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The impact of the Bealtaine arts programme on the quality of life, wellbeing and social interaction of older people in Ireland

Published online by Cambridge University Press:  22 July 2011

EAMON O'SHEA*
Affiliation:
Irish Centre for Social Gerontology, National University of Ireland, Galway, Ireland.
ÁINE NÍ LÉIME
Affiliation:
Irish Centre for Social Gerontology, National University of Ireland, Galway, Ireland.
*
Address for correspondence: Eamon O'Shea, Irish Centre for Social Gerontology, National University of Ireland, Cairnes Building, Galway, Ireland. E-mail: eamon.oshea@nuigalway.ie
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Abstract

There is increasing evidence in the international literature that engagement in the arts can enhance the physical and psychological wellbeing of older people. Such engagement can increase the self-confidence and morale of older people and provide opportunities for increased social connections, leading to higher levels of social cohesion. This article is based on an evaluation of a national arts festival in Ireland called Bealtaine that celebrates creativity in older people each year during the month of May. The festival is unique in the wide range of arts-related activities it includes and the different types of organisations involved, such as local authorities, libraries, educational institutions, health and social care organisations, and voluntary bodies for older people. It includes both long-standing professionally facilitated arts programmes and one-off events at local and national levels. The evaluation used quantitative and qualitative methods to analyse two major postal surveys with organisers and consumers of the festival and face-to-face interviews with older participants, artists and organisers. The findings are overwhelmingly positive in terms of the personal and social gains arising from participation in the festival. In this context, the study provides support for the provision of enhanced and sustained funding for creative programmes for older people and, more generally, for the development of an integrated policy for older people and the arts in the country.

Type
Articles
Copyright
Copyright © Cambridge University Press 2011

Introduction

This paper addresses the question of whether participation in the arts impacts on the quality of life, wellbeing and social interaction of older people in Ireland. The framework for consideration of this question is provided by data generated by an evaluation of an annual national month-long festival called Bealtaine (which is Gaelic for the month of May) that celebrates and promotes the involvement of older people in the arts across the country. The Bealtaine festival creates opportunities for older people to participate in the arts at various levels in Ireland during the month of May, with an emphasis on enjoyment and participation at all levels. The festival involves multiple arts events and takes place in a variety of settings throughout the country. The festival incorporates all forms of art, including: music, theatre, literature, poetry, dance, film, story-telling, painting, drawing, print-making, sculpture and photography. Article 27 of the Universal Declaration of Human Rights which states that ‘everyone has the right freely to participate in the cultural life of the community, to enjoy the arts …’ (United Nations General Assembly 1948) is the cornerstone of the Bealtaine approach to participation in the arts.

Historically, in Ireland, there was very limited investment in the arts, at any level, at the time when the current generation of older people were young, and therefore very little opportunity for them to engage with the arts from an early age. The vast majority of older people have grown up without any formal exposure to creative expression or opportunities, thereby making it more difficult to foster engagement and interest in the arts in later life. A recent study, for example, found that while economic background is important, people in older age cohorts are generally less likely to attend arts events than people in younger age groups (National Economic and Social Forum 2007). This task is made harder by the continued absence of any unified public policy on participation in the arts in later life. Overall, there is very limited funding currently dedicated to older people and the arts in Ireland. Bealtaine operates in a policy vacuum that does little to enhance the work of the festival in achieving specific goals and objectives. While those who organise and participate in arts programmes have long been convinced of the individual and social benefits of the arts (Health Development Agency 2000), the reality is that very little support is provided at official level in most countries for arts programmes for older people.

This has fuelled a growing international demand for evidence-based research on the effectiveness of arts-based programmes in generating improved personal and social outcomes for participants (Newman, Curtis and Stephens Reference Newman, Curtis and Stephens2003). There has been a good deal of recent debate about whether it is possible, or even desirable, to measure the impact of participation in the arts and, if so, what are the most appropriate methods to measure participation? (Belfiore Reference Belfiore2002; Galloway Reference Galloway2009). Traditional quantitative methods may not be appropriate in evaluating the impact of the arts, particularly if it is the manner and quality of engagement that matters rather than simply the number of encounters with an artistic programme (Cohen Reference Cohen2000). The question then is how to measure the level and depth of engagement? While systematic research into the impact of community arts programmes is at an early stage, there has been some investigation using an experimental design complete with control group into the impact of arts programmes on health. This work reports positive returns from investment in arts programmes for older people across four main areas: physical health; morale; relationships with others; and intergenerational legacy (Cohen et al. Reference Cohen, Perlstein, Chapline, Kelly, Firth and Simmens2007).

