Why culture and inclusion are key to dementia care

House of Memories is a unique education programme created by National Museums Liverpool to help museums across the UK, and beyond, support people living with dementia. It’s our mission to help people live well with dementia and it’s a job I’m incredibly passionate about.

A new approach to dementia care

When House of Memories began in 2012, it was unusual for a museum to take a direct and active interest in the lives of people living with dementia, particularly with the goal of developing digital resources and training for families and care providers.

But we knew we had a unique perspective and position that could help make important strides in the field of dementia care. Museums are experts at looking after memories andHouse of Memories is designed to provide knowledge and understanding of how information about a person’s history and life experience can be a valuable tool for reaching people in a deeply meaningful way. Something that dementia can sadly make very difficult. So we started to develop interactive training sessions, provided access to a free object loan service and created the museum memory app: My House of Memories. We also began working closely with the health and social care sector to make National Museums Liverpool an important asset for older people, their families and care networks.

The power of objects

It has never been more important to support older people who remain vulnerable, socially isolated and ‘shielded’, as a result of the Coronavirus pandemic. At present, there are substantial barriers to digital social engagement for isolated older people, including a lack of access to technology and support to engage actively online. For older people who continue to be lonely and isolated the My House of Memories app and similar digital tools provide a unique way to record and share hidden memories that enable a renewed connection between neighbours, families and community networks.

Based on the power of objects to elicit deeply held memories, the free app allows people to explore everyday objects from the 1920s to 1980s. Objects like cinema tickets, a Singer sewing machine and a 10-shilling note, brought to life with music and film, can help those living with dementia draw on memories to create personal connections with family, friends and caregivers. Users can also save objects to their own memory trees, memory boxes or memory timelines to share with family and friends.

Connecting people

House of Memories’ commitment to design an inclusive programme has been successful and challenging in equal measure. The My House of Memories app was co-created with people living with dementia and required us to re-think our approach to achieve dementia friendly digital design.

The way in which we communicate with each other has changed dramatically and that meant we had to change too. Museums exist in a world where society no longer wants to be a passive consumer. People of all ages can now make movies on their mobile phones; take photos and blog about their experiences. People demand constant and immediate access to cultural heritage. This presents both opportunities and challenges for the museum sector to learn how to connect, to listen, and to understand how people wish to engage with their culture, heritage and their personal, and often sensitive histories.

Reaching diverse audiences

Allowing everyone in society to access such experiences is not the job of the few. A truly inclusive museum enables the whole organisation to embrace a shared goal to enable the whole of society to benefit; a deep-seated belief that everyone should feel connected to and be part of how a museum tells its stories and reflects those who visit them. Museums are bursting with brilliant objects and incredible stories, to inspire, challenge and stimulate us and it is imperative to me that our diverse and under-represented audiences are reflected and listened to. This would of course include our older population, but recent events and demands for change across the world, sparked into life by the killing of George Floyd are evidence that as a society, we still have a very long way to go before we can say we are truly inclusive.

This challenge will defeat all but those with a solid determination and commitment, as it will defeat those who devote insufficient effort, time and patience.

Published By: Carol Rogers, Director of House of Memories

Source: www.liverpoolmuseums.org.uk

Cultural mediation can be understood through the lens of sociocultural theory, which emphasises that human thinking develops through social interaction and the use of cultural tools such as language, symbols, and artistic expression.

In the context of art and cultural mediation, these tools are not limited to words – they also include images, movement, storytelling, and shared experiences. Meaning is not created individually; it emerges through dialogue – between participants, artworks, and the mediator.

Rather than transmitting knowledge, the mediator creates conditions for reflection, interpretation, and connection. In this sense, cultural mediation supports processes similar to what has been described in research as internalisation – when shared experiences gradually become personal understanding.

When we speak about wellbeing, we often speak in simplified terms. We ask whether people feel happy, satisfied, positive, or emotionally balanced. These are important questions, but they may not be enough. Carol Ryff’s influential 1989 article challenged exactly this narrow understanding of wellbeing and argued that psychological wellbeing is much broader than happiness or life satisfaction alone .

For those of us working in cultural mediation and adult learning, this insight remains deeply relevant. If culture is to contribute to wellbeing, then its role cannot be limited to entertainment, distraction, or temporary emotional uplift. Cultural experiences can also support meaning, connection, growth, dignity, and agency.

