaboration between care, support and welfare in the neighborhood.

Systematizing lessons learned
Moniek Willemstein, program manager of the ZonMw Local Networks program: “A lot of experience and practical knowledge was gained in the various networks. For example, we looked at how to better organize fall prevention through collaboration between healthcare and welfare or at everything that is needed to properly design a meeting place for older persons in their neighborhood. But little knowledge and experience was exchanged between the networks. We wanted to bundle the various insights, lessons and experiences, and make them available to local networks. We also wanted to gain insight into the approach to the synthesis itself. How do you approach learning across multiple projects? Those involved have exchanged knowledge and experiences about this.”

Process and results
Prof. Dr. Tineke Abma, professor of Elderly Participation and director of Leyden Academy, about the challenges and insights gained: “We were tasked with initiating a dynamic, non-statistic, learning process between the networks. But how do you do that? People learn from and with each other when ‘productive interactions’ arise. In other words, people want to meet others who struggle with the same issues. Different perspectives are crucial, as is safety to share not only success stories, but also doubts, questions and disappointments.”
One of the most important findings is that local collaboration requires investing in relationships, getting to know each other and establishing new connections. This is often accompanied by tensions. Especially when domains that ‘speak different languages’ come together, for example healthcare and welfare. And sometimes even broader with housing associations, social entrepreneurs and municipalities. Results are important, but the process is just as important!

Participation of older participants is crucial
Most networks started from healthcare, for example a general practice or home care institution. But more is needed to improve the quality of life of older people. The eight domains of the WHO’s age-friendly communities model were helpful in this regard. It turned out that elderly people were often not included in the local network. New insights emerged in the networks where older people did actively participate. Professionals realized that not all questions can be solved with care. For example, when experiencing loss and loneliness, older people indicated that attention and a listening ear were in many cases more important than solving (care) questions. A ‘good life’ is not only achieved through good care. Citizen participation, inclusion, good communication and environment are also important.

“The value of collaboration is sometimes difficult to pin down. It has value, that is what many people experience, but what does that mean? Getting to know each other and therefore finding each other more easily, especially when problems arise, is very valuable when working together.” – Barbara Groot, researcher

Positive energy
The enthusiasm to actively participate in the process was unprecedented. The dynamic nature of the knowledge synthesis has released positive energy and set a lot in motion. Working with creative methods in particular made a lot of difference. The ‘Working together as a forest’ card set was designed together with the participants, in which the ecosystem of a forest is used to look at and talk about different aspects of networks. This helps to reflect and to think about the common vision.

Connection with education
During the final meeting with the project leaders, many students and teachers from different levels of education were also present. The participants concluded that it is important that the professionals of the future learn to work with so-called wicked skills; listening, asking open questions, putting yourself in the other person’s shoes, dealing with conflict, etc. These – in addition to substantive professional knowledge – are desperately needed to make sustainable cross-domain collaboration future-proof.

Contact is something special. Really in contact with another person, with yourself, with your work, with your environment… then you know you’re alive. Real contact is also rare, especially in places where work pressure is high and the need for it is so strong. In healthcare, for example.

The importance of contact
Reasons enough for our healthcare aesthetic workshop, led by Tom Maassen, to organise a two-day Arts & Health event around contact. We organised this third year of Arts & Health together with The Care Lab at The University of Manchester, led by James Thompson, author of the book Care Aesthetics (2022). On Thursday 30 and Friday 31 May, about eighty participants looked for ways to strengthen contact in healthcare through dance, song, theatre, meditation, visual arts, rituals, stories, and conversation. Surprise and recognition, pleasure and sadness, at a distance and very close. It became clear how aesthetics and care are connected, and how powerful the connection between care and art can be. Present were healthcare professionals, healthcare managers, elderly people, artists, and researchers. It was precisely this diversity in backgrounds that made this event a great success. A lot of energy and creativity was unleashed during the dozens of sessions. To give you a little insight, we will explain the content and experience of some sessions.