There is a small, mainly cross-sectional, international literature that reinforces this view, with evidence that engagement in the arts can enhance the physical and psychological wellbeing and the quality of life of older people (Greaves and Farbus Reference Greaves and Farbus2006; Smith Reference Smith2002; Strumpel and Billings Reference Strumpel and Billings2008). Such engagement has been found to increase the self-confidence and morale of older people, as well as providing opportunities for increased social connections, both with other older people and with younger people. Participation in the arts generally may also enhance social inclusion, foster solidarity and contribute to the development and sustainability of social capital (Lowe Reference Lowe2000; Morris Hargreaves McIntyre Consultants 2004; White and Robson Reference White and Robson2003). Moreover, it has been suggested that engagement in the arts can result in increased social cohesion (Matarasso Reference Matarasso1997; Newman, Curtis and Stephens Reference Newman, Curtis and Stephens2003). Some specific examples of positive outcomes include experimental research in the United States of America which found that involvement in a theatre group resulted in improved memory and an increase in psychological wellbeing for older people (Noice, Noice and Staines Reference Noice, Noice and Staines2004). Similarly, older people receive wide-ranging personal and social benefits from participating in arts exhibitions and visual art-making (Fisher and Specht Reference Fisher and Specht1999; Reynolds Reference Reynolds2010). There are also reports on the positive influence of music and art on the health and quality of life of older people (Cohen Reference Cohen2009; Hays and Minichiello Reference Hays and Minichiello2005). Studies of individual arts projects suggest that the building of trust, the use of professionally trained artists, and the provision of sustained funding and support may be important elements in achieving some of the transformative effects outlined above (Moloney and McCarthy Reference Moloney and McCarthy2006).

The absence of creative opportunities can impact negatively on the lives of older people, particularly for people living in residential care settings. A study of the quality of life for older people in health-care settings in Ireland found that there is a lack of meaningful creative activities for residents in many facilities, leading to a negative effect on their quality of life (Murphy et al. Reference Murphy, O'Shea, Cooney, Shiel and Hodgins2006). Older people in residential care in Ireland have few choices and little autonomy in their lives particularly if they are physically frail. Creativity programmes, where they exist in residential care, provide a distraction from the routine of residential care life, allowing opportunities for self-expression that are otherwise absent. There is evidence that participating in arts programmes within various care settings can have beneficial impacts on the physical health of patients and on their psychological wellbeing (Staricoff Reference Staricoff2004). Similarly, a number of recent studies in Ireland have found that arts programmes involving music, visual arts and drama have a positive effect on the quality of life of older people in residential care (OCS Consulting 2004; Russell Reference Russell2007).

Active engagement with the arts can impact positively on patients with mental health difficulties allowing them to be calmer, more attentive and more collaborative; they were also better able to express themselves after participating in the creation of work under the guidance of art specialists (Malley, Datillo and Gast Reference Malley, Datillo and Gast2002). Drama therapy can help patients who have difficulties in communication, cognition and social skills (Snow, D'Amico and Tanguay Reference Snow, D'Amico and Tanguay2003) and can enhance self-expression in people with dementia (Knocker Reference Knocker2002). There was a reduced need for medication and physical restraint in disruptive patients. Those who engaged in music and singing were better able to recall events from their lives, to express themselves and dance enabled them to increase their range of movement.

This paper examines the impact of the Bealtaine festival on the quality of life and wellbeing of older people living in Ireland. The paper also outlines the social benefits attached to older people's participation in the Bealtaine programme. While causal relationships are difficult to establish, there are already strong indications that creativity matters for ageing well through fostering and protecting a sense of personal identity, competence and connectivity among older people. Participatory arts programmes can have positive effects on the general health, mental health and social activities of older people. There are also social gains from creativity programmes linked to solidarity, social connectedness and social capital. Our focus in this paper is whether the organisers of, and participants in, the Bealtaine festival report similar outcomes to those outlined above and whether there are any differences between them in how the festival is perceived and measured in terms of its impact on health and wellbeing. Since research on community arts programmes in general and national arts festivals in particular is at an early stage of development, the paper also offers some useful insights into the processes and outcomes through which older people can benefit from engagement with the arts, including the policy implications arising from participation.

The Bealtaine festival

Bealtaine is a month-long festival, held annually during the month of May, to celebrate creativity in older age. It began in 1996 and is organised by Age and Opportunity, which is a state-funded organisation, whose aims are broadly to promote the increased participation of older people in Irish society and to combat ageism. The target population for the festival are people retired from paid and unpaid work who are aged 65 years and over, but there is not an exclusion policy in operation, so younger older people may also attend events in the festival. The purpose of the festival is to celebrate creativity in older age, highlighting older people's current engagement in the arts and encouraging their continued and future participation. The specific aims of the Bealtaine festival are to:

  • Promote recognition of our capacity to grow and be creative in older age and ensure that this is reflected in policy and practice at all levels.

  • Develop opportunities for older people to participate meaningfully in the arts as artists, organisers and critics.

  • Develop and articulate a national policy for the arts in older age that acknowledges the potency of the arts to transform lives.

