My preclinical elective course, Creative Arts with Older Adults, is an experiential laboratory for first- and second-year medical students, as well as selected Program in Liberal Medical Education undergraduates, at Hattie Ide Chaffee Home in Riverside, RI. Through structured activities with older adults, students participate in role-playing, observation, interpersonal engagement, and collaborative interaction, both individually and in groups. These experiences are designed to foster meaningful connection, empathy, communication, and reflective awareness across generations.

What I consider most significant is the students’ written reflections on these encounters. Most compelling to me are those reflections that demonstrate an authentic “inside-out” process, reflections that thoughtfully integrate intellectual understanding with emotional resonance and personal self-awareness. In these moments, the students’ experiences are not merely described but deeply examined and meaningfully transcribed into reflective insight.

“As I look back on the time spent at the nursing home, each day stands out with its own set of stories and experiences that together weave a rich narrative of connection and learning,” reflected Nicolette John MD’28. Nicolette wrote that each art session became far more than just drawing and coloring as she described how a resident named Rita told wedding stories through sketches. The drawings “were like a window into her soul,” Nicolette wrote. “Her tales painted a picture of her youth, filled with hope and celebration.” Nicolette went on to explain how moments of artmaking like this are a conduit to the resident’s history, and how important it was that she was there, listening and learning.

Nicolette’s reflections illustrate a deep connection to the residents. “As [Rita] recounted her wedding day, the joy in her voice added color to our drawings, and I felt privileged to share in the tapestry of her past,” she recalled. She added that the residents’ journeys through artmaking, although initially with some hesitations, are like “a gradual bloom of self-expression and a voice in painting.”

Reflections, Nicolette wrote, bring a depth of learning that help us understand the culture of dementia, loneliness, and aging—“the silent language of empathy and friendship, the act of watching … and participation, the symphony of recollection and presence, and finally the tapestry of movement and music.” Truly, these are a celebration of life.

Nicolette also reminds us of the joy that comes from “letting go and embracing the moment, and how the residents’ enthusiasm can be contagious.” She wrote that these experiences not only taught her about the residents but also about herself and the profound impact of intergenerational relationships. “These moments have shaped my understanding of the beauty in every stage of life,” she wrote. “I leave this semester with a treasure trove of memories, a deeper understanding of the aging process, and a heartfelt desire to continue this enriching journey in whatever form it may take.”

The Power of the Arts

When students reflect on their time with residents, their words help us understand the world of dementia from the inside out. Older adults with cognitive impairment live in a reality shaped by memory loss and confusion, a world that masks their sense of reality. Students may initially feel sadness when they hear residents say, “I want to go home,” especially at sundown. Yet they learn to gently redirect, offering comfort through positive, meaningful distractions. Understanding dementia is a process, one of trial and error, thoughtful reflection, and the hope of doing or saying something that brings comfort.

Many students observe how happy residents are to “have someone actively listening.” Companionship is so precious to them. Their stories remind us of our own lives—where we’ve been, where we are, and where we’re going. One day, we too may be asked to share our life stories.

Kira Nguyen ’28 MD’32 wrote, “Even in the silence, it felt warm and my heart was full.” Silence is often perceived as peaceful, comforting, and reflective. However, as Kira observed in her interactions with Margaret, who was 100 years old, silence can also be a profound manifestation of loneliness. Following the loss of her husband, Margaret frequently expressed a deep sense of isolation, an experience that is not uncommon among older adults.

Loneliness among this population can significantly impact overall quality of life, affecting both emotional well-being and physical health. Human connection remains an essential component of holistic care. Seemingly small gestures, like a simple greeting, a gentle touch, or a shared moment of presence, can have a meaningful impact. Even something as subtle as a smile can foster warmth and reassurance.

For residents who seldom receive visitors, the students offer a valuable source of social engagement and emotional support that goes beyond companionship. By recognizing each resident as a unique individual with a personal history and identity, students contribute to fostering dignity, respect, and a renewed sense of belonging.

Icy Liang ’25 MD’29 enjoyed scribing during one of our narrative writing sessions. “The prompt was to write about the resident’s favorite foods,” she recalled. Irene shared her love for big fish with breadcrumbs, her dislike for tuna sandwiches, and her fondness for certain drinks she can no longer enjoy, such as margaritas and light beers. She recommended the turkey dinners at Chelo’s. “After today’s session, I feel especially grateful for all the small choices I can make in life, even ones as simple as what meal I’m having,” Icy wrote. It is remarkable how visiting a nursing home can remind us of life’s simplest treasures, which we often take for granted until we see how others live.