“There is momentum in society to really highlight the aesthetic dimension of care. We can make the attention to this more sustainable through research, education and organizing these types of experience-oriented events. I am convinced that this will lead to better care.” – Tom Maasen, philosopher, and researcher

The miraculous journey of Fi
By Marjolein Baars and Doris Hochscheid
This beautiful performance was a penetrating and at times comic struggle of an elderly woman. Fi’s journey is about being stuck, (informal) care, surrender and acceptance of the situation you are in. It’s a messy search, as life can be, for ways to reinvent yourself. The audience also enjoyed Doris Hochscheid’s striking cello playing, in an ingenious constantly changing decor, with windows that opened and closed, a moving tram, a street, beach, birds. The message was as confrontational as it was hopeful: your grip on circumstances may be very limited, but you can control your attitude towards them.

Rituals for loss
By Ruchama Kramer and Marijn Graven
How do you give shape to farewell and loss? How do you convert fear and uncertainty into hope and desire? How can a farewell also be a new beginning? Ruchama Kramer and Marijn Graven guided the participants in pairs in designing a ritual for each other. A number of these rituals were performed during the session. The combination of ritual and theatre made it a very strong whole. It led to intense experiences and a strong emotional involvement of all participants.

In contact with each other
By Ester van der Geest
Ester van der Geest investigates how touch can be a relevant part of the contact between elderly people and informal caregivers. In this session, the participants learned to come into physical contact with each other, to experience what touch does to you and what it means to someone else. In healthcare we are no longer used to using and discovering this most basic form of contact, touch.

Stories of beautiful care
By James Thompson and Jenny Harris
In the United Kingdom, healthcare is always portrayed negatively, and the focus is mainly on problems such as costs and things that go wrong. But something changed during corona. People looked out for each other. This experience prompted James Thompson to focus on positive healthcare stories. It became clear that beauty is not only in appearance but also has inner characteristics. And that caring is (or can be) something beautiful. James Thompson and Jenny Harris joined the participants in looking for stories about beautiful care. It is precisely in sharing stories about the beauty of care that contact is created.

Exploratorium of the body
By Nieke Koek
In this session Nieke Koek took the participants on a walk outside. With a piece of clay in hand, they walked in pairs in search of how they felt. First in silence and later in conversation. It was not about feelings such as happiness or sadness, lonely or hunted, but about what a feeling looks like, what colour or shape it has. For example, yellow with some green and a bit grainy, or a bowl with a hole in it or with tentacles and deep cracks. While one talked, the other asked questions and in the meantime the clay was kneaded into a shape that expressed this.

Show the wood
By Tom Maassen
Tom Maassen conducted research in the care aesthetic workshop into what woodworking can tell us about care and about entering relationships. A lot of love and care goes into the wood. But what happens there? After a brief introduction, the instruction given to participants was ‘show the wood’. Participants chose lime, olive, walnut, or ebony wood. In the meantime, Tom asked questions and made short interventions. In the attempt to show the wood, you encounter both yourself and the wood in all its special features and idiosyncrasies. The participants were surprised how much they managed to really establish an exchange with the wood.

Voice and body awareness
By Chantal Goosens and Remco Hooijkaas
In this plenary session, Chantal Goosens had the audience sing together and explore in pairs how contact can be made through the voice. You don’t have to be able to sing, everyone can make a sound! Chantal invited everyone not to try to sound nice, not the way you want to sound, but just to sound the way you sound. This also includes taking risks, which is quite scary, according to one participant. It is about giving space to your body and your voice, so that you also create space for the voice of the audience. The session ended with everyone singing the beautiful ‘Dios es Amor’.

“I was very touched by it.” – Anneloes Schuppen, dance teacher
“I have never felt so safe while singing.” – Daphne Raad, researcher

Choreography of contact
By Anneloes van Schuppen
Anneloes van Schuppen knows how to find a very nice balance between ecstatic dance, choreography, and self-exploration in her sessions. In this way, various layers of contact were based on the question ‘What would you like to be in more contact with?’ During the session, participants could reflect on this question with pen and paper. From contact with yourself and with your body, they encountered someone else, with the group and with the space. Discovering new perspectives, inputs and insights about yourself and others, by doing, experiencing, and expressing. The participants worked towards a short, but moving and beautiful choreography.