These aims reflect the broader remit of Age and Opportunity to bring about the increased participation and enhanced status of older people in Irish society. Each year there is a unifying theme for the festival which various organisers across the country can subsequently use, if they wish, as a focus for their own event. The Bealtaine brochure lists the major events and venues in each county and describes in more detail some of the high-profile activities. Bealtaine is unique in the wide range of activities in which it engages and the different types of organisations involved: including local authorities, health agencies, national arts groups, libraries, educational institutions, care settings and voluntary organisations for older people.

The festival encompasses many art-forms and includes both long-standing professionally facilitated arts programmes, sometimes using international co-ordinators, and one-off events linked to local organisations. Events are organised both by older volunteers, arts officers, librarians, artists, facilitators and health-care workers. Inclusiveness is a major aim of the festival. This is important since a recent report has found that people with lower income and lower educational attainment are much less likely to be involved in the arts in Ireland than other socio-economic groups (Lunn and Kelly Reference Lunn and Kelly2008).

Bealtaine has grown consistently since its inception in 1996 and spectacularly in recent years. In 2007, when this study was completed, the festival touched the lives, to a greater or lesser extent, of just over 50,000 older people who participated in over 1,200 different events. According to the most recent annual report from Age and Opportunity, estimated participation has now increased to 100,000 in 2010. The sponsoring organisation Age and Opportunity works with various participating agencies to develop the programme, employing a part-time artistic director and overseeing a lot of the planning and publicity, but is directly involved in the provision of only some local and national events. The festival is run on a very limited and fragile budget which depends on the generosity of various state budget holders and one-off grants from supportive private and philanthropic benefactors. The total budget has risen to around €100,000 in recent years; when the budget exceeds this figure it is mainly due to one-off funding for particular projects. While the overall goal is to inspire both activity and participation, there is an ongoing tension between maximising the artistic quality of the work covered by Bealtaine and universal participation in the festival. In recent years, the strategy has been one of developing a strong central artistic programme for Bealtaine, thereby attracting greater funding support from arts organisations and higher profile for older people within the arts generally.

Methods

This paper focuses on the impact of the festival on individual older people and the associated social effects. The assessment of the impact of the festival on older people is based on domains identified from a variety of sources in the literature (Cohen et al. Reference Cohen, Perlstein, Chapline, Kelly, Firth and Simmens2006, Reference Cohen, Perlstein, Chapline, Kelly, Firth and Simmens2007; Matarasso Reference Matarasso1997, Reference Matarasso1998; Newman, Curtis and Stephens Reference Newman, Curtis and Stephens2003) and from discussions with the steering committee of the festival. Individual impacts include: self-expression, personal development, critical appraisal and quality of life; social impacts include: social networking and engagement with the community. The choice of self-expression and engagement with the community was influenced by the work of Cohen et al. (Reference Cohen, Perlstein, Chapline, Kelly, Firth and Simmens2006, Reference Cohen, Perlstein, Chapline, Kelly, Firth and Simmens2007), while the focus on personal development and social networking originated from work done by Matarasso (Reference Matarasso1997, Reference Matarasso1998) in various communities. Quality of life was included in order to capture the wide range of generic benefit that seemed to permeate the literature, even if never fully acknowledged or measured therein, while critical appraisal was included following discussion with the organisers of the festival. The domains chosen for exploration of the most important aspects of the festival from the standpoint of the organisers reflected our early discussion with the festival committee and influences from the general artistic literature.

The final questionnaire which was developed to measure the impact of the Bealtaine festival on older people was not tested for validity and reliability. However, significant pilot work was undertaken to establish whether the various domains were meaningful to Irish respondents. Some domains were dropped on the basis of information from the pilot; for example, questions on spirituality were deemed irrelevant by pilot participants and, therefore, were excluded from the main questionnaire. Data for the main study were collected using tick box options and Likert responses for specific domains. There was an option for respondents to elaborate on all of the impact questions outside the structured questionnaire responses.

The approach adopted to evaluation is similar to that of Matarasso (Reference Matarasso1997), i.e. using social auditing as a means of exploring the social impact of creative programmes in relation to its constituent aims and those of its major stakeholders. One advantage of this approach is that the activity (in this case the festival) is viewed as a complex whole and the views of all stakeholders are taken into account; furthermore it allows one to see if an organisation's stated objectives are being met. Another advantage is that it focuses on long-term outcomes – that is the long-term effects on participants rather than short-term outputs (in this case the artistic product) (Belfiore Reference Belfiore2002). This ensures that it is the benefits of participation that are being assessed. Moreover, this approach overcomes the difficulty associated with making an assessment on community interventions without any prior measurements that would allow before and after comparisons to be made. Community cultural events tend to make people feel better about themselves and their communities, but without prior measures it is difficult to establish the range and magnitude of such effects.

