Elyssa Twedt (St. Lawrence University)
Dennis R. Proffitt (University of Virginia)
Donna Hearn (University of Virginia)
Please note: Instructors are welcome to use or adapt these teaching ideas for their own classes, provided the use is noncommercial and appropriate credit is given.
To: (1) foster values of citizenship and build students' confidence in their abilities to help others; (2) form intergenerational relationships between undergraduate students and the elderly by working towards common goals; (3) develop students' research skills; (4) highlight the reciprocal nature between knowledge learned in the classroom and knowledge acquired through real-world experiences; and (5) teach students about dementia and how the environment affects individual well-being.
This service-learning assignment provides students with first-hand experience seeing the positive effects of art, nature, and music on the well-being of individuals diagnosed with dementia. Students begin by attending lectures that cover Alzheimer's disease, dementia, aging, and the restorative effects of art and nature on afflicted individuals. Groups of three students are then paired with an elderly couple, one member of whom has dementia, to create multimedia digital projects (e.g., online scrapbooks, interactive DVDs) involving experiences with art or nature tailored to the needs of their specific couple. Students meet weekly with their assigned couple to discuss the family's interests and goals for the project and to obtain feedback on the evolution and impact of their project on the family's well-being. Finally, students give a class presentation describing their project, the feedback received from their family over the semester, and their overall impressions. Through this field experience, students go beyond traditional lecture learning and develop a customized project that promotes the well-being of someone experiencing dementia.
Description of Assignment
An important role for teachers is to design courses and learning activities that create intrinsic motivation for learning and that help students realize how knowledge learned in the classroom can be applied to real-world situations. To illustrate this approach, we designed a service-learning activity to teach students how interaction with stimuli such as art, nature, and music can positively affect the general well-being of individuals diagnosed with dementia.
In this psychology seminar, called Art and Aging, students first attended lectures to learn about Alzheimer's disease, dementia, aging, and what is known about art and nature's restorative effects on afflicted individuals. For example, viewing nature and art may improve individuals' mood, reduce stress, and improve cognitive performance (Kaplan & Berman, 2010; Ulrich et al., 2008). To teach these concepts beyond textbook material and to create an interactive, multidimensional learning experience, groups of three students were paired with an elderly couple — often a husband and wife, one member of which had dementia — to create digital projects that provided interactive experiences with aspects of art and/or nature and that would benefit and delight each couple.
This assignment was the central component of the course and was completed in various stages throughout the semester. The elderly couples volunteered to participate and were recruited by the local Alzheimer's Association. Students met weekly with their families to learn about their interests and goals for the project, to obtain feedback on how the project should evolve, and to evaluate the impact their project had on their family's well-being. This collaborative and iterative effort allowed family members to actively participate in the creation of the projects with their individual needs and interests in mind. At the end of the semester, students gave a presentation describing their project, feedback from the family, and overall impressions. Students learned from their hands-on experiences to be more aware and understanding of the impact that dementia has on afflicted individuals and their families, and that dementia takes on a variety of forms. As a result, each group designed a unique project that catered to their specific family.
For example, one individual with dementia, Sam, along with his caregivers, worked with three students to create a digital scrapbook that could be passed on to his children, including photographs, personal drawings, and video narratives outlining his life. The importance of this project to Sam was highlighted when he called this project his "bag of jewels." Sam's caregivers remarked that this course allowed them to meet Sam's needs in a way they could not do on their own. They said that when Sam was involved with this project, he was animated and enthusiastic, and acted more like he used to before he was diagnosed with dementia. This sentiment was not lost on the students, who remarked on the strong bond formed with this family over the semester.
Another participant, Eunice, had severely impaired vision and hearing as well as moderate dementia. Students learned in class that her particular type of dementia made it difficult for her to make decisions or sustain attention for long periods of time, due to damage to the prefrontal cortex. In designing a project that focused on her interests yet respected her limitations, three students created an interactive DVD that included pictures of her three favorite interests: family, birds, and clouds. To address Eunice's hearing and vision problems, the students used a projector to present the video on a large wall and used headphones to amplify the sound. Eunice's daughter stated that this project appealed to her because it respected her mother as an adult, whereas other activities have seemed too childish.
