1. Promoting and Enabling Healthy Choices: Cultural & Behavior Change The Place for Arts & Humanities

2. Reimbursement Reductions Medicare Medicaid Commercial Investment Reductions Reduced Giving

3. Increasing uninsured population Increasing diversity of patients Increase in chronic care Increase in critical care Patient population aging Increase in patient expectations Nursing shortage crisis Exhausted and burnt out work force

4. Arts in Arts in Healthcare An Overview

5. 2004 Survey of U.S. Hospitals* Over 2,500 hospitals now have arts programs * conducted by JACHO, Society for the Arts in Healthcare and Americans for the Arts

6. Reasons Hospitals Invest in the Arts 96% to serve patients 78.6% to create a healing environment 78.2% to support patient mental and emotional recovery 56% to serve patient families 53% to help patients & families deal with serious illness 51.9% to build community relations 46.3% to be part of a patient’s physical recovery 40.7% to serve hospital staff 35.5% to communicate health information 32.7% to attract positive press 17.5% to attract new donors

7. Types of Artists Working in Care Units 82.2% Musicians 46.3% Performing 39.7% Visual artists 31.8% Dancers 11.4% Poets & Writers 77.6% Use arts therapists 67.4% Use professional artists

8. Use of the Arts to Support Hospital Staff 74.8% Music 69.6% Crafts 64.3% Visual Arts 38.5% Poetry/Writing 35.5% Movement 28.4% Performing Arts

9. Caring for the Caregivers

10. People Need Long Term Care Are 53% are over 65 44% are between 18 and 64 3% are under 18 The fastest growing segment is people over 65 and, within that, people over 85 70-80% of care is provided by informal caregivers 1 in 4 households is involved in long term care

11. Caregivers who experience mental or emotional strain have a 63% higher risk of dying than non-caregivers 46-59% of informal caregivers are clinically depressed * Older Women’s League, Family Caregiver Alliance

12. In our retreats for doctors, they often speak of the deep caring they felt they could not show to their patients or speak of to other physicians. Such behavior is considered unprofessional. Doctors are alone with these emotions and isolated from other physicians and caregivers because of them. In the workshops, this isolation and the ensuing loneliness becomes apparent. It is not unusual for a physician to speak about the death of a particular patient, sometimes a death that occurred many years ago, and to cry for the first time over it. At one retreat, when asked why he had not cried before, a physician responded, “Only another physician would understand my loss. And who would ever cry in front of another physician?” Shanti Norris, director Center for the Healing Arts

13. Events for Staff

14. DHMC Creative Writing Club

15. Duke University Medical Center Annual Staff Musical Performance Duke Cultural Services Program Produces an annual performance featuring dancers, singers and actors representing nearly every hospital department

16. Lombardi Cancer Center, Georgetown Medical Center At Lombardi, the Arts and Humanities Program conducts mask- making sessions for doctors and nurses

17. CAHRE University of Florida, Gainesville Days of Renewal Physician John Graham-Pole, MD, leads a “Laughter Workshop” for nurses

18. Music for Relaxation

19. Humanities & Medical Education

20. Cutting Out the Stone of Madness: Bruegel the Elder

21. Using the Arts to Help Medical Students Explore Issues of Doctoring Images Showing How Dr. Sandra Bertman’s Students Envisioned a Cadaver Dissection Before Doing One

22. Communicating Health Information

23. San Diego Children’s Hospital Entrance

24. Westchester Children’s Hospital

25. Edmonton Nurses’ Station

26. Katie & Neal Teaching Health

27. Katie Teaching About Health

28. Fruit Heart Poster

29. Safe Play Poster

30. Health Heart Posters

31. Heart Posters, 2

32. Heart Parade, Gateshead

33. Heart Parade, Gateshead 2

34. “When you came here and said ‘We’re all going to make lanterns out of sticks and glue and walk down the streets with them’, well, I thought you were mad. I’d never have believed what I’ve seen tonight. Look, it’s Friday night and everyone’s eating brown bread and soup and enjoying it!” participant “For at the core of this event as of much arts in health work is the nurturing of emotional intelligence and informal learning. The association of good times and positive self image with an ephemeral arts event and its processes is a potent one. …It’s a rite of transformation.

35. Four Projects

36. SAH - HRET - NAP To develop a pilot project, with approximately 30 hospitals reflecting diversity in demographics and location, to measure the value of engaging healthcare staff in arts activities as a means of stimulating increased job satisfaction, greater sense of community, and self expression

37. SAH - Wye River To create a pilot program to enhance end of life care by integrating the arts into hospice practices and using the arts as a means of creating a public dialogue about hospice as quality of life. The goal is to increase in the use of hospice by minorities, augment patient and family satisfaction, and improve key outcomes such as sense of dignity, control and self- determination. It is also posited that activity incorporating the arts into day-to-day care will increase caregiver sensitivity and awareness of individual, family and community (cultural) values at this critical time of patients’ lives.

38. SAH - Wye River To develop a pilot project, using the arts and humanities to reduce the risk factors that lead to Adult Onset Type II diabetes in children by educating elementary and middle school children, as well as their parents, guardians and members of the school staff, of the benefits of a healthy lifestyle and stimulating them to adopt and incorporate behaviors that lead to enhanced health.

39. SAH - Wye River (a)To use the arts and humanities to change stereotypes about aging by medical students as a means of increasing their desire to work in elder care (b)To use the arts and humanities to reduce the use of the ER as the gateway to hospital care by the uninsured.