Beyond Happiness

Loneliness among older men is a growing public health crisis, with research showing that men over 60 are particularly vulnerable to social isolation. But what if museums could offer more than just historical artefacts?

What if they could become spaces for connection, purpose, and creativity? At Beamish Museum, an ambitious collaboration known as the Dovetails Project has emerged as a powerful example of how museums can address loneliness through creativity, shared purpose, and meaningful relationships.

Led by Michelle Kindleysides, Head of Health and Wellbeing at Beamish Museum, Beth Marston, Health and Wellbeing Support Worker, and Dr Henry Collingham, Innovation Fellow from Northumbria University, the Dovetails Project brought together Beamish Museum’s Men’s Group and Kids Kabin, a children’s creativity charity based in one of Newcastle’s most deprived areas.

Synthetic Memories is a creative project that uses Artificial Intelligence (AI) to bring personal memories to life, especially those without photos or videos. By turning people’s detailed recollections into AI-generated images and short videos, this project helps recreate moments that might have faded with time.

Helping People with Dementia and Alzheimer’s

One of the most meaningful uses of Synthetic Memories is in therapy for people with dementia or Alzheimer’s disease. These AI-generated images can help spark forgotten emotions and encourage conversations about the past. Therapists have found that revisiting these recreated memories can improve emotional well-being and help slow cognitive decline.

School of Generational Storytelling was a year-long interdisciplinary project by artist Eamon O’Kane, supported by artist Chelsea Canavan. Set within six care homes throughout Sligo, the project reflected on how we share knowledge across time, how creative practice can support wellbeing, and how relationships between individuals, disciplines, and institutions can be cared for through art.

A significant outcome of the project was a set of bespoke creative toolkits, which have been given to each of the care homes involved in the project.

School of Generational Storytelling was commissioned by The Model and supported by the Arts Council’s Arts Participation Project Award. The project was curated by Marie-Louise Blaney, Education Curator at The Model, and formed part of The Model’s broader arts and health programme.

Mapping the Space of Dementia brings together scientists, clinicians, care workers, care partners, people living with dementia and an artist, to explore how we position and locate ourselves in our world. Artist Mick O’Kelly uses brain imaging technology to capture cognitive difference, which is then mapped onto stained glass and installed in the home environments of participants.

The project was initiated by O’Kelly in 2022 following a Research Atlantic Fellowship with the Global Brain Health Institute (GBHI) at the University of California San Francisco.

Participants

Some Dance to Remember is an inclusive dance research project using adaptive Irish céilí dance and traditional Irish music for people living with dementia and their professional carers. The dance sessions took place in a dementia care day programme in the greater Midwest region of Ireland from October 2019 to February 2020.

Participants

The project was led by Séan Dónal O’Shea (postgrad researcher at Technological University of the Shannon Midwest) with a supervisory team of Jennifer Moran Stritch, TUS Midwest Loss and Grief group/Social Sciences ConneXions, and Carmel McKenna of Munster Academy of Dance/Social Sciences ConneXions. Dance participants included people living with dementia and their professional carers attending dementia day and respite care in the Midwest of Ireland.This research project aimed to investigate the psychosocial effects arising from the introduction of a pilot adaptive Irish céilí dance programme for people with dementia and their carers.

Irish Hospice Foundation launched the fourth round of its Seed Grant programme in 2024, this time focusing on creative exploration and responses to grief and loss in residential care. Awardees included activity co-ordinators, artists, clinicians, educators, and academics, aligned with nursing homes in Limerick, Louth, Clare, Cavan, Donegal and Dublin.

The programme took place in collaboration with Caru — a continuous learning programme for care and compassion at end of life in residential care.

Participants

What do railways, forests, Eurovision, and old suitcases have in common? On the surface, not much. But for people living with dementia in Liverpool—and increasingly around the world—these seemingly ordinary touchpoints are proving to be extraordinary tools for connection, memory, and care.

This is the insight driving House of Memories, a dementia awareness programme from National Museums Liverpool. Since 2012, the initiative has turned museums into something more than repositories of the past: they have become engines of empathy, bridges between health and culture, and laboratories for testing what happens when you place personal history at the heart of care.

Why Museums?