Because of the existence of various events and multiple stakeholders – organisers, artists and older participants – the study adopted a holistic multi-perspective approach and sought to elicit the views of these different groups of stakeholders. Some of the programmes are long term in that they take place throughout the year and from year to year (some groups have been meeting for over ten years), while others are opportunistic one-off activities that may or may not be sustained beyond the month of the festival. Long-term groups tend to exhibit their year's work during Bealtaine; for example, visual arts groups might hold their major art exhibition during May, a writer's group might launch a collection, a drama group might produce a play during the festival. Where the interviewee is a member of such an on-going group, he or she is referred to in the data as a ‘long-term group interviewee’. Other programmes in the festival may be one-off events, sometimes ‘taster’ sessions, such as a drama workshop lasting an afternoon, or a writer's workshop that takes place over a couple of days. Other events may simply involve the participant as being part of an arts audience, sometimes for the very first time in their life. The level of engagement with Bealtaine varies greatly across participants.

The methods used to collect data were:

  • Context interviews with members of the Bealtaine steering committee.

  • Postal questionnaire sent to all of the 435 organisers of Bealtaine events across the country. The list of organisers was obtained from Age and Opportunity, the organisation that operates the festival. The questionnaire included questions on type of organisation, level of involvement, satisfaction with Bealtaine, impact of Bealtaine on the participation of older people in national and local arts programmes; impact of Bealtaine on the quality of life, wellbeing and social interaction of older people. The response rate was 43 per cent.

  • Participant postal questionnaires for older people sent to one randomly selected Active Retirement Association (ARA) in each county in Ireland. The ARA was asked to distribute the questionnaire to all of its members and a stamped addressed envelope was provided for the return of completed questionnaires to the researchers. Members of ARAs from over half (14) of the 26 counties in Ireland returned completed questionnaires, aggregating to 253 completed questionnaires or approximately one-third of all questionnaires distributed. Some responding ARAs would have had almost 100 per cent return rate. Questions were asked on demography, engagement with the arts, type of event/programme attended and impact of Bealtaine on quality of life, wellbeing and social interaction.

  • Qualitative interviews with older participants in various arts programmes, facilitators of arts programmes, artists and organisers of events. These face-to-face interviews with 26 people allowed a more detailed and nuanced picture to emerge than was possible from quantitative data alone.

Formal ethical approval was not considered necessary for the study as respondents were not deemed to be vulnerable adults, or adults in vulnerable situations. However, during the face-to-face interviews standard ethical procedures were followed; respondents were assured that participation was voluntary, that responses would be anonymised and that confidentiality would be respected. Purposive sampling was used to select representative participants for qualitative interview. The aim was to cover a range of different types of arts activity in urban and rural areas. The older participant interviewees were contacted through gatekeepers such as county arts officers, or facilitators of classes, or through Age and Opportunity participant lists. In addition to older participants, different types of organisers were interviewed such as: county arts officers; librarians; a care worker in a hospital; as well as facilitators of dance, drama, intergenerational, creative writing and visual arts programmes. All interviews were digitally recorded and transcribed. Content analysis was used to elicit the major issues of relevance to the various stakeholders. Quotations from the interview data are used to provide richer detail and more nuanced responses than are available from the questionnaires.

Results

Of major importance is whether the festival achieves its objectives from the viewpoint of the organisers themselves. The findings are positive in that regard. A large majority of organisers (74%) believe that one of the most important aspects of Bealtaine is that it stimulates older people to participate in the arts (Figure 1). One local authority arts officer said that:

Figure 1. Most important aspects of Bealtaine according to organisers of events.

I would have no doubt but that Bealtaine has encouraged people – nationally – I think it has … actually participating in the arts and when I say participating I mean taking part themselves, but also being receivers, being part of an audience … and going to galleries, or theatres or whatever. (Interview with Local Authority Arts Officer)

A similar proportion of organisers (74%) identify social/community networking as a very important aspect of Bealtaine. Almost half saw the festival as an important opportunity for celebration and excitement for older participants. Libraries and Older Person's Groups said that the Bealtaine festival creates awareness of the service they provide. Another important aspect identified is the opportunity provided to showcase work produced during the year. The festival also provides organisers with a reminder and incentive to come up with events and programmes for older people every year. Almost three-quarters of organisers believe that the festival is successful in promoting positive attitudes towards and among older people. Those who see Bealtaine as successful in this regard suggest that its very existence raises confidence and self-esteem among older people; its high visibility nationwide through billboard campaigns, media coverage and arts ambassadors creates an awareness of the importance of participation and shared cultural experience.

The findings, both from organisers and older people themselves, are overwhelmingly positive in terms of the personal and social gains accruing to older people who participate in Bealtaine (Figure 2). The festival facilitates self-expression and personal development, with equally strong effects on social networking and engagement with the community. In general, older people are more positive about the festival than are organisers across a range of criteria.

