Arthi Kozhumam

As we approach the last few weeks of the Spring 2021 semester, I can feel my time as a program support assistant for Dementia Inclusive Durham (DID) and TimeSlips slip away — in a way. While there is more to look forward to with these organizations, including continued volunteering sessions, as I approach the end of my undergrad and first-year Master’s year at Duke, I can see both an end of the road for the COVID-19 pandemic with ongoing vaccination deployment, as well as for my time in Durham with DID and TimeSlips.

Looking back, I have fond memories of watching time slip away in my interactions with DID site leads and staff, TimeSlips staff and collaborators, peers, and elders. In building relationships with individuals over a Zoom screen or phone line over open-ended, “beautiful” questions, I have seen the value and importance of honest connection not only during the pandemic or in these sessions, but in all aspects of human interaction. The skills I’ve practiced both as a volunteer and support assistant for DID and TimeSlips – flexibility, active listening, patience, adaptability, compassion, and genuine kindness – are important for the growth and development of any community, whether it be an institution, neighborhood, state, or even the world. A community in which we all approach individuals with love, curiosity, and genuine understanding despite differences or limitations is one that can work together efficiently to achieve and target public health epidemics, whether it be COVID-19 or the US’s ongoing experience with loneliness.

This work has shown me the immense power in people coming together, even virtually, from across the United States and world, for a common cause. Each interaction I have that drives me to keep volunteering, learning, and sharing has shown me that building relationships through global and public health work is my purpose. After participating in creative engagement sessions, I have learned that global health is more than just a skill set – it is a perspective. Global health was not just the implementation science, regression modeling, or qualitative coding skills I learned as a researcher, volunteer, and student group leader. It was the relationships I built, the organizations I served, and the importance of building and finding genuine relationships with others – which has translated to how I will see people I interact with on the ground during my future field research, and how I communicate with international research assistants on data science-focused projects.

Each week during meetings with DID and my professor Dr. Sarah Wilbur’s Friday afternoon course, I am challenged to think and be more creatively. The header image for this article is the flyer I created for our “Fridays @ 4” creative engagement sessions, led by Dr. Wilbur, DID’s Artists in Residence, and students in our course with attendance of members from the DID and TimeSlips communities. As we take trips to and through the world, accompanied by kitchen utensils and headgear we’ve fashioned as exploring equipment, we each contribute an answer to thought to the building of a detailed and wonderful story. What I see for example as wooden spoons, actually can be used as oars for us to swim through the sky in our magic school bus, on our way to our next adventure. And each thought we add to the story, either by voice or by chat, takes it in a new and amazing direction. The creativity of each individual in these calls never ceases to inspire me to keep pushing myself to think outside of the box, and learn from others about how they might see the same things as I do very differently.

As mentioned in my last post, you can contact individuals at TimeSlips (including Kathy Hawkins) to train in this facilitation method, first starting by watching modules and then participating in volunteering sessions of your own with elder clients. Please also feel free to reach out to me, at ask59@duke.edu, with any questions about how you can become involved in this project. But, I believe that anybody regardless of their experience level or knowledge about TimeSlips can and should be creative. This work has shown me that we all have innate child-like creativity, that when put together with others can tell a story and build friendships without having anything else in common. For our communities to continue to come together and support each other through the pandemic and other public health issues, for example loneliness and other mental health crises, this mindset is crucial.

Do not be afraid to be the first one in your institution, town, or family to ask or answer a beautiful question, to bring up a picture and ask others around to help you build a story around that image, or even just talking about creativity and the world in new ways. Even as my time through GradEngage begins to end, the lessons I have learned and relationships I have built will continue to remain strong for much longer.

“So many people think creative care is something they’re not capable of. To me, personally, it’s a one-on-one exchange of ideas and of mutual caring and regard for another person.T oo often people feel like they can’t be creative in their caring – that they have to be a Van Gogh or a Matisse, [but] it’s just about being yourself in relation to another.”

I took a breath and smiled. I sat down with Mrs. Kathy Hawkins, Engagement Coordinator for TimeSlips, the morning of March 24th to hear her story: how she had come across TimeSlips, her previous and current roles, and how all of her work intersected with Dementia Inclusive Durham, the organization I have been serving as a program support assistant with through GradEngage. The following is an overview of and reflection on my meeting with her. I hope that I can do her wonderfully storytelling justice.

In our conversation, she told me about being a Music Therapy intern, coming across TimeSlips through a dementia conference she attended. At the time, the TimeSlips method was not even 5 years old, consisting of primarily a 2.5 to 3-hour class during which participants discussed creativity and what animals or kitchen utensils they would be. Kathy’s role was to see how TimeSlips could be applied to programming in the dementia services units. She spearheaded the coordination of the program for her own site.