In many Western models of wellbeing, there’s a persistent idea that our needs follow a straight line—from survival to fulfillment. This belief, rooted in psychologist Abraham Maslow’s “Hierarchy of Needs,” suggests that we must secure “basic needs” like food, shelter, and safety before we can truly experience “higher needs” like belonging, creativity, or purpose. This hierarchy has been used by policymakers, funders, and health experts alike as a kind of priority list for deciding how to address individual and social problems.

In many ways, this pyramid framework is comforting, offering an orderly, clear starting point to build upon. But real life is rarely that linear. As we’ve seen in recent years, health and wellbeing are deeply interconnected. In reality, human life looks less like a hierarchical pyramid and more like a holistic pie. We live webs of relationships, conditions, and experiences that contribute to our overall wellbeing.

Consider the person juggling multiple jobs who lacks time for rest or connection, versus an entrepreneur embracing financial uncertainty in pursuit of a dream. Or someone living with chronic illness, whose life falls outside of conventional definitions of health and productivity. Are these lives less “actualized” because they don’t fit the pyramid? What about individuals living in poverty or navigating systematic barriers—are they less entitled to purpose, expression, or joy?

How can the Van Gogh Museum remain accessible for the growing group of elderly people in the Netherlands? This is the key question addressed by the Age Friendly Van Gogh Museum programme.

The Van Gogh Museum is dedicated to being accessible to everyone, and inclusion is the primary concern. The museum’s inclusion policy is geared towards young people, young residents of Amsterdam, people with a physical disability and the growing group of elderly people in the Netherlands. In addition to focusing on the group of active over-70s, in recent years, the museum has also turned its attention specifically to vulnerable elderly people. It can be difficult for this group of people to experience art independently.

Inclusion for the elderly

This special day is designed for seniors who face challenges in experiencing art independently, connecting them with the work and life of Vincent van Gogh. Through this collaboration, Hyundai and the Van Gogh Museum aim to improve accessibility at the museum.

Connection Day

Connection Day is more than just a museum visit: it offers a meaningful moment of contact for seniors who are often sidelined due to physical or social limitations. Feelings of loneliness are particularly common during the summer months, when friends and family are often on holiday, and many community groups and clubs close their doors.

From Amsterdam to Liverpool and Brussels to Montreal, creative aging activities in cultural institutions are changing older adults’ relationships to art and to museums, and paving the way for wider recognition and support for older adult creativity.

Museum leaders the world over are realizing that creative aging’s intersection with public health, community planning, and participatory arts is a powerful and positive catalyst for change in the cultural sector.

The impact of private funding on creative aging in the US and UK

The Victoria and Albert Museum in South Kensington is setting an inspiring precedent for how museums can support people living with dementia.

In a recent conference presentation for the Museums, Health & Well-Being Summit, Abigail Perry, Polly Harknett and Holly Power—representing the learning, interpretation, and audience insights teams—shared the museum’s efforts to deliver meaningful dementia-friendly programming and redesign gallery spaces to be more accessible.

This initiative highlights the transformative role museums can play in fostering wellbeing and inclusivity.

Supporting the work of contemporary artists has always been integral to the mission of the V&A: to champion creativity and inspire makers, creators and innovators everywhere. Since 1869—when the V&A’s first Director Henry Cole offered an onsite studio to the pioneering photographer Julia Margaret Cameron—the museum has hosted over 70 artists in residence.

The Adobe Creative Residency Programme at the V&A was initiated in 2024. Each year, three artists spend 12 months in residence in dedicated studios onsite at the V&A South Kensington. They take inspiration from the world-class collection and collaborate with the Learning Team to expand public programming with schools, young people, and families. The residencies bring making into the core of the museum, and gives artists and creators unprecedented access, with the opportunity to display their work at the V&A at the end of the programme.

Ciara (left) sitting on one of her ceramic stools. In the joyful form of a jelly mould, they provide a place for rest and conversation. Ciara’s work uses the ‘nerikomi’ technique of layering coloured clays to create vibrant patterns. Photos by Ciara Neufeldt.

Worldwide, the general population is getting older. In EU countries, for example, 19.2 per cent of the population was over the age of 65 in 2016. This is an increase of 2.4 per cent since 2006. There are also more people living over the age of 80, as life expectancy rates rise higher than before. People are choosing to have children later in life. Also, the number of children being born is decreasing in developed countries. This means that the old age dependency ratio is changing. Quality of life has also increased, of course. Many of these older adults are enjoying active, healthy lives. But others are experiencing a variety of deteriorating health conditions, such as dementia.

