Play Elements as Mechanisms in Intergenerational Arts Activities to Support Community Engagement with End-of-Life Issues
1. Introduction and Aim
Contextual Background: Studio DöBra
2.1. Community-Based Data Generation
3.1. Creating Permeable Magic Circles
Sandra: I thought it was interesting how [I] reacted when it got silly, because I noticed how I reacted myself […] In my role, I thought, “oh, now maybe the older people take offense that it’s not a respectful way to talk about death, but that it becomes…”Anna: I think that I took a little offense, or I thought that they weren’t… weren’t really present.Sandra: Yes, that they were somewhere else.Anna: They were in their play…
They don’t have the experience […] they’re still direct. You could hear it [when they talked about] the kiwi and everything else they came up with, which is so delightful with children.
3.2. Balancing Restrictions and Freedoms
I wish we’d had more time to talk [about EoL topics] and less time to do arts and crafts. Because that took some of the focus.
“But we need to have respect for the bird, it cannot become ugly.”
Sasha (addressing participants): It could be that I would decide, but […] now you have this vehicle […] and three [afterlife destinations] to travel to […] so how are you going to travel there? Do you have any idea? This is a little bit like playing.[Participants have a lively discussion but seem uncertain about what to do.]Sasha: Everyone who built this, now you are going to test traveling to these three different destinations in your imagination […] We’re in a kind of airport now. How are you going to do this?[Participants discuss but still cannot agree.]Sasha: Shall we let each group take the others to their destination? You understand? Yes or no?[No clear response.]Sasha: OK, I’ll make it simple. There are three groups, and each group decides how you travel to your destination. I decide that this group (points to one group) starts. You’re the pilots, the others are the passengers.[Participants get ready.]Sasha: Everyone! Let’s pretend this is a theatre or a film set, and we say ‘ACTION!’ so the film starts, the event of traveling to this destination. […][Participants get ready.]Sasha: OK! […] ACTION!
Nils (child): We got to build a vehicle, and then we got to sit in it and travel […] to different […] after-death-places.Bengt (older participant): We talked about… up in heaven […] we traveled up there with the spaceship… I said […] it will take two hours maybe to travel there, and that’s when […] we came to the conclusion that there would be food […] and then the little girl said that chewing gum was important.
Anna (partner): We (referring to partners) all felt as if we weren’t really needed, because they were so independent, both in… that they understood, that the assignments were clear, I think, and that they worked well together, the older adults and the children, and that the material was there so they helped each other technically and theoretically. […] and that was a nice feeling. Then it felt like… we had prepared well, when we weren’t needed.
3.3. Balancing Restrictions and Freedoms
Alex (child): My mother says that my grandmother has gone on a trip, but she’s dead. […] She still says that she’s gone on a trip […] and I don’t believe her.Sasha (partner): How long has she been gone?Alex: […] since I was three.[…]Bengt (older adult): It’s hard on kids, they ask, where did they go […] it can be sensitive too… She’s not around anymore.MK: It’s strange.Bengt (older adult): It’s strange. You grow up with your family, you can think that they’ll be there forever and then they’re gone, that’s the way of life, the same with flowers in the field, during the summer there are beautiful flowers and then they die, after that there’ll be new ones, those can be their children and grandchildren, the same with trees, everything. (Addressing Alex) Your mother gave birth to you, when you grow up you’ll have children, that’s how we are.
That was very beautiful, very beautiful. […] The pretty fabric there and everything was so pretty.
It became… very respectful, […] calm, and harmonious when everyone went in together, […] and the project starts, and then we leave other things outside.
3.4. Continuing a Sense of Community after Ending the Arts Workshops
“It was a lot of fun to participate [in Studio DöBra]! It was a pity that the bird died because it could have lived longer and done more in life!”