“I did not realize the effect that TimeSlips could have, not just on the residents, but also administrators and family members,” she stated. And that when participants (clients and volunteers alike) attend a TimeSlips session, they often feel like that’s when they are making a difference. Her current role as engagement coordinator is “what [she] has been doing for the past 18 years – bringing people together, shaping their training experiences, and working with the community.”

Prior to becoming engagement coordinator, Kathy worked independently to develop TimeSlips programs and classes with oversight from TimeSlips:  teaching TimeSlips at community colleges, conferences, and for organizations. She served as interim program coordinator, conducting much of the same tasks she does now: plugging people in to training,, linking existing certified facilitators and communities of care, and as she says “being the cheerleader for TimeSlips.”

Kathy described several similarities in her previous work with youth and current role with elders living with dementia: “Children or young adults…do not get their fair due in society. Society says, ‘You are your future, you have all the innovation and the ideas, but you haven’t reached ‘it’ yet. You couldn’t really make a decision about that because your brain isn’t fully formed.’ We say the same to people living with dementia – ‘You’re not really “with it”’, or ‘Your brain isn’t what it used to be.’ There’s ageism on both sides that they can’t quite understand or know what you’re talking about, which is untrue.”

We ended our Zoom with a brief discussion about TimeSlips and Dementia Inclusive Durham (DID), and the impact of COVID-19 on training and creative engagement sessions. Kathy told me that she was brought in to work with DID last Spring to moderate the online creative engagement sessions on Thursday mornings. She started interacting with artists, including my professor, Dr. Sarah Wilbur, and realized “This is a group I identify with…” She feels very strongly associated and aligned with the folks at Durham.

For how COVID shaped DID and TimeSlips and what she does as engagement coordinator,  she feels that “ways into care communities: postcards or letters, phone calls, physically distanced sessions, Zoom or even text messages…right now we need to prioritize which one is standard based on which community has access to which resources. COVID-19 continues to shape and ebb and flow the programming and plans of TimeSlips and DID.” For example, Kathy notes, “Just as we started to get really used to the virtual world, there are some places opening up and reducing all restrictions. Others are still restricting everything, including mail…it’s just this increased flexibility to the differences that people are needing…it teaches us to be more responsive and to be in-the-moment.”

She ends with a quote that I will never forget:

“We’re trying to resuscitate the connective tissue of people’s daily lives in how they create together, knowing that they can.  My job, my joy is figuring out how to link people together who may not know others out there exist. If there’s a similar goal in mind, if you fuel each other, it  grows that connective tissue so beautifully.”

For readers looking to become involved with or learn more about DID, TimeSlips or Kathy’s work, her email is kathy@timeslips.org.

Hot chocolate. Rain against my window. Coffee in the morning. My puppy on a sunny day. These were all chat and verbal responses to the TimeSlips beautiful question “What relaxes you?” posed by one of our Dementia Inclusive Durham (DID) site lead meeting attendees. Twenty five of us had come together from various organisms (DID, TimeSlips, and Duke University) and physical locations to discuss site updates and plans for centralized DID organization moving forward. As we went around the virtual Zoom room, I learned from participants the intricacies involved in running and leading sites and client schedules, and the many moving parts to implementing the TimeSlips creative care method with both volunteers and elders. I shared my updates on the master calendar and student team database I was designing and reminded attendees of the Friday afternoon creative care gatherings happening through Professor Sarah Wilbur’s half-credit Interdisciplinary Arts class.

Joined often by Kathy Hawkins of TimeSlips and Carmelita Karhoff of Dementia Inclusive Durham, Dr. Wilbur or an artist in residence at one of the sites took the students in our course through a story together – one afternoon about the sounds of the color blue, another about snow and winter, and another about superhero powers. Even across barriers of physical distance and differences in age between participants, I could feel the trust and joy grow in our space each session. The excitement felt by both returning and new volunteers was something I wanted to cultivate – through supporting them by organizing session logistics and client matches – so that they too could have the magical experiences I’ve had as a volunteer. While my work behind the scenes with Dementia Inclusive Durham has taught me some of the inner workings of NGO functioning and how to work with individuals holding different roles, my sessions with clients and other volunteers show me why we are doing this in the first place – to build relationships across barriers, show and embody the importance of living in the moment, and contribute to improving the health of and learning from vulnerable members of our community.

As students in Dr. Wilbur’s spring course look forward to their initial meetings and weekly sessions with their respective clients, I think back to my own first session a few months ago. What started with a few minutes discussing “What is the most beautiful sound in your home? The world?” turned into seven weeks of laughter, emotional conversations, and music-making with our respective instruments. I’ve learned, and want to emphasize to others, that communication with elders or individuals with disabilities does not have to focus on the past, memories, or physical ability – connections can be built across any kind of topic, as long as they are approached mindfully and with curiosity and compassion. I hope that volunteers experiencing and utilizing creative engagement can not only improve the measured quality of life of our elderly clients but show to them (many of whom are pre-medical and pursuing public health) the importance of empathy and imagination in their relationships with peers, elders, and future patients and collaborators.