In 2018, the World Alzheimer’s Report found that there were 50 million people globally living with dementia. One person develops dementia every three seconds. This number is expected to rise as the population continues to age. Helping these people to continue living an active life is a key part of their health and wellbeing.

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

According to the latest review of data, there are some 850,000 people living with dementia in the UK. Globally, this devastating disease affects more than 55 million people worldwide, with almost 10 million new cases diagnosed every year according to the latest research from the World Health Organisation (WHO). And this figure is expected to increase dramatically in the coming years as more and more countries face the challenges that come with an ageing population.

Even in its mildest form, dementia can have a major impact on daily life, a fact that makes finding and accessing support early particularly important. While there’s no cure for dementia, therapy and self-care remain effective tools for managing the condition and supporting more independent lives. Indeed, awareness surrounding the benefits of social prescribing alongside traditional clinical care has grown rapidly in recent years.

With the right programmes in place, museums and galleries can reach out to ensure community engagement, accessibility and appropriate support for people with dementia. Often this involves the provision of tools, techniques and therapy aids that can be utilised by families and carers.

The issue of loneliness has been making headlines in recent years. More and more people are feeling isolated and alone. In fact, a recent study found that one in five Americans always or often feel lonely or socially isolated. Human beings are social creatures. Prolonged loneliness can have a host of negative effects. It has even been referred to as a silent killer. This is an issue which can affect anyone, at any age, although elderly people are sometimes more at risk.

Studies have shown that social isolation has a serious impact on physical health. One piece of research found that loneliness can cause a comparable amount of damage as smoking 15 cigarettes a day. Social isolation affects mental health too. Loneliness can lead to an increased risk of depression. Lonely people have a 64% increased chance of developing clinical dementia. Making meaningful connections with other people is vital. Positive social interactions are a key part of health and wellbeing.

What have museums got to do with loneliness?

Lisa Hester is a visual artist and academic, drawn to how play and symbolic language can create space for wellbeing and emotional expression in community and care contexts. She is currently developing an arts practice with older people in residential care and lectures on the MA Art, Psyche and the Creative Imagination programme at TUS Limerick School of Art and Design.

Hester was awarded an artsandhealth.ie Emerging Artist Bursary in 2025, funded by the Arts Council and HSE, to reflect on her arts and health practice. She homed in on her own reflective habits – how she interprets situations and documents affective experiences – and their role in ethical decision-making.

In Reflections on Reflecting, Hester sets out the conceptual framing that guided her inquiry, summarises the development of her practice to date, and provides short overviews of the reflective episodes that shaped her learning.

What does it mean to be an artist working with people? To make art with people who may be at their most vulnerable? To foster connections in systems that weren’t built for art?

Artist Helen Keenan works at the intersection ‘where art and complicated lives are met.’ Collaborating with older adults in residential care through dance, poetry and art, Helen meets people who are making a life in a ‘home’ that is not their own, some of whom she notes are ‘operating within a different internal reality.’

Helen delves into the complexities of being an artist in this space in a new poetry collection, funded by the artsandhealth.ie Emerging Artist Bursary. The 13 poems and concluding reflective thoughts that form Arts & Health Practice – A Poetic Reflection are a rich exploration of artist identity, meaning-making and human connection.

There is a wide range of mediums, materials, techniques, and strategies that you can use within art-making programs. Projects will depend on the educator's areas of interest and expertise, as well as the interests and abilities of participants. This portion of the guide provides an outline for general planning and implementation of art-making programs both at your museum and off-site. For sample projects related to specific themes, see the Art Modules.

It is important to determine the participants' interest in making art. Some adults who have not made art regularly throughout their lives may not be comfortable with this type of expression, while others may be very keen to get involved. When determining whether you will offer art-making programs, take the following into consideration:

The experience and comfort-level of your staff. Are the educators comfortable facilitating both art-looking and art-making programs? Are they interested in working with the same group over time, if requested? Are they available to work off-site at a care organization, if necessary?
The size of the groups. Is the group too large? Will members be sufficiently interested and engaged? Will group size affect their ability to participate?
Logistical considerations related to the art-making program or to a program that includes both art-making and art-looking components. For example, if you are thinking of looking and discussing art in the galleries followed by an art-making activity, will you have enough time? (A program should not exceed two hours.) Will a studio space be available? Are the studios close to the galleries and easily accessible?

