“Also, when you’re happy,” Ms. Schnauz countered. “Listening takes time.”
In Germany, which has the largest number of people over age 65 in Europe and a robust system of publicly financed local museums, tours like this one are increasingly common — found in major museums in Berlin as well as more obscure institutions in provincial communities.
Ms. Kastner, the Lehmbruck Museum’s outreach coordinator, first developed her program in Duisburg, a former industrial hub in northwestern Germany, in 2006, after a colleague’s mother was told she had dementia.
“At first, we did it for our colleague,” Ms. Kastner said. “We saw how hard this situation was for her, and we thought, ‘What can we do to make things easier?’”
Since the co-worker had often brought her mother to the museum, Ms. Kastner said, they decided to see if that would help.
It did, and over a series of lunchtime discussions with her colleagues at the museum, Ms. Kastner decided to create the program. They got in touch with the local Alzheimer’s association and set up some group tours.
“After that, it went very quickly,” Ms. Kastner said. “We determined that it was very interesting for people.”
Ms. Kastner led the group from the copper tree to a piece by the German visual artist Rebecca Horn, who cast a pair of her own pointy-toed party shoes in metal and affixed them to a steel slab. Now warmed up, the visitors shared their observations eagerly.
“I’m a practical person,” said Henny Mimitz, the former housewife. “You can’t wear those shoes outside.”
A pair of slowly waving metal rods sticking up from the shoes caught the eye of Muhammed Nasrudinsada, the former mechanic. “Like a cradle in the wind,” he said.
“But you can’t wear those shoes outside,” Ms. Mimitz said, shaking her head.
Finally, Ms. Kastner again asked: What did it mean? Heidrun Mann, a resident of the home who had been silent until now, spoke up.
“It’s over,” Ms. Mann said. “There are no more steps to take.”
Ms. Kastner asked how that felt. Ms. Mann reflected, looking at the artwork. “To me, it’s beautiful,” she said.
As the group moved to a sculpture made of three large, golden rings titled “Intertwined in unending love,” Thomas Seel said the tour was good for his wife, who suffers from aphasia. “She’s lost the ability to speak,” he explained. “But she’s paying attention, she’s engaged. It’s good to see.”
Over the coffee and cookies that are part of each tour, Marita Neumann, who runs the adult care home, said activities like these were important.
“We see a lot of people who are very interested, very awake — things are possible we didn’t think were possible,” she said. “People with dementia also need adventures. They need to get out, just like us.”
Inge Rasch, another day visitor, said she enjoyed the museum tour because she likes company. “You get lonely, otherwise,” she said. “I also love coffee, but I don’t need to come here for that. I can drink coffee at home.”
Loneliness is something the spouses and family members of the patients also understand, said Hanni Stemmann, who used to bring her husband to the dementia program. He died, but she still comes by herself. “They’re nice people,” she said, looking around the museum’s light-flooded space. “And when you’re suddenly alone, it’s hard to get out.”
After the group left, Ms. Kastner reflected on how to create a museum tour for dementia patients.
“Normally, what you do in a tour is you find a recurrent theme, and build on it,” she said. “You can’t do that here. But in the moment, you can observe beautifully, and talk about it. It’s very intense, it has a different quality. You can experience wonderful moments.”
Ms. Kastner said her work with people with dementia has taught her to be a better listener. “Even when someone doesn’t speak, you need to dignify their presence,” she said. “To say, ‘You are seeing.’ That is also a contribution.”
Video requires sequential memory, so it does not work well for the tours, but there are otherwise very few limitations on what kind of art Ms. Kastner and her colleagues choose to highlight. An exhibition about the value of art included a Constructivist piece — a glass case full of coins, with a water faucet — that spurred a lively discussion about how each person had handled their finances.
Ms. Kastner, who holds art-making workshops every two weeks in addition to the tours, said that both caretakers and art professionals have noticed that people with dementia may enjoy looking at and making art, even if they were not interested in it when they were well.
Ms. Kastner noted that, on her regular art tours, people sometimes have trouble connecting with artworks because they put so many interpretive or analytic layers between themselves and what they are looking at. People with dementia, she said, have an easier time of simply reacting emotionally to what they see.
She did not tell the group that Rebecca Horn had turned her party shoes into art after she had suffered a stroke and could no longer wear them. The group nonetheless picked up on the artist’s themes precisely.
“You just have to experience the space that art creates,” Ms. Kastner said. “It requires a deep trust in art, and in the visitors.”
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