Figure 2. Impact of Bealtaine on older participants from perspective of organisers and participants.

Self-expression

Both participants (87%) and organisers (68%) share the view that Bealtaine facilitates self-expression among older people. This is particularly evident in relation to dance, visual art and creative writing. People discovered talents that they had been unaware of and that they were able to nurture in a safe environment.

Interviews with participants give further insight into the impact of Bealtaine on self-expression. A participant in a Bealtaine Writer's Group describes her experience in the group as being very empowering and giving her the confidence to write; another member of an arts group who has participated in programmes organised by the Irish Museum of Modern Art (IMMA) for many years says that the experience has made him better able to express himself not only artistically but socially, as a result of the discussions about art that form an integral part of the IMMA programmes.

I have to say I have found my voice since joining this group. (Interview with member of long-term writer's group)

You're used to talking and discussing within a group so it takes away the reservations that were there before. (Interview with member of long-term visual arts group)

While these impacts were more likely to be associated with on-going programmes (usually) run by professional facilitators, similar effects can arise within ‘taster sessions’ run by local authority arts officers or within a peer-led writer's group. These sessions act as an introduction to the arts for older people, enabling them to perhaps express themselves artistically for the first time, and this often leads to a desire for more on-going involvement.

Personal development

A large proportion of organisers (59%) perceived the impact of Bealtaine on the personal development of older people to be strong or very strong. According to organisers, participants sometimes discover hidden talents, participation and learning new skills boosts the confidence of older people, attending classes increases their independence and opens up to the concept of lifelong learning. Dance, drama and visual art programmes were specifically mentioned as encouraging personal development.

An even higher proportion (89%) of participants agreed that participation in Bealtaine encouraged their personal development in terms of enhanced learning and organisational skills. One respondent wrote that ‘becoming part of a craft can help you develop your ideas’, while another felt that ‘being part of the committee organising Bealtaine events helped us form ideas as a group and I enjoyed being part of the organisation committee’. The face-to-face interviews reveal that some participants gain confidence in their skills and go on to develop further artistically and personally. One man who attended just a Bealtaine ‘taster session’ writer's workshop said he had written before but had always been reluctant to acknowledge this in public:

You would be kind of ashamed to say you were writing. I have heard this from other people who say the same. (Interview with participant in writer's taster session)

After attending the workshop and receiving positive feedback on his writing both from the facilitator and from other participants, he gained the confidence to submit his work for a competition and joined a year-round writer's group. For this participant, Bealtaine was important in terms of his development, both personally and as a writer.

A participant in a long-term (IMMA) art programme highlights the way in which he has developed in terms of learning and becoming more open-minded about appreciating different art forms:

You learn a lot because when I started, I knew practically nothing about modern art and it was a new subject to me … . That's one thing that's good in art, it gives you an open mind, that you take a thing in and you don't say ‘No’ straight away, you look and examine. (Interview with participant in long-term visual arts programme)

A care worker in a hospital described what he saw as a profound change in the residents as a result of the Bealtaine programme. They changed from being passive recipients of distraction-based entertainment provided by care staff to setting the agenda for, and participating in, the Bealtaine programme. Their awareness of available activities in the community outside the hospital has grown and they now value their own creative potential and their knowledge of traditions. As a result, their interaction with the staff has changed and is now predicated more on the basis of equality – they now feel empowered to initiate and demand specific types of artistic events for themselves.

Critical appraisal

The question of whether Bealtaine encourages critical appraisal among participants was endorsed by fewer of the organisers, with only 31 per cent perceiving a strong impact (Figure 2). Those reporting significant effects mention the following as examples of the development of critical appraisal:

  • Improves skills – older artists realise they have something to offer.

  • Encourages them to discuss art.

  • Encourages older people to communicate their opinions/make suggestions.

  • Older people learn to give and take constructive criticism.

Almost one-third of organiser respondents said the festival had a neutral or weak effect – this depended on the nature and duration of the programme and the type of facilitation. They explained that one-off events with no continuity have little effect on critical appraisal.

In contrast, a majority of participants (70%) believed that participating in Bealtaine had encouraged them to think critically about the arts. More than a quarter have no opinion on this, probably because some of the events would not lend themselves to developing a critical perspective. Interviews with participants suggest that being part of comprehensive professionally led programmes particularly encouraged the development of a critical perspective. One participant in a weekly dance club said that her perspective on dance is different to the way she had seen it prior to participating – she now looks at how a dance piece is choreographed and constructed, whereas previously she did not engage in this kind of critical appraisal as she had never had the opportunity to be involved in this way before. She had gained this perspective in a relatively short period of time, having attended various workshops and subsequently attended a weekly dance club run by a professional facilitator. A participant in a long-running visual arts programme explains how members of his group engage in developing a critical perspective:

We go round the gallery for each exhibition and we have a chat about it and whether we like it or whether we don't and we come up with why we don't like it and if we like it, why we like it, so that keeps the brain active. (Interview with member of long-term visual arts group)

Those interviewed from the Bealtaine Writer's Group say that they regularly receive critical appraisal of their work from their peers which they find both supportive and stimulating.