Maxine Slater ’23 MD’27 reflected on dance, describing it as “restrictive at best and oppressive at worst.” She wondered how older adults with limited mobility could fit into such a paradigm. Yet aging bodies, despite the rigidity of arthritic joints, tender muscles, and tired bones, can still move with grace and meaning. What matters most is the heartwarming connectedness that movement fosters. These moments make a profound difference in the quality of life for older adults.

Grace Kim ’23 MD’28 wrote of her Singing for the Soul program: “I printed less music sheets than usual, but we had around 15 seniors join us today and we had to have residents share sheets! Though at first the lack of sheets was less than ideal, it encouraged residents to interact with one another. Two [residents], Trudy and Gladys, shared a sheet, and it was heartwarming to see them murmuring together and beating on their drums. I was able to see friendships between the residents, which was really sweet. Cindy and Rita seemed to get along really well, as did Mavis and Hilda.”

In her fourth session, Grace introduced holiday songs. Though she was concerned that repeating songs might get boring for the residents, it clicked that they enjoy familiarity. This made her wonder if singing holiday songs took residents back to their childhood where they celebrated and sang with their family. Grace decided for her next session to do just that: By encouraging more interactions between the residents, she introduced a partner system, having them drum on the same instrument. “We played a couple of Swedish songs for Gunner today and he was awake for it and very giggly,” Grace wrote. “He’s a man of few words, but this was the most he ever spoke with me! He even reached out for my hand and dragged his hand across my face with a smile.”

Another resident, Jean, “doesn’t say many words, but she vocalizes a lot,” Grace continued. “I wasn’t sure if she was trying to say something to me or showing discontent with the class. But today, her vocalizations sounded like the melody to what we were singing! She also typically has her head down and doesn’t take the lyrics sheet, but today she was alert and flipping through the pages.” Though the sing-alongs were done in a group setting, Grace saw how the one-on-one interactions made a difference because of the small wins: “Even if only 2-3 residents sung today out of the 6, that’s incredibly exciting.”

Joseph Oldam MD’27 fondly recalled a transformative workshop involving Margaret, the centenarian resident who presented a unique challenge in her engagement. When he mentioned the cello, she immediately sprang to life, moving her hands as if she were playing the instrument while humming a symphony for about five minutes. It was a remarkable sight, watching her vitality return as she seemed to transcend time, reconnecting with her past as a cellist performing live on stage.

The profound question arose: Was Margaret simply reminiscing and role-playing, or did she genuinely believe she was showcasing her musical talents once more? Andrew Chen MD’27 noted, “This was a testament to the power of the arts.” He expressed his intrigue in how the complex and specific memories associated with playing the cello were elicited so vividly. This encounter underscored the intricate relationship between music, memory, and identity, highlighting the therapeutic potential of the arts in reconnecting individuals with their past and enriching their present experiences.

“I sat next to Hilda,” Andrew wrote, “and using her input we drew a picture of a garden. Something particularly interesting about working with Hilda was her need for physical touch. She enjoyed holding hands or feeling a hand on her forehead ‘even more than drawing or eating.’ It seemed like physical touch for her was almost a prerequisite for participation in activities, and when asked if she would like to color or play one of the recently donated drums, Hilda would usually decline, but when asked again, while being held in some way, she began to play some of the instruments and offered more input on what she’d like to see in the garden that we were sketching together.”

Andrew went on, “Hilda is very sweet and although the position I was sitting in (one hand on Hilda’s forehead, the other sketching) looked funny, I got a better sense of how everyone’s needs are different and how dynamic things can be when spending time or caring for elderly folks.” The power of touch is so important, especially for Hilda, and Andrew knew just how to touch her heart.

Barry Zeltzer is a clinical assistant professor of medical science at The Warren Alpert Medical School and chief executive officer of Hattie Ide Chaffee Home in Riverside, RI. He is an editorial board member of the American Journal of Alzheimer’s Disease and Other Dementias and a member of the Rhode Island Advisory Commission on Aging.