Reviving memories through art

Her eyes have failed and her mind is beginning to fade, but in her mind's eye, 88-year-old Nellie Woolley still sees clear and bright.

Visiting the Big Apple Circus in Boston last week, Woolley, who lives at an Alzheimer's care facility in Brockton, clapped in time to the music, laughed with the crowd, and beamed as a young woman sitting beside her described the clowns and acrobats and dogs jumping over obstacles on their hind legs. Memories come harder for Woolley now, but the circus drew some deeply held ones to the surface.

''It brings things back, back to when I was a girl," she said. ''I used to go and just walk around and see the clowns. I can picture it in my mind."

The circus visit was part of an innovative form of treatment for Alzheimer's patients that uses music and art and, in this case, a common childhood experience, to stir memories and enliven their minds. Organizers of the initiative -- called ''Artists for Alzheimer's" and launched by Hearthstone Alzheimer Care, which runs the Brockton residence and seven others in Massachusetts, New York, and Connecticut -- believe that art and other multisensory experiences can help patients tap into memories that the disease has shrouded but not stolen.

John Zeisel, Hearthstone's president, said that Alzheimer's ''hides" people's memories, but that an intense, immediate experience like the circus helps find them. ''You can't hide from this," he said. ''That helps get them back to who they are."

Hearthstone officials bring artists to their residences to perform and help patients create their own art. They are working with the Museum of Modern Art in New York City to offer specialized tours for people with Alzheimer's.

Art therapy cannot halt or reverse the progression of the degenerative brain disease, which gradually impairs the ability to think, remember, and communicate. But proponents believe the therapy can engage the mind's expressive and emotive powers that remain intact, sharply improving patients' quality of life.

The fundamental theory behind the therapy is that Alzheimer's patients are ''still with us," Zeisel said, and can appreciate and be soothed by art and music. Seeing art and listening to music can help reduce the disease's symptoms, including feelings of confusion, anxiety, and depression, he said.

''There's no drug on the market that can do what this circus can do for them," said Hearthstone's director of community relations, Sean Caulfield.

The potential of art therapy for patients suffering from dementia is receiving more attention, with the number of Alzheimer's patients poised to surge as the baby boom generation ages. An estimated 4.5 million Americans now have Alzheimer's; by 2050, the number is expected to rise as high as 16 million. The US population age 65 and older is projected to double within the next 25 years, according to the National Institute on Aging.

''It's an issue whose time has come," said Lesley University professor Shaun McNiff, a past president of the American Art Therapy Association and the author of several books about art therapy. ''Art is not limited to one cognitive, cerebral channel. It's an interplay between all the senses, and so it can engage people wherever they happen to be."

At the circus, a one-tent production held at Boston's City Hall Plaza, Anna Imbergamo, 77, who also lives in the Hearthstone facility in Brockton, recalled going to the circus at Boston Garden as a child. She and her family would walk from their home in the North End, she said.

Betty Madsen, 76, a resident at Springhouse, a Jamaica Plain retirement community invited to participate in the initiative, also fondly recalled childhood visits to the big top. She chuckled as a grandmotherly clown welcomed her to the show last Thursday.

''Of course they make you laugh," she exclaimed. ''That's what they're here for."

As the show went on, Madsen swayed and tapped her feet in time to classics like ''Singing in the Rain." She clapped her hands excitedly at the trapeze artists and chuckled as the grandmother clown outdueled two pirates. ''You're never too old for the circus," she said.

Karen Pollack, outreach coordinator for Springhouse, said Madsen was far more animated than usual. Madsen and the other elderly patients, who are in the early or middle stages of the progressive disease, may have forgotten what day it is or what they had for breakfast, but can still recall childhood events or the tune of old songs.

By awakening their minds, the circus and other engaging activities ''act as a type of medicine," she said. ''Their memories are in there.

''Sometimes they just need to be teased out."

Paul Raia, director of patient care of the Alzheimer's Association of Massachusetts, said that while there is no research showing that art therapy helps Alzheimer's patients, there is anecdotal evidence that it can reduce the agitation and aggressiveness the disease can cause.

''Art can change emotions positively very quickly," he said.

Woolley said she is becoming increasingly forgetful, and that worries her. But hearing the songs reminds her of happier times, like going to the movies with her teenage friends.

Caulfield, carefully observing the patients' reactions, called the circus and other forms of art therapy ''a conduit for patients to come to themselves."

''We're grounded in our own memories. It's who we are," he said, recalling a passage from Dostoevsky's ''The Brothers Karamazov."

''If one has only one good memory left in one's heart, even that may sometime be the means of saving us," he said, quoting the author.