Quality of life

Over two-thirds (67%) of organisers believe that participating in Bealtaine had a strong impact on the quality of life of older participants. They specifically mention the following benefits:

  • Psychological benefits – gives meaning and purpose to life, reduces loneliness, combats depression.

  • Increased social networking.

  • Pride in skills/achievements.

About 20 per cent of organiser respondents perceive Bealtaine to have had a weak or neutral effect on quality of life. These are mainly organisers of one-off events who say the effects are limited due to lack of continuity or for other reasons.

A much higher proportion of participants (86%) agree with the statement that ‘participation in Bealtaine has improved my quality of life’. Once again they mention physical, psychological and social benefits.

I found a new hobby/interest.
Good way to meet new people.
Singing is very beneficial to health and it is energising.
It encouraged me to be more outgoing – get out of the house.
It's a brilliant day out for me – when we went on a tour.
I meet different people.
(Quotes taken from questionnaire responses)

Evidence from the face-to-face interviews reinforces the positive psychological effects of the festival. One woman emphasised the beneficial effects that having something to look forward to and being absorbed in creative activity has had on her quality of life:

It gave me a new lease of life. I'm a widow and I live alone and it was marvellous to have something to get out for – to get involved in and then to forget your pains and aches and get completely immersed in the whole thing. (Interview with participant in intergenerational project)

A participant in a visual arts programme attached to IMMA echoes this view and also mentions the sense of psychological wellbeing brought about by producing a work of art:

You're getting out of the house and you've something always to look forward to and then in the evenings I can paint away for a few hours and it makes life a lot easier to live if you have interests. I think what kills people is lack of interest … I'm happy in myself because being creative gives you so much satisfaction. … It gives you a sense of wellbeing if you do a good painting or if you do a good piece of sculpture with clay. (Interview with member of long-term visual arts group)

Another participant believed that focusing on art reduces his anxiety about his health:

I probably think about the art more that I think about my health. If you keep worrying about yourself, you're going to get something anyway so that in itself is a good thing. (Interview with member of long-term visual arts group)

Another interviewee emphasised that the opportunity to participate in a public forum to perform/display their talents had a positive effect on their self-esteem:

The festival allows older people to publicly share their talents, which is good for self-esteem. (Interview with member of Bealtaine Writer's Group)

Overall, both organisers and participants strongly believe that participation in the festival has a very positive impact on quality of life.

Social networking

A majority of organisers (59%) see strong effects on social networking. Again this is more likely to be the case where programmes are on-going rather than for one-off events. Organisers report the following effects:

  • Formation of new friendships.

  • Broadening of social inclusion.

  • Participants mixing with participants in other groups.

  • Participants joining other groups for new activities.

  • Higher levels of interaction for residents in care settings.

A very high proportion of older people (95%) agreed with the statement that ‘participating in Bealtaine means that I have got to know people I wouldn't otherwise have met’. Those engaged in intergenerational projects mention that they have extended their social networks by getting to know local young people. People mentioned a range of positive social impacts:

It's nice to be part of a group.
We got to know people in the same situation as ourselves.
I've met lots of people and I am amazed at various talents people have.
Bealtaine is a great opportunity to meet people, young and old.
People who take part come from all sorts – different communities take part.
(Quotes taken from ARA questionnaire responses)

Interviews confirm that participants extend their social networks through participating in Bealtaine in various ways ranging from the formation of lasting friendships in their own groups to meeting other older people involved in similar activities locally and elsewhere. One woman says:

My life would be very lonely without Bealtaine. I have Bealtaine friends – we meet every Friday – this group wouldn't exist without Bealtaine. (Interview with member of long-term Bealtaine Writer's Group)

As well as forming lasting friendships, several participants said they benefited from networking with other groups (e.g. other writer's groups or art groups around the country) both in terms of social interaction and in gaining inspiration from others engaged in similar artistic work. One respondent wrote that she has ‘formed a big circle of friends, who are interested in similar activities’. Thus Bealtaine has helped people to form new communities of older people engaged in the arts around the country.

Engagement with the community

More than half of organisers (55%) felt that Bealtaine facilitated positive engagement with the community. Such involvement was particularly important for more dependent older people, some of whom were in long-stay care. A few organisers mentioned exhibitions and other events held in day care centres, nursing homes and hospitals which facilitated great connectivity between people living in long-stay care and those living in the community. It appears that Bealtaine has helped to break down barriers between groups that were previously isolated (such as people in long-term residential care) and their local community. This confirms similar effects that have been documented in previous research (O'Morain and Leahy Reference O'Morain and Leahy2007).