This guide details how to establish a museum program for individuals with Alzheimer's disease and their caregivers. Educational programming is at the heart of a museum's public mission and serves as a gateway for exploring works of art and cultural history. Offerings should extend to all audiences, including individuals with cognitive disabilities. The program should focus on participants' abilities in order to create an accepting and engaging environment in which the disease is a nonissue.

Designing a Program

Program Goals

In our example, a daughter (D.) and her father (F.) plan to go to the The Museum of Modern Art together. F. has always had a passing interest in art, but has a hard time "appreciating" contemporary art because, he says, "I don't really understand much of what's going on in the works."

Logistical Considerations

D. and F. had previously attended a Meet Me at MoMA program and received passes that allowed them to come to MoMA for free with three other family members (up to five people). D's husband and his sister are also interested in attending and making the Museum visit a meaningful and enriching family experience. They decide to go to MoMA later in the afternoon, around 3:00 P.M. They commit to leaving to leaving at 5:00 P.M. at the latest, in order to prevent fatigue from setting in, and plan an early dinner to complete the outing. Luckily, D.'s sister-in-law has a car, so they decide to drive on a Wednesday afternoon and park in one of the parking lots that provide discounts to MoMA visitors.

Engaging with art at home can also be enriching and rewarding. Because this experience is between the caregiver and the person with dementia, there is plenty of leeway to adjust and adapt the parameters and the components set forth in this section. Since there is a deep intimacy between you and the person you will be sharing these experiences with, feel free to transform the guidelines to best serve the psychological, emotional, and intellectual needs of both of you.

Logistical Considerations

Participants

Visits to art museums and galleries can be rich and rewarding experiences. Viewing original works of art in quiet, contemplative spaces that allow for social interaction can be beneficial for everyone involved and provide an opportunity for self-reflection and self-expression. There are many ways to visit a museum or gallery, and you can involve a variety of people in your experience.

Independent Visits and Programs

Family visits to museums and galleries

To create a multiweek program for participants in your organization, refer to the Art Modules. You have the option of sequencing multiple existing modules to create a multipart program that includes both art-looking and art-making components, or you can mix images from the Images section. If possible, you may incorporate trips to a museum into the program.

The following example features a four-part program at a care organization that includes both art-looking and art-making sessions. This program was conducted by a MoMA educator with a group of individuals with early-stage Alzheimer's disease.

The program was divided into separate art-looking and art-making, or studio, sessions. At the beginning of each studio session, the educator introduced reproductions of images from the previous art-looking session to incorporate the ideas discussed then into the art-making process. Although some participants who are in the early stages of the disease may be able to recall the artworks from the earlier discussion with little difficulty, it is always useful to reintroduce the images.

This guide focuses on the structure and set-up of off-site programs at museums or art galleries and on-site programs at your facility. Programs at your facility can be a source of pleasure and pride for participants. They also allow everyone to engage with art in a safe and familiar environment and might allow for greater participation, as some individuals may not be physically capable of making a trip off-site. Museum visits can also provide intellectual stimulation brief primer on issues to consider when planning a trip to a museum.

General Planning

Logistical Considerations

This example shows how educators can design a structured yet flexible museum session around a clear theme, combining art discussion with personal reflection. The approach can be adapted to any museum collection or cultural context.

1. Choosing a Theme

Select a theme that is both accessible and meaningful across cultures. In this case, the theme “The City” was chosen because most participants have personal experiences of urban life—whether through living, working, or visiting cities. This creates immediate entry points for conversation.

Engagement with art can have significant benefits for people with dementia and their caregivers. This is true whether the experience involves looking at and discussing art or creating art. In both cases, art can be used as a vehicle for meaningful self-expression. Indeed, engagement with art, through close looking and discussion, offers a person with Alzheimer's disease the chance to:

Explore and exchange ideas about art and artists
Experience intellectual stimulation
Make connections between personal stories and the world at large
Access personal experiences and long-term memories
Participate in a meaningful activity that fosters personal growth

In addition to the above benefits, caregivers also gain from art experiences by exploring their own interests in art while the person in their care is present, safe, and engaged. In some settings, such as museums and care organizations, they can interact socially with other caregivers, share stories, and learn in a supportive environment where they are relaxed both physically and mentally.