For the students, this course provided a mechanism to learn the value of independent research, to develop problem solving skills, and to apply basic knowledge learned in the classroom to a meaningful, real-world situation. The students took an iterative and collaborative approach to designing their final projects by using information learned from lectures, by collecting regular feedback from their assigned families, and by using that feedback to alter their project until the final version met each family's expectations and needs. Often, students' original project ideas became something quite different by the end of the semester, after having the opportunity to see first-hand how their family responded to the project. Students expressed gratitude at having the opportunity to participate in a hands-on learning course that could positively impact the community. As students neared graduation, several remarked that this course prepared them for post-college life in a way that no other course could match and that their experiences through this course would be unforgettable.
Evidence of Effectiveness
Although learning was not quantitatively assessed, students completed a reflection paper as a final assignment to describe their learning experiences while working on the project. Collectively, the reflection papers revealed that seeing firsthand how lessons learned in the classroom influenced experiences in the real-world (and vice-versa) intrinsically motivated students to do well, not just to earn a high grade, but to create an enjoyable project for their assigned family. For example, several students created extra projects for their assigned family that went beyond the classroom requirements and continued past the semester; others commented that they put effort into this course not because they had to but because they wanted to. Furthermore, meeting with their families on a weekly basis reinforced the lessons learned in the classroom, creating a deeper and longer-lasting understanding of Alzheimer's disease, dementia, and environmental influences on well-being. Students commented that:
- "It was truly wonderful to be part of an academic class that not only benefited me as a student and future psychologist, but also benefited the community."
- "I never thought that I would feel such a great sense of fulfillment after finishing a class."
- "[W]orking with Jim has made me more aware of how devastating the effects of Alzheimer's disease can be... These lessons could not have been acquired through reading a textbook and I am thankful for them."
- "[I]n this class, everything that students learn about Alzheimer's disease and dementia is reinforced through engagement with that particular community. It really helps one to get a grasp of the disease."
- "We used the information we learned in class to inform our project design and the way we interacted with Debbie and Eunice, and we used our interactions with Debbie and Eunice to enforce and deepen our understanding of what we learned in class."
- "I believe that the hands-on model gave me more motivation and initiative to learn and solve the problems presented to us because I was personally involved with the projects."
- "The entire experience has been extremely rewarding... I found myself putting in an extra effort because I felt my group mates and I could truly make a difference in our patient's life."
- "A lecture or a textbook cannot teach you what I learned from my interactions with our group's family. While I appreciated the background information on the literature and characteristics of Alzheimer's disease that our guest lecturers provided, it was not until I had the opportunity to interact with individuals affected by this disease that I internalized what the lecturers had explained."
Implementation and Variations
The goal of the assignment was to provide an opportunity for the students to apply skills that they had learned in the classroom in a way that benefited the community, fostering the value of citizenship and building students' confidence in their ability to help others. Although we used the assignment with university students, it could readily be adapted for use with high schools students. In addition, students could work with afflicted individuals in nursing homes, low-income neighborhoods, hospitals, or home-care programs.
Students in this course used iPads, laptops, and desktop computers to create their projects. The choice of software depended on student preference and skill levels but often included PowerPoint, iMovie, or website design. These media provided a means for students to efficiently develop their projects, but the same learning goals could also be met using non-digital tools. For example, students could create artwork, photo albums, or plan interactive activities such as visiting museums or attending concerts.
For teachers without access to a local Alzheimer's Association, some alternatives might be to collaborate with a university research laboratory that recruits elderly participants, partner with a local nursing home or memory care facility, or place advertisements in the local newspaper.
Kaplan, S., & Berman, M. G. (2010). Directed attention as a common resource for executive functioning and self-regulation (PDF). Perspectives on Psychological Science, 5, 43-57.
Ulrich, R. S., Zimring, C., Zhu, X., DuBose, J., Seo, H., Choi, Y., et al. (2008). Review of the research literature on evidence-based healthcare design. Health Environments Research and Design Journal, 3, 1-13.