A care worker in a hospital who is a Bealtaine organiser indicated that being involved with the festival had a significant effect on the lives of the hospital residents. The process is reciprocal; the community has become much more involved with the hospital and the residents have become much more aware of what's happening in the local area and now ask to attend arts events outside the hospital:

I suppose it has broken down the walls of the hospital … It has opened it up and it has involved everybody, especially the community. (Interview with care worker in a hospital who organises Bealtaine events)

Again, there was a very high positive response (87%) among older participants to the statement that ‘participation in Bealtaine had increased their level of involvement in their community’. Some people have joined community groups and resident's committees and even actively fundraise for these organisations. Others say that they are now more aware of what is happening in the community:

I'm out and about more and meeting people – I'm also becoming more aware of people and their needs.
I'm aware of what's going on in the community.
(Quotes taken from questionnaire responses)

One member of a long-term writer's group associated with Bealtaine says that being part of the group has encouraged her to teach a creative writer's group in her local community centre. She says her work there is ‘stimulated and cross-fertilised by my involvement in Bealtaine’. Intergenerational and drama events also tended to draw in the local community and participants talked about getting to know younger people in their area for the first time as a benefit of the festival. Organisers said that participants became more involved with volunteers, artists, school-children and other community members through these events.

Discussion

Bealtaine has had a visible impact on the engagement of older people in the arts in Ireland at national and local level, despite having very limited resources. The festival has grown every year and has met its objective of providing opportunities for meaningful engagement in the arts by older people, both as artists and participants. This is particularly apparent in longer-term programmes that are facilitated by professional artists, but is also discernible in short-term one-off programmes. Older people also have more opportunities to organise events themselves as reflected in the growth in the number of older people running various programmes. Bealtaine requires a considerable amount of voluntary activity from older people; time spent fund-raising, generating publicity, organising the event and participating in the event. Active Retirement Associations are particularly reliant on members’ own time contributions to producing arts events and activities.

Our data support the existing literature in pointing to significant personal and social gains from participation in Bealtaine. People value the contribution to identity and self-expression that arises from participation in the festival. The vast majority of respondents report strong effects on personal development, social networking, social engagement and quality of life. We know from the limited longitudinal trial-based evidence available internationally (Cohen et al. Reference Cohen, Perlstein, Chapline, Kelly, Firth and Simmens2007) that these effects are likely to combine to promote better physical and mental health among participants. However, without consideration of the various transmission mechanisms, it is impossible to say with any certainty what the magnitude of these effects are for Ireland. All we know is that older people value participation in Bealtaine and their lives appear to be enhanced by the variety of experiences associated with that engagement.

The fact that older participants tend to place more value on their engagement with the arts than the organisers suggests that the resulting experience is interpreted differently by the two groups. It may be difficult for a third party to estimate the impact of social programmes on older people, even if that third party is, in some cases, the organiser of the programme, even more so when the domain in question is art, which is inherently a subjective experience. Moreover, the meaning older people give to the effect of Bealtaine on their lives is probably determined by their experiences across the lifecourse, which is likely to be more complex and multifaceted than can be fully understood by proxy valuation (Bond and Corner Reference Bond and Corner2004). When older people talk about the festival in terms of finding voice, overcoming shame, opening minds, taking away reservations, promoting self-esteem, giving a new lease of life, it is easy to understand the depth of feeling associated with participant involvement and the difficulty for organisers to capture, let alone measure, such effects. This is particularly so if organisers are more concerned about the quality of the event from an artistic point of view rather than its impact on older people. Some organisations were concerned about the nature of the art produced by Bealtaine, particularly when professional artists and facilitators were absent, but that view was not universally shared by older participants, for whom the social aspect tended to dominate any concerns about artistic quality.

Bealtaine also had an impact beyond the personal, as would be expected from the evidence presented earlier in regard to the positive effect of arts festivals on social cohesion through the building of social connections and social capital at local and national level (Lowe Reference Lowe2000). Older participants appear to have been stimulated by the festival to become more involved in their local communities, sometimes for the simple reason that their voluntary effort was required for the event to happen at all. They became more visible through engagement with the arts, and appeared comfortable with that visibility, something which is not well reported in previous literature. The fact that they were part of a largely public celebration seemed to enhance the sense of belonging and collective identity associated with their participation. Moreover, the festival has also provided opportunities for organisations such as libraries and long-stay care settings to impact positively on social inclusion through arts programmes that reached out to hitherto marginalised groups of older people.

The success of Bealtaine must be tempered by the fact that, currently, only a maximum of 20 per cent of older people get to experience it, up considerably in the past few years, but still not enough, given the potential public health gains from participation. This is largely down to resources and inertia in the public bureaucracy about the potential and possibilities of arts programmes for older people to impact on the health of older people. Some counties have a very small number of programmes, with little continuity from year to year. ARAs in some areas are still unaware of Bealtaine, especially in rural parts of the country. Some older people remain excluded from Bealtaine, even when programmes exist in their area. Participation rates among men generally and among very older women are particularly low across a whole range of arts activities. In that regard, the support of a vibrant and well-resourced local authority arts officer is very important for the widening and deepening of Bealtaine. There is also a perception among some groups that Bealtaine is a Dublin-oriented festival, arising from excessive centralisation of the arts generally in the capital city and the holding of key high-profile Bealtaine activities there as well.

The Health Services Executive has also been slow to recognise the potential benefits of the arts for the health and wellbeing of older people, notwithstanding the excellent work done by some organisers in day care centres and long-stay residential care settings. Health policy for older people in Ireland is dominated by a medical interventionist model that has biased provision and resource use towards care and cure. What this study tells us is that engagement with the arts carries considerable potential, though not easily measured, to enrich the life of participants across a variety of health-related domains. People have needs beyond the biological and the medical which, if met, may postpone or prevent some of the negative consequences of ageing that so dominates public policy. Of course we need much more information to support this viewpoint and it is important not to over-estimate the data from this study. What is clear is that future studies on health and quality of life of older people should recognise the importance of the arts and creativity in the lives of older people. Resources will not always be available to undertake arts intervention trials, or even before and after studies, but more work is needed to test for the complex relationships and transmission mechanisms between creativity, self-expression and health. The evidence is not yet compelling in regard to the gains associated with community-based arts interventions relative to other uses of scarce public resources, but acknowledging and investigating the potential of such interventions would be an important first step in encouraging the development of a more comprehensive database for practitioners and policy makers. Moreover, there are things that policy makers in Ireland could do immediately in respect of arts programmes for older people without the need for any additional evidence.

Policy implications

There is currently no unifying arts policy for older people in Ireland, which means that existing supports remain fragmented and inconsistent across sectors and regions. Responsibility for arts policy in the country is largely vested in the Department of Arts, Sport and Tourism and The Arts Council. However, older people are not referenced as a target group in the Department's Arts and Culture Plan (Department of Arts, Sport and Tourism 2008); similarly older people are not explicitly mentioned in the Arts Council's strategic planning documents (The Arts Council 2005a). This contrasts with the situation in Northern Ireland which explicitly states its commitment to the promotion of the arts among older people in its policy document (Arts Council of Northern Ireland 2007). In terms of legislation, local authorities are the organisations with most responsibility for broadening participation in, and access to, the arts, taking social inclusion into account. Unfortunately, the fact that the Arts Council has a written policy only for young people (The Arts Council 2005b) makes it more likely that local authorities will develop programmes for this group rather than older people. In those local authorities with the most active Bealtaine programmes, the arts officers either have a strong commitment to, or experience of, working with older people either in Ireland or abroad. Similarly, the Health Services Executive does not currently have an official policy on older people and the arts; initiatives where they exist again depend on the interest and resources of local health managers.

Public policy needs to impact more coherently on the wide variety of agencies with responsibility for the delivery of arts programmes and community-based health and education programmes for older people. To achieve this goal, overall responsibility for policy for the arts and older people should be given to the Office of the Minister for Older People, whose remit covers many different government departments and agencies, with new funding being made available to local authorities, health agencies and organisations involved in the production of integrated creative programmes for older people in a variety of settings. It will be very disappointing if the new National Positive Ageing Strategy for Older People, which at the time of writing (early 2011) is nearing completion, does not pay considerable attention to the role of creativity in enhancing health and wellbeing among older people. The results of this study suggest that additional investment in participatory arts programmes for older people will likely yield considerable public health benefits into the future.

Conclusion

Bealtaine is a major creative programme for older people in Ireland. Although occurring in May, the programme resonates all year round in some places and for some people. Bealtaine is now part of the creative landscape for many older people and their families and its effects are felt locally and nationally. Bealtaine impacts positively on the quality of life of older people affected by it and yields considerable social gains in terms of cohesion, connectivity and social capital. Our research confirms an increasingly held view that creativity in older age is a sustaining and sustainable concept that has the potential to enrich both individuals and society. Unfortunately, this view has not yet been recognised by an official system that continues to view public support for older people in terms of an illness paradigm rather than a health-enhancing framework. Older people are holistic beings with multiple needs that cannot be met solely through health and social care interventions. It is time, therefore, to recognise the importance of creativity in older age and to provide practical support to Bealtaine and similar initiatives through increased resources and funding. Simultaneously, more information is needed on the various pathways and transmission mechanisms between creativity in older age and improved personal and public health. In particular, we need more complex intervention studies to explore how creative expression and participation in arts programmes can enhance health and wellbeing for some people.

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Figure 1. Most important aspects of Bealtaine according to organisers of events.

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Figure 2. Impact of Bealtaine on older participants from perspective of organisers and participants.