Across Dementia Inclusive Durham’s seven sites, no one creative care session is the same. Some invite group sessions with elders and an artist, listening to music and journaling about experiences. Others are focused on one-on-one sessions between elders and student volunteers, working together to answer beautiful questions and build a story. Still others are still building infrastructure for their own work, attending our Friday afternoon practice sessions and learning from other site leads how they could participate in the TimeSlips method. It has been incredibly rewarding to truly see the diversity of how creative engagement can be applied, and assist both more rooted sites in gaining volunteers and newer sites in supporting and learning how they can join in the process. With my master calendar of sessions and database of student volunteers in tow, I am excited to continue acting as a magician behind the scenes during the rest of the semester – and look forward, at the end of this fellowship, to assisting with the continuation of this supporting role and seeing how creative engagement can be adapted to be continued over Zoom and hopefully applied in person as well.

Arthi is working as a program support assistant for Dementia Inclusive Durham, assisting in volunteer support and Creative Engagement session organization between Duke University undergraduates and elders living with dementia and other intellectual disabilities.

TimeSlips is an organization founded by theatre-maker, scholar, and MacArthur Fellow (2016) Anne Basting that seeks, as their mission statement notes, to “bring meaning and purpose into the lives of elders through creative engagement.” Their partnership with Dementia Inclusive Durham (DID), which encourages collaboration with volunteers and artists in residence, seeks to bring meaningful engagement to community members experiencing dementia.

The project uses an inclusive and creative community of care approach to create a strengthened dementia-capable system of support and services in the Durham community. Its target population are persons with dementia living alone, those aging with intellectual and developmental disabilities with dementia, and their families and caregivers. Seven organizations, including the Durham Center for Senior Life and Mt. Sylvan United Methodist Church, are participating across the Durham community to serve as the sponsors/sites for the engagement of persons with dementia and delivery of the TimeSlips intervention. Trained volunteers, ranging from Duke service-learning students to Artists in Residence, facilitate and support intervention sessions for participants living with dementia using the TimeSlips methodology.

As part of a Fall 2020 course with Assistant Professor of the Practice (Dance) Dr. Sarah Wilbur titled “Artists in Healthcare: Collaborations and Complexities,” I conducted weekly, half-hour Zoom and Phone sessions with elders and their care partners participating in the DID project engagement sites to ask beautiful, open-ended, imaginative questions. Inside of these sessions, we shared laughter, conversation, and space with each other despite differences in age, life stage, and memory. Our discoveries were featured in mid-November through a webinar at TimeSlips’ Creative Care Fall Festival, viewable here. I was given the incredible opportunity to work as a student of Dr. Wilbur’s on a “test phase” of the DID work in her course this fall, and am excited to work with DID as they move into full implementation across seven Durham Creative Care Sites as a program support assistant.

Though the majority of my work in public health as an Accelerated Master’s of Science in Global Health student has been in international contexts, global health is local health, and cultural communication doesn’t have to be experienced just outside the United States. Through Dr. Sarah Wilbur’s course, I was able to work extensively with individuals experiencing dementia and learn how to interact patiently and actively with elders through beautiful, open-ended questions that invite imagination.

Just as I had learned to communicate effectively across different languages and ways of life in my fieldwork in India, I was given the chance to learn from elders themselves the culture (including experiences, activities, and ways of communication) of dementia and living in the present moment. I wish to continue this work in a supportive role to give back to the organization that has taught me much about what it means to be present, to listen, and to genuinely be human. Young students and adults want to engage with elders in a mindful way, but often do not know how. Elders experiencing memory loss seek meaningful connection, but sometimes find it challenging to explore commonalities with children and young adults especially if asked about their past. In a time of significant physical distance due to COVID-19, the work of TimeSlips through DID’s care sites serves to facilitate open-ended conversations, art-making sessions, and honest discussions about mental and emotional health for elders living with dementia despite their memory loss.

My own goal of focusing on sustainability and health infrastructure aligns well with DID’s own 3-year goal of implementing sustainable infrastructure for future site implementation. In order to achieve the organization’s goal of working with 70 seniors over 3 years, this infrastructure is needed in a timely and efficient manner to maximize the productivity and positivity of experiences of staff and volunteers. DID has expressed a priority of enlisting an individual to carry the momentum from the Fall course and volunteer programming, in order to reach their 3-year goal. Using the quantitative and qualitative skills I have learned in my undergraduate and graduate education, I hope to aid in their communication and organization with Site Partners as well as volunteers to support the stabilization and centralization of DID’s operations moving forward.