The Arts and Dementia: how might the arts contribute to the creation of more inclusive ageing societies?

日本被描述为一个“超老龄化社会”，有27%的人口年龄在65岁或以上（数据：世界银行）。另一个挑战是痴呆症的发病率；《2016年世界阿尔茨海默病报告》指出，460万日本人患有痴呆症，到2025年将增加到700万。这种人口结构已经在东南亚其他国家出现，西方国家的人口预计将在未来30年内向日本的情况发展。由于痴呆症没有有效的治疗方法，在预防或治疗方面也没有重大突破，因此必须更加重视照顾人们的方式。我们必须考虑如何挑战根深蒂固的公众态度，这种态度被认为痴呆症患者是一种负担，无法作为公民参与。正如日本的“橙色计划”（2015年）所述，我们必须“实现一个个人意志得到尊重、尽可能长时间生活在舒适和熟悉的环境中的社会”。有令人信服的证据表明，艺术对痴呆症患者的重要性，以及它们在增强幸福感、健康和认知功能方面的有效性。我们感兴趣的是共同创造艺术如何挑战人们普遍认为的痴呆症患者缺乏创造力和依赖性。我们将共同创造艺术定义为将过程置于产品之上，平等地评估所有贡献，并且不存在生产者和消费者之间的区别。共同创造可以促进机构和社区，也是为家庭和照顾者工作的有力方式。我们建议建立一个跨学科的网络，以研究艺术家、社会科学家、护理人员和痴呆症患者共同创作的方式，帮助社会重新设想那些因其状况和经历而变得脆弱的人的位置。我们将利用在英国和日本开发的专业知识。英国对痴呆症患者艺术实践的研究被认为是相对先进的。在日本，将痴呆症患者纳入社会被认为是一个紧迫的问题，学术界、政策制定者和第三部门都在参与其中。我们的网络将以纳入痴呆症患者而闻名，他们将在各个阶段为我们的活动提供信息。首席研究员和联合研究员在与痴呆症患者密切合作方面有着丰富的经验，日本的同事们热衷于学习这种工作模式。该网络将把实际工作与跨学科和文化界限的批判性对话结合起来。它将通过一系列的交流、分享实践和第一手方法来建立。例如，作为他们在惠康（www.createdoutofmind.org）实习的一部分，英国研究人员开发了一种新的方法，通过音乐和舞蹈来衡量痴呆症患者的幸福感和代理能力。这项创新工作将与我们的日本同事一起形成和完善。这些措施和做法在多大程度上可以外推到日本的文化和社会将被探索。在衡量以艺术为基础的干预措施的影响方面，英国学者可以借鉴日本的专业知识。我们还将探讨可以开展合作研究的领域。预计通过这些关键对话，人们将对艺术有助于重新构想更具包容性的社会的方式产生新的理解，产生的结果将为痴呆症护理的政策和实践提供信息并产生积极影响。该网络的研究结果将转化为两国都能理解的成果，并具有学术界以外的相关性。我们的研究结果将通过文章、网络和媒体传播，为进一步的合作研究铺平道路。我们的建议是一个影响痴呆症患者护理实践和政策的机会，将具有全球意义。

Japan is described as a 'super-ageing society', with 27% of people aged 65 or over (data: World Bank.) An additional challenge is the incidence of dementia; the World Alzheimer Report 2016 stated that 4.6 million Japanese are living with dementia, rising to 7 million by 2025. This demography is already paralleled in other countries in SE Asia, with populations in the West predicted to move towards the Japanese situation within the next 30 years. With no effective treatment or significant breakthroughs in prevention or cure for the dementias, more attention must be given to the ways in which people can be cared for. We must consider how ingrained public attitudes, dominated by the perception of those with dementia as a burden and unable to participate as citizens can be challenged. As stated in Japan's Orange Plan (2015), we must 'realize a society where one's will shall be respected, and one can live in pleasant and familiar surroundings as long as possible.' There is convincing evidence that demonstrates the importance of the arts for people with dementia and their effectiveness in enhancing wellbeing, health and cognitive function. Our interest is in how the co-creative arts can challenge the commonly held perception that people with dementia are non-creative and dependent. We are defining the co-creative arts as privileging process over product, valuing all contributions equally, and where there is no distinction between the producer and consumer. Co-creativity can promote agency and community and is also a powerful way of working for families and carers. We propose the establishment of an interdisciplinary network to conduct research into the ways in which co-creative work by artists, social scientists, care practitioners, and people living with dementias can help societies re-envision the place of those made vulnerable by their condition and experiences. We will draw on expertise developed in both the UK and Japan. UK research into arts practice for people with dementia is recognised to be relatively advanced. In Japan, the inclusion in society of those with dementia is recognised as an urgent issue with which academics, policy makers and the third sector are all engaging.Our network will be distinguished by its inclusion of people with dementia, who at all stages will inform our activity. The Principle Investigator and Co-Investigator have extensive experience of working closely with people with dementias - a mode of working which colleagues in Japan are enthusiastic to learn from. The network will combine practical work with critical dialogue across disciplinary and cultural boundaries. It will be established through a series of exchanges, sharing practice and approaches first-hand. For instance, as part of their residency at Wellcome (www.createdoutofmind.org), the UK researchers developed a new way of gauging wellbeing and agency with people with dementia, using music and dance. This innovative work will be shaped and refined with our Japanese colleagues. The extent to which these measures and practices can be extrapolated into Japanese culture and society will be explored. UK scholars can learn from Japanese expertise in measuring the impact of arts-based interventions. We will also scope areas where collaborative research can be pursued. It is anticipated that new understandings of the ways in which the arts can help to re-envision more inclusive societies will emerge through these critical dialogues, producing outcomes that will inform and positively impact both policy and practice in dementia care. The findings of the network will be translated into outcomes that can be understood in both countries and have relevance beyond academia. Our findings will be disseminated in articles, online and in the media, paving the way for further collaborative research. Our proposal is an opportunity to influence practice and policy in the care of people living with dementia in ways which will have global significance.