“Even though it was out of my comfort zone, I experienced it as special and pleasant.” – Participant

Dance coach
By Mariëlle Peerenboom
After a conversation about challenges in making contact, the participants started to move more and more. Under Mariëlle Peerenboom’s inspiring guidance, words and movements merged more and more smoothly, towards an art of making contact.

Generation mixer (Imaginary communities)
By Lieke de Kock and Greet Meesters
Imagine an island that has never been discovered before. What can be found on that island? Who lives there? With playing and writing exercises, set construction, music, and all kinds of different art forms, the island comes to life. Young and old connected in fantasy, that is Generation Mixer. In addition to talent development, the method is about promoting the mental well-being and social skills of the participants. In this session by Lieke and Greet, the participants experienced this unique and very effective working method. First, the participants completed the sentence ‘In my imaginary world there is ……..’ in image and sound. Then everyone got to work on representing their part of the island on paper, ‘decorating’ it and bringing it to life.

Care aesthetics in Manchester
By Kate Maguire-Rosier and Réka Polonyi
Kate and Réka presented the first findings of their research Care as an aesthetic practice, from the University of Manchester and the NHS, on the assessment of dementia patients. Kate and Réka developed a framework for sensory and embodied dementia care. This framework illustrates what a healthcare aesthetic practice in a complex environment might look like. The presentation was interspersed with exercises and discussion and focused mainly on the researchers’ reflections on the process of co-production. Questions were raised such as: How was the collaboration? What tasks were involved? What are the lessons learned?

And more ………….
But there was more. Berit Lewis introduced the participants to her extensive knowledge of the effects of meditation and treated them to a few in-depth exercises. She also did a meta meditation for the entire audience, an exercise to move from compassion for yourself to compassion for the entire universe. Furthermore, the participants were introduced to the crdl of Dennis Schuivens and Jack Chen. This instrument creates musical moments of meaningful contact between people with a physical or cognitive disability and their loved ones. The event ended with a conversation between Tineke Abma, James Thompson, Tom Maassen and the audience. The focus was on questions such as ‘What exactly is healthcare aesthetics?’ and ‘How can we give the special experiences of the past few days a place in healthcare and healthcare education?’

On April 22, an important Chinese delegation of policymakers and healthcare administrators – amongst others the mayor of Shanghai – visited Leyden Academy on Vitality and Ageing to exchange ideas on ageing. Also present were two representatives of the Dutch Ministry of Health, Welfare and Sport, the former Chancellor of Leiden University, the former Dean of Leiden University Medical Centre (LUMC), the Head of Department Public Health and Primary Care/campus The Hague, and a representative from Aegon International.

Ageing populations
China and the Netherlands are incomparable when it comes to size and scale. The city-region of Shanghai alone is as big as the Netherlands, Belgium, Luxembourg and the north of France combined, with a population of 40 million inhabitants. A commonality is that both countries are dealing with an ageing population and related challenges such as ageism, loneliness, health disparities, and access to long-term care. This was the core topic of the work visit.

Prevention
David van Bodegom, professor of ‘Vitality in an ageing population’ at LUMC, spoke about the importance of collective prevention to postpone frailty in old age. His research shows that daily physical exercise in peer groups (so-called Vitality Clubs) do not only benefit the health condition of older people, but also help to prevent loneliness. While people in the Netherlands are not used to outdoor group exercise, the Chinese population is. Besides Tai-chi it is very popular among older women to dance on public squares, according to the Chinese officials. The public government stimulates role models and promotes these activities by offering public spaces to exercise. Van Bodegom: ”We can learn from China in that regard.”

