A Case for Adult Coloring Pages and Pre-made Images in a Long Term Care Facility

Anