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For patients whose prognosis requires palliative care, combating the symptoms of their disease–pain, stress, depression--can consume every waking hour. Understandably, learning to live with the knowledge that their core condition is not likely to improve can cause the most well-adjusted optimist to lose the lust for life.

That is why healthcare providers are always searching for new ways to relieve the symptoms of chronic, debilitating illness. One method that has grown in both popularity and effectiveness is art therapy, which offers patients a creative diversion from the exhausting task of trying to feel better. There is nothing new about this concept; most hospitals have had some type of art therapy program in place for years. Research has shown it improves patients’ stress levels, lucidity, vital signs and lab values.

But at Florida Hospital Celebration Health, registered nurse Lorraine Zima-Lennon is integrating more than glitter and water colors into the Artist-in-Residence program she has managed for the past seven years. There is a growing emphasis on using the written and spoken word, and in extending that creative outlet to those dispensing healthcare, not just receiving it.

Zima-Lennon recently organized a day-long workshop featuring poetic therapist John Fox, who founded the nonprofit Institute for Poetic Medicine in Palo Alto, Calif. Fox’s visit was funded through an AIM Together Florida grant, which is a joint effort of University of Florida/Shands Hospital, the National Endowment for the Arts and the Florida Division of Cultural Affairs.

Fox read his poetry to staff and visitors, visited bedside with oncology patients and then held a workshop for nurses, who were asked to write about their feelings in dealing with cancer patients.

“It was incredible,’’ said Zima-Lennon. “We had 25 nurses there. It was a wonderful exchange and very emotional. Some had breakthroughs.’’

Patty Jo Toor, an oncology certified RN and director of the Cancer Institute at Celebration Health, took part in the journaling session led by Fox. “It’s very helpful for the nurses,’’ she said.

The emotions that came out when they were writing these poems were remarkable, Toor said.

“We need to help nurses deal,” she said. “Every day, they take on patients who have family and life issues. So, to be able to … release that emotion is so needed.’’ Toor said Zima-Lennon plans to offer a journaling session for oncology nurses once a month at Celebration Health.

Involving patients in writing exercises has been a rewarding supplement to the “art-cart’’ activities that Zima-Lennon and her 40 volunteers use to take patients’ minds off their dismal situations.

“I had a mother who was dying and her adult son and daughter were in the room,’’ Zima-Lennon recalled. “I have journals on my carts and I have a list of questions for patients about leaving a legacy. It’s a list of about 30 questions the families can use to review the patient’s life. The daughter and the son were able to go through the list of questions and have something positive to think about while their loved one died,’’ she said. “The creative diversion works for the families as much as the patients. That’s what we’re all about. We are not therapists.’’

Zima-Lennon told another story to illustrate the benefits of art therapy to patients’ families.

“I had a wonderful volunteer who worked in oncology at Altamonte (another Florida Hospital campus) who was told not to go into a room because there was a patient in there who was actively dying. Our art carts are all bright, and beautiful, and the volunteer kept walking by the door of the room,’’ she recalled. “There were two sisters and the mother of this gentleman who was dying. Finally one of the sisters asked about the cart. My volunteer said ‘This is creative diversion therapy.’ ‘You have to come in here,’ she said.’’
Zima-Lennon continued: “They started making paintings in the dying patient’s favorite colors. It turned a very solemn, sad situation into a wonderful sharing of the person’s life in a positive way. That’s how creativity can help’’ in end-of-life circumstances.

Zima-Lennon was on the committee that began the palliative care team at Florida Hospital. “We believe in tending to the whole person, body mind and spirit,’’ she said. “We feel that creativity is a function of spirituality, just like pastoral care or social work. I was asked to bring in this aspect’’ with the Artist-in-Residence program, adding, “We’ve done significant work.’’

More and more, physicians recognize art therapy’s role in palliative care, Zima-Lennon said.

“Doctors didn’t really understand it in the beginning, taking a nurse off the unit. But now doctors are saying it is a great thing. I actually have doctors writing ‘Art PRN’ on their orders,’’ she said. “And I had one cardiologist invite me to his office and I did a six-week creative group with his cardiac patients.’’

Music is another art medium popular with patients, Zima-Lennon said.
“Sometimes we’ll put headphones on a patient as they are expiring and just play beautiful music. Everything we do is based in research and there are studies that prove that when patients have harp music playing, for instance, that they lift up higher at the end.’’ She said. “Music can help relax patients and get those happy hormones circulating. And that is what we’re all about, stress reduction and positive diversion.’’

On the cancer unit, Toor said Zima-Lennon’s therapy is an effective complement to palliative care.

“I have patients who are really uncomfortable. What better way to get to some of those bottled-up emotions than through art?’’ Toor asked.

“I see (Zima-Lennon’s) work with our oncology patients and they really enjoy when she comes in. They relax and they start focusing on something besides the fact that they are ill and the disease,’’ Toor said. “It’s a great program and the patients really look forward to it.’’

So do her nurses, Toor said. Once a month, someone under Zima-Lennon’s tutelage comes in and plays piano or guitar. “Not only does it change the whole environment for the patients, but it helps the nurses, too. They really look forward to it,’’ Toor said.

And Toor is finding other uses for the art that that flows from the oncology unit. “We’re taking some of the patients’ artwork and the nurses’ poetry and having it framed. We’ll have a silent auction and use the money to raise money for more art therapy,’’ she said.



September 2007

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