Olderpreneurs and retirement
Digital learning expert Marie-Louise Kok talked about the desire of many Dutch people to stay active after their retirement: 73% of employees want to keep working after retirement and 10-15% of people over 50 want to start their own business.​​
Unfortunately, the general focus on young entrepreneurs leads to a lack of confidence in older entrepreneurs​. Therefore, Leyden Academy and Aegon developed Silver Starters, a blended learning program for people over 50 years who want to start their own business. An evaluation showed that 85% of the participants was more active, 67% had more self-confidence and 67% was better prepared for the future. The officials shared that in China men retire at 60 and women at 55 years of age. Then they make room for the next generation and watch after their grandchildren, so their children can focus on work. When they need help, their children take care of them.

Sustainability of older-persons care
Tineke Abma, Executive-director of Leyden Academy​ and professor of ‘Participation of older people’ at LUMC, spoke about the sustainability of older-person care in European perspective. An international comparison (The Netherlands, Denmark, Germany, and England) showed a wide variety of approaches in financial coverage, access to long-term care and the role of informal care.

The general trend in most of the studied countries is to facilitate older people to live self-sufficiently at home as long as possible. Six major issues are closely interrelated and are subject to public debate in each country: cost-sharing, privatization of care, (the burden of) informal care, staff shortages, quality of care and migrant workers.

The officials from China recognized these issues. In the bigger cities like Shanghai there is a lack of healthcare workers, which is fulfilled by people from the rural areas. Hence, lack of personnel is not an issue, but lack of skilled personnel is. Furthermore, the government stimulates old-for-old program where the younger generations take care of the older ones, for which they receive financial compensation.

Personalized care
Josanne Huijg senior investigator and staff-member of Leyden Academy presented an innovation program in long-term care for older people, called the ‘Enjoying life approach’. This approach starts with knowing the client’s identity and focusses on well-being. It envisions a paradigm shift from a standardized, biomedical to a personal approach: from disabilities to possibilities, from diseases to wellbeing, from needs to desires, and from protocols to relationships. The officials expressed their interest in personalized care, because in China care is standardized. They also wondered whether this requires other ways of measuring quality, and how cost-effective this approach is.

The Chinese delegation expressed that they were very impressed by the high quality presentations, and were inspired by the visit. The staff of Leyden Academy and other participants really enjoyed the interactive exchange.

We would like to express our gratitude to Marco Keim, the CEO of Aegon International, for arranging this visit, as well as to Wouter Knecht and Christel de Boks. Many thanks also for the advice from former dean Pancras Hogendoorn, former Rector Magnifici of Leiden University, Carel Stolker and Douwe Breimer, Wilco Achterberg, as well as Annemarie Montulet. Additionally, we appreciate the contributions of Mattijs E Numans from LUMC, Rosalien Stroot and Marjolein Don from the Ministry of Health, Welfare and Sport, and interpreter Echo Zhang for their involvement and input.

Is your country also interested in care for older persons in the Netherlands, in the research projects and activities of Leyden Academy, and in exchanging ideas? Let us know: info@leydenacadeny.nl.

In the project ‘Caring stories’ we developed a narrative-based adult education for health care professional groups which are often forgotten in (further) vocational education. We aimed to achieve this by training nursing assistants and welfare professionals in person-centered care through listening, interpretation and understanding of stories.

Activities
We implement and exchange experiences in two trainings of narrative-based training in the Netherlands and in Spain. We distinguished four activities 1) prepare through a kick-off meeting in co-creation with health care professionals the content and planning of the training, 2) develop, prepare, and implement the training 3) evaluate the training through questionnaires, discussion groups and 4) disseminate findings in a hybrid conference, handbook, key recommendations, and online platform.

Impact
This narrative-based training allows health care professionals to collect, understand, listen, and interpret narratives of older adults. This kind of training will assist in the attunement to the mutuality of a caring relationship and provides better person-centered care. We also aim to explore the value of narrative-based education for groups that are neglected or have a hard time accessing suitable vocational training that fits with their everyday practices.

This project run from 1 September 2022 to 31 January 2024, and was made possible by the Erasmus+ program.

ILC in the UK is The International Longevity Centre, had published a new report.

We know that we’re living longer, which means many people will also be working for longer. When adults continue to learn and upskill, there are key benefits to individuals and society as a whole:

• improved employment opportunities: reskilling and upskilling improve productivity, adaptability, knowledge and general employability
• strengthened economies in the face of rapidly changing labour markets: a lifelong culture of learning is linked with economies that are stronger and more competitive and innovative
• improved general wellbeing

ILC’s report, Redefining lifelong learning: Lessons from across the globe, produced in collaboration with Phoenix Insights found that while there’s no silver bullet to improve learning and retraining, in addition to public investment, there are key themes that emerge from global learning leaders.

With contributions of our Leyden Academy digital learning expert Marie-Louise Kok.

Go to the full report.

Much more attention needs to be paid to the positive effects of the use of art in healthcare. Art makes people feel better and helps them to better cope with their illness. Art can also mean a lot in the social domain and prevention, and in shortening hospital admissions. Research results and successful initiatives underline this, says professor Tineke Abma.
More than two hundred researchers, administrators, policy makers, healthcare workers, artists, teachers, experts and other stakeholders have participated in a broad study by Arts in Health the Netherlands. Together they outline how art can contribute to the transition in healthcare and how the field can be further strengthened.

Care through creativity
The consortium Arts in Health the Netherlands has drawn up a white paper that shows that art plays a valuable role in humanizing and making healthcare future-proof. Research shows that activities such as singing in a choir or visiting museums are not only enjoyable and inspiring, but also have demonstrable health benefits. Despite these findings, art is still used far too little in our healthcare. We advocate the integration of art and creativity in healthcare institutions and communities to promote health and well-being. When you are creative, the focus is no longer on incapability’s, but on what you can still do. Art encourages individuals to deal with their illnesses in a different way, it provides a sense of comfort and also helps reduce feelings of loneliness and alienation. Art can also play a role in prevention by increasing well-being and strengthening social connections in communities.

“I see it in my father. He is labelled as Alzheimer’s. It’s only about what he can no longer do. You can imagine what effect that has on his self-esteem. But now he sings every Thursday evening in a choir. He forgets a lot, but surprisingly enough not that appointment. He really doesn’t want to miss it. He says he has friends there. And it helps my mother that he is cheerful, that he tells stories.” – Tineke Abma, professor of Participation of Older People

Time for action
There are already wonderful initiatives and programs in the Netherlands that use art as care, but the field is far too fragmented. The white paper is an intersectoral exploration of Arts in Health in the Netherlands, and contains an agenda and goals for the next ten years. It serves as a call to action! The initiators emphasize the need to strengthen the field by joining forces and developing a joint vision for research, education and practice.

Click here for the English version of the white paper ‘Arts in Health in the Netherlands – A national agenda’, which was published in February 2024. Professor Tineke Abma, director of Leyden Academy on Vitality and Ageing is co-author of this white paper and since January 2023 Steering Committee Member of Arts in Health the Netherlands.

With great ambitions to improve patient care and provide citizens with tools to live their lives in good health, an international group of experts is coming together for a two-day workshop. ‘The future of diagnostics, about personalized prevention’ is the title of the Spark Impact Workshop which will be held on January 10-11, 2024 at the location of health insurer Zorg en Zekerheid in Leiden.

Wearable sensors, metabolomic biomarkers for seniors and AI – for measuring bodily functions – provide an increasing data flow and potential healthcare cost savings. In the Spark workshop, scientists will discuss the possibilities and effects of these types of applications to enable personalized prevention for health-conscious patients and citizens.

The workshop has a format that brings out creativity, including multidisciplinary round table sessions where delegates discuss various issues. The aim is to jointly create powerful and innovative concepts and networks that can be used for a future better life for older patients and citizens.