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
- Walter, T. How people who are dying or mourning engage with the arts. Music Arts Action 2012, 4, 73–98. [Google Scholar]
- Hartley, N.; Payne, M. The Creative Arts in Palliative Care; Jessica Kingsley Publishers: London, UK, 2008. [Google Scholar]
- Tsiris, G.; Tasker, M.; Lawson, V.; Prince, G.; Dives, T.; Sands, M.; Ridley, A. Music and arts in health promotion and death education: The St Christopher’s Schools Project. Music Arts Action 2011, 3, 95–119. [Google Scholar] [CrossRef]
- Kleijberg, M.; Ahlberg, B.M.; Hilton, R.; Tishelman, C. Death, loss and community-Perspectives from children, their parents, and older adults on intergenerational community-based arts initiatives in Sweden. Health Soc. Care Community 2020, 28, 2025–2036. [Google Scholar] [CrossRef] [PubMed]
- Kleijberg, M.; Ahlberg, B.M.; Macdonald, A.; Lindqvist, O.; Tishelman, C. Navigating power dynamics in engaging communities in end-of-life issues–Lessons learned from developing community-based intergenerational arts initiatives about death and loss. Death Stud. 2019, 1–14. [Google Scholar] [CrossRef][Green Version]
- Nan, J.K.M.; Pang, K.S.Y.; Lam, K.K.F.; Szeto, M.M.L.; Sin, S.F.Y.; So, C.S.C. An expressive-arts-based life-death education program for the elderly: A qualitative study. Death Stud. 2018, 44, 131–140. [Google Scholar] [CrossRef] [PubMed]
- Seymour, J. The impact of public health awareness campaigns on the awareness and quality of palliative care. J. Palliat. Med. 2018, 21, S30–S36. [Google Scholar] [CrossRef] [PubMed][Green Version]
- Bertman, S. Using the arts and humanities with the dying, bereaved, … and ourselves. In Death, Dying, and Bereavement: Contemporary Perspectives, Institutions, and Practices; Stillion, J., Attig, T., Eds.; Springer Publishing Company: New York, NY, USA, 2015; pp. 245–259. [Google Scholar]
- Nan, J.K.M.; Lau, B.H.-P.; Szeto, M.M.L.; Lam, K.K.F.; Man, J.C.N.; Chan, C.L.W. Competence enhancement program of expressive arts in end-of-life care for health and social care professionals: A mixed-method evaluation. Am. J. Hosp. Palliat. Med. 2018, 35, 1207–1214. [Google Scholar] [CrossRef] [PubMed]
- la Cour, K.; Josephsson, S.; Tishelman, C.; Nygard, L. Experiences of engagement in creative activity at a palliative care facility. Palliat. Support. Care 2007, 5, 241–250. [Google Scholar] [CrossRef] [PubMed]
- Beaumont, S.L. Art therapy for complicated grief: A focus on meaning-making approaches. Can. Art Ther. Assoc. J. 2013, 26, 1–7. [Google Scholar] [CrossRef]
- Neimeyer, R.; Thompson, B. Meaning making and the art of grief therapy. In Grief and the Expressive Arts: Practices for Creating Meaning, 1st ed.; Thompson, B., Neimeyer, R., Eds.; Routledge: New York, NY, USA, 2014. [Google Scholar]
- Lindqvist, O.; Tishelman, C. Going public: Reflections on developing the DöBra research program for health-promoting palliative care in Sweden. Prog. Pallative Care 2016, 24, 19–24. [Google Scholar] [CrossRef] [PubMed][Green Version]
- Israel, B.A.; Schulz, A.J.; Parker, E.A.; Becker, A.B.; Allen, A.J., III; Guzman, R.J.; Lichtenstein, R. Critical issues in developing and following CBPR principles. In Community-Based Participatory Research for Health Advancing Social and Health Equity, 3rd ed.; Wallerstein, N., Duran, B., Oetzel, J., Minkler, M., Eds.; Jossey-Bass & Pfeiffer Imprints, Wiley: Hoboken, NJ, USA, 2017; pp. 31–44. [Google Scholar]
- Bradbury, H. Introduction: How to situate and define action research. In The Sage Handbook of Action Research, 3rd ed.; Bradbury, H., Ed.; Sage: Los Angeles, CA, USA, 2015; pp. 1–9. [Google Scholar]
- Wallerstein, N.; Duran, B. Theoretical, historical, and practice roots of CBPR. In Community-Based Participatory Research for Health Advancing Social and Health Equity; Wallerstein, N., Duran, B., Oetzel, J., Minkler, M., Eds.; Jossey-Bass & Pfeiffer Imprints, Wiley: Hoboken, NJ, USA, 2017; pp. 17–29. [Google Scholar]
- Tavory, I.; Timmermans, S. Abductive Analysis; The University of Chicago: Chicago, IL, USA, 2014. [Google Scholar]
- Hamayon, R. Why We Play-An Anthropological Study; Hau Books: Chicago, IL, USA, 2016. [Google Scholar]
