ICOM Voices Art as Therapy: The National Palace Museum’s Approach to Dementia Care

Since 2006, the National Palace Museum (NPM) in Taipei has extended its reach to serve Taiwan’s aging population, recognising the profound impact that art can have on the elderly. As Taiwan is expected to attain super-aged society status by 2025, senior citizens have emerged as a key audience for the museum. To address accessibility challenges, NPM has partnered with senior homes, libraries, and city district health centers, offering specialised courses that integrate its vast collection of ancient Chinese art with the lived experiences of individuals over 65. These courses foster engagement through a variety of approaches, including art-making, physical activities, replica handling and museum visits, creating a meaningful dialogue between the artefacts and seniors’ life stories.

In light of the World Health Organization’s 2019 report affirming the positive effects of the arts on health, well-being, and disease management, NPM explored how its collections could contribute to dementia care. Dementia is a growing concern in Taiwan due to the aging population, hence prompting a multidisciplinary collaboration between the museum and the Dementia Treatment and Research Center of Taipei Veterans General Hospital (TVGH) in 2021. This partnership resulted in ‘Live for Today: Cognitive Card Set’ (LFTCS), an innovative project that seeks to enhance cognitive function, communication, and social interaction for elderly individuals with mild dementia or cognitive impairment.

 

The ‘Live for Today: Cognitive Card Set’ Project

Drawing from 60 carefully selected works of art, the LFTCS is organised into 10 thematic categories that mirror key stages of life – childhood, adulthood, late adulthood – and experiences or things such as food, plants, animals, festivals, seasons, and classic masterpieces. The cards are large, easy-to-handle, and are complemented by an artwork introduction booklet and a user manual designed for healthcare professionals, ensuring that the tool is accessible to both patients and caregivers. The collaboration brought together museum educators, psychologists, and occupational therapists, demonstrating the value of cross-sector partnerships in the development of non-pharmacological interventions for dementia care.

The card set offers versatile use: it can be utilised one-on-one, in group settings, or with caregiver involvement. The training workshop, organised by the museum and the hospital, aims to explore practical techniques and develop varied implementation methods.

A pilot study was conducted in conjunction with the ‘Live for Today’ thematic activities at a daycare center and Dementia Community Services Site to assess the preliminary feasibility, acceptability, and potential impact of the card set on seniors living with dementia. At the daycare center, three participants (one male and two female, average age 78.3) took part in the study. Additionally, five pairs of participants, each consisting of a person with dementia and their informal caregivers, were recruited from two Dementia Community Services Sites. These pairs included one male and four female participants, with two individuals diagnosed with questionable dementia (Clinical Dementia Rating 0.5) and three with mild dementia (Clinical Dementia Rating 1), with an average age of 76.4 years. This study offered valuable insights into how the ‘Live for Today’ project could enhance engagement and support for those experiencing cognitive decline.

Figs. 2 and 3. Seniors participated in NPM’s ‘Live for Today’ program led by Ting Jung Hsu, an occupational therapist. Photos courtesy of Marion Tsai.

Preliminary findings revealed that artworks depicting everyday life – such as scenes from Up the River During Qingming, a Chinese painting which has several versions that represent farming, family, marriage, school life, and people from all walks of life – elicited strong emotional responses from seniors with dementia. These pieces evoked personal memories, encouraging both reminiscence and engagement. For instance, as Subject A viewed the card depicting a farming scene (Fig. 4) – a detail from Qiu Ying’s version (c. 1494-1552) – they remarked: ‘When I was a child, we didn’t have a cow to plow the fields, so we had to rely on manpower. My mother used a shovel to till the land. She would wake up at 3 a.m. to prepare breakfast for everyone by 5 a.m., and then head out to work in the fields.’

Subject B recalled a similar memory: ‘When there wasn’t enough manpower for farming, I had to handle everything on my own – leveling the land, weeding, planting rice, and harvesting. Neighbors would also help each other out. After the harvest, they would share some of their earnings, often preparing porridge to make sure everyone was fed.’

Fig. 4. A card of ‘Live for Today’. Detail from the painting Up the River During Qingming by Qiu Yi (c,1494-1552). Image courtesy of the NPM.

Looking at the card depicting a wedding (Fig. 5), Subject A commented: ‘My eldest sister got married in a similar way, but I was very young at the time, so I don’t remember much about it.’ Subject C shared more details about how these weddings took place: ‘The bride would often cry in the sedan chair on the way to the groom’s house. Just before arriving, someone at the front would gently remind her to stop. Once the sedan chair reached its destination, the groom would kick the door sill and invite the bride to step out.’

Fig. 5. A card of ‘Live for Today’. Detail from the painting Up the River During Qingming Qing Dynasty version, 18th century. Image courtesy of the NPM.

When family members accompany relatives living with dementia, they share an experience, allowing them to explore and appreciate art together. Realistic depictions of everyday life tend to evoke nostalgic memories more profoundly than simplified line drawings.

A family member recalled: ‘Mom has recently developed an interest in using images to document her life. The artworks from the National Palace Museum, far from simplistic pictures, spark her appreciation for beauty and inspire her to engage more deeply. She’s also found that these pieces offer a way to connect with others and share her life stories.’

This kind of feedback from the participants and their caregivers indicated that the card set helped to generate positive emotional experiences, enhance social interaction, and even alleviate the caregivers’ burden by improving mood and communication among the seniors.

Conclusion

The success of the LFTCS has sparked further interdisciplinary collaboration. Since its launch, NPM and TVGH have co-organised seven training workshops, engaging over 350 medical professionals and senior service providers across Taiwan. The initiative exemplifies the power of integrating the arts into healthcare, showcasing how museums can play a vital role in improving the quality of life of individuals living with dementia.

Through this innovative project, the NPM demonstrates how museum collections can transcend traditional boundaries, serving not only as a repository of cultural heritage but also as a dynamic resource for promoting holistic well-being within the community.