The organization is in the hands of the DusraVoila consortium, which stands for Dutch Society of Research on Aging & Vitality Oriented Innovations for the Life course of the Aging Society. With, among others, Frans van der Ouderaa and David van Bodegom on behalf of Leyden Academy.

The first global Citizen Science for Health conference was held from 29 October till 1 November 2023.
Herewith the registration of the keynote “The Participatory Turn in Health Research. Its Roots, Methods, Ethics, Validity and Future” by professor dr. Tineke Abma.
Tineke Abma is Executive-Director of Leyden Academy of Vitality and Ageing and Professor ‘Participation of Older People’ at the department of Public Health & Primary Care at Leiden University Medical Centre. She has been researching themes closely related to patient participation, participatory action research, ethics and diversity in the context of healthcare. Abma: “It means involving people whose lives are at the centre of research in making the key decisions of any research project: what should be the focus of the research, what are the research questions, how to answer these questions, what information to collect, how to make sense of the information, how to share it and what action to take as a result.”
The keynote has been summarized to 20 minutes.

About 24 to 40 million older Europeans have difficulty reading and understanding texts. This often leads to lower digital skills, stress, uncertainty, and health problems. For this reason, we have developed a playful and interactive healthy lifestyle course to support people with low literacy. The toolkit and the accompanying mini-training for professionals and volunteers who want to organize the course is now available.

Learning through play
Growing older with pleasure! is designed as an eight-week course, consisting of weekly two-hour meetings. During these meetings, participants learn in an accessible way, using interactive game cards, about topics that matter to them: the aging body, nutrition, well-being, digital skills and being heard. The course was developed according to the principles of meaningful play and collaborative learning. In the first case, learning skills through play is central, with the aim of gaining knowledge and ideas in a fun and enjoyable way. This approach has a positive effect on memory and recognition, motor skills, self-confidence, and social well-being. Collaborative learning focuses on group-oriented learning, active learning through involvement and strengthening social relationships, in the context of everyday life.

“Low-literate older people have often had to deal with disappointing learning processes. They have lost motivation along the way. It is important to get to what they do find important. There are too few projects that respond to this.’” – Jolanda Lindenberg, researcher Leyden Academy

Positive reactions
The interactive course has already been tested in various European places. A total of 200 participants took part in the pilots, ranging in age from 53 to almost 100 years. Some participants indicated that they felt less pressure and found it easier to share and try things out. The pilot was also a promising experience for the trainers involved. “People quickly come up with solutions by consulting with each other and sharing their experiences.” says Rita Castela of AI9.PT from Portugal.

“You have a lot to deal with as an older person. During the course I learned to tackle issues spiritually, mentally, and physically. I especially loved the game element. There was also a disadvantage: the course is too short.” – Anita, participant

Free teaching materials
Grow older with pleasure! is a collaboration between Leyden Academy, Stichting Lezen en Schrijven, University of Copenhagen, University of Coimbra and AI9.PT, and is supported by Erasmus+ (a European Union program). The free toolkit can be downloaded from the LOLit website. In addition to the course material, you will also find a step-by-step mini training for healthcare professionals who want to apply the course in their organization.

“The special thing about this project is that people get the feeling that they belong, that they feel part of society, that is moving to hear.” – Peter van Deursen, adult education Erasmus+

This is the message that Tineke Abma would like to convey. On Friday, June 23, she delivered her inaugural lecture ‘The Art of Belonging’ following her appointment as  professor of Elderly Participation at the University of Leiden. This is a brief summary of her inaugural speech.

The elderly are a gift to society
Participation, or taking part, is of great importance to elderly people. People such as Afifa Tadmine (73), whose face represents Leyden Academy. With her BLOEM Foundation, Afifa is –and has been for years-very committed to the activation of women who live in social isolation. Or take Leo and Netty Olffers, who have opened their living room to elderly people in the Laak district of The Hague for years. These are no exceptions. Older people are busier than ever:  babysitting their grandchildren, working as volunteers, whilst often still working in paid jobs themselves. Participating is meaningful. It contributes to the well-being of the elderly and is at the same time a great ‘gift’ for society.