- Huizinga, J. Homo Ludens-A Study of the Play-Element in Culture [Homo Ludens. Proeve Eener Bepaling van Het Spel-Element der Cultuur, 1938]; Angelico Press: Brooklyn, NY, USA, 1949. [Google Scholar]
- Frissen, V.; Lammes, S.; De Lange, M.; De Mul, J.; Raessens, J. Homo ludens 2.0: Play, media, and identity. In Playful Identities-The Ludification of Digital Media Cultures; Frissen, V., Lammes, S., De Lange, M., De Mul, J., Raessens, J., Eds.; Amsterdam University Press: Amsterdam, The Netherlands, 2015. [Google Scholar]
- Calleja, G. Ludic identities and the magic circle. In Playful Identities-The Ludification of Digital Media Cultures; Frissen, V., Lammes, S., De Lange, M., De Mul, J., Raessens, J., Eds.; Amsterdam University Press: Amsterdam, The Netherlands, 2015. [Google Scholar]
- Gordon-Nesbitt, R.; Howarth, A. The arts and the social determinants of health: Findings from an inquiry conducted by the United Kingdom All-Party Parliamentary Group on Arts, Health and Wellbeing. Arts Health 2020, 12, 1–22. [Google Scholar] [CrossRef] [PubMed]
- Gualano, M.R.; Voglino, G.; Bert, F.; Thomas, R.; Camussi, E.; Siliquini, R. The impact of intergenerational programs on children and older adults: A review. Int. Psychogeriatr. 2018, 30, 451–468. [Google Scholar] [CrossRef] [PubMed]
- Fancourt, D.; Finn, S. What Is the Evidence on the Role of the Arts in Improving Health and Well-Being? A Scoping Review; Health Evidence Network (HEN) Synthesis Report 67; WHO Regional Office for Europe: Copenhagen, Denmark, 2019. [Google Scholar]
- McMillan, D.W. Sense of community. J. Community Psychol. 1996, 24, 315–325. [Google Scholar] [CrossRef]
- Westerlund, C.; Tishelman, C.; Benkel, I.; Fürst, C.J.; Molander, U.; Rasmussen, B.H.; Sauter, S.; Lindqvist, O. Public awareness of palliative care in Sweden. Scand. J. Public Health 2018. [Google Scholar] [CrossRef] [PubMed]
- Polit, D.F.; Beck, C.T. Generalization in quantitative and qualitative research: Myths and strategies. Int. J. Nurs. Stud. 2010, 47, 1451–1458. [Google Scholar] [CrossRef] [PubMed][Green Version]
- Morse, J.M. Critical analysis of strategies for determining rigor in qualitative inquiry. Qual. Health Res. 2015, 25, 1212–1222. [Google Scholar] [CrossRef] [PubMed]
|Studio DöBra 1, 2016|
|Project Group Partners||Children||Older Adults|
|n = 7|
DöBra research program: MK a,b
Artistic organization for children:
After-school center: Teacher
|n = 8||n = 8|
|Invitation to participate||MK approached community organizations||Through after-school center and parents||Individually, through involved community organizations|
|Gender||5 women, 2 men||4 girls, 4 boys||5 women, 3 men|
|Age||Median 37, ages 28–65||9||Median 82 ages 65–85|
|Studio DöBra 2, 2018|
|Project Group Partners||Children||Older Adults|
|n = 7|
DöBra research program: MK a,b
Municipal organizations for culture:
|n = 8||n = 8|
|Invitation to participate||Municipal organization for culture approached MK and the other community organizations||Through after-school center and parents||As a group (independently hosting weekly creative sessions), through the municipal organization for elder care|
|Gender||6 women, 1 man||4 girls, 4 boys||8 women|
|Age||Median 33, ages 29–64||9||Median 83.5 ages 66–93|
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations.
© 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Kleijberg, M.; Hilton, R.; Ahlberg, B.M.; Tishelman, C. Play Elements as Mechanisms in Intergenerational Arts Activities to Support Community Engagement with End-of-Life Issues. Healthcare 2021, 9, 764. https://doi.org/10.3390/healthcare9060764
Kleijberg M, Hilton R, Ahlberg BM, Tishelman C. Play Elements as Mechanisms in Intergenerational Arts Activities to Support Community Engagement with End-of-Life Issues. Healthcare. 2021; 9(6):764. https://doi.org/10.3390/healthcare9060764Chicago/Turabian Style
Kleijberg, Max, Rebecca Hilton, Beth Maina Ahlberg, and Carol Tishelman. 2021. "Play Elements as Mechanisms in Intergenerational Arts Activities to Support Community Engagement with End-of-Life Issues" Healthcare 9, no. 6: 764. https://doi.org/10.3390/healthcare9060764