The art of belonging: being and desire
According to older people participation is useful if it contributes to belonging. ‘Belonging’ sounds like a combination of two verbs: being and longing, or ‘being’ and ‘desire’. Belonging refers to a deep human desire to belong without having to conform. Being accepted is not self-evident. As soon as people reach retirement age, they are confronted with processes of social exclusion. They do not experience belonging (anymore). This is even more true for older people who have had to deal with exclusion based on class, ethnicity or another sexual identity all their lives. Opportunities for participation are unevenly distributed in our society.

Dominance of economic thinking
Current policy for elderly focuses mainly on healthcare costs for an aging population and the perceived limited economic usefulness of elderly people. The elderly are presented as a cost item and vital elderly people are expected to contribute to the economy and healthcare crisis by providing informal care, on top of all the tasks they already perform. But what do they want? This and other forms and combinations of meaningful participation remain underexposed, such as participating in socio-cultural activities that offer older people opportunities for continued growth and development. The need to learn does not stop after the age of 65. This is precisely what I wish to do with my chair

Art touches and connects beyond words
It is high time to give a new meaning to the concept of participation so that it contributes to meaning and belonging. This can only be done if we are prepared to accept that we humans are always connected with, and therefore dependent on, the world around us. Participating artists and social designers have a lot to offer. They are not so much focused on the defect or clinical picture, but take into consideration the (older) person and their creative potential. It is important for them to initiate a creative process, to express feelings, and they do this with care and concern, with concern for well-being of elderly people. What makes theatre, dance or singing together have so much to offer? In short: Art is not so much about transferring information or meaning, but primarily about sensual and sensory sensation. The experience is intensified and people are temporarily pulled out of their everyday life. Something resonates in people, which is aroused by the movements and the music, and that ‘feeling sound’ creates inspiration. This is why art touches and connects beyond words.

Transdisciplinary research with elderly people
I have always been an advocate for participatory research with people that contributes to their self-insight and mutual understanding. Drawing on different, sometimes conflicting perspectives, we can gain more insight into the experiences of others, and by entering into an equal dialogue we can broaden and enrich our own horizons. Involving patients or clients in research is becoming more and more common, but the participation of elderly people in research is much more limited, especially when it comes to elderly residents in nursing homes or elderly people with cognitive or verbal disabilities. We therefore have little or no knowledge of their perspective, and are thus confronted with our own methodological limitations. We invariably assume that people are autonomous and speaking subjects, and researchers often forget that there are people who cannot express themselves well in speech or whose words are not necessarily related to their emotions or actions. Excluding people from research is in fact silencing them. This is why I plead for transdisciplinary research together with older people and artists as co-researchers, and for the use of arts-based methods.

Moral horizon
Belonging forms the moral horizon for my research into elderly participation. That horizon outlines a movement and direction that my team and I are committed to in our research with, for and by older people. We want to contribute to 1) reducing inequalities of participation for older people and therefore their belonging, and 2) to promoting participation and belonging through a broader view of where participation takes place. Not only in informal care and work, but especially in areas that may have no direct economic benefit, but do generate vitality, meaning and connection, such as active participation in participatory art and culture.

Our research into the value of art
To gain more insight into the value of participatory art with and for the elderly, we conducted research into visual arts in hospitals, participatory theatre, inclusive dance, art for older migrants, clowning for people with dementia and intergenerational art in which children and elderly people work together, creating imaginary communities and visualizing what connects ‘us’ beyond age. We do not hesitate to ask critical-reflexive questions. Because art is no cure for everything and is not the solution or answer for the current healthcare crisis. But I do plead for an optimistic and hopeful vision of the third and fourth phase of life with room for participation in socio-cultural arrangements. The enormous creative potential this releases is enriching both for the elderly and our entire society.

A dance a day keeps the doctor away!

Professor Tineke A. Abma
Professor of Elderly Participation at the University of Leiden
Executive Director of Leyden Academy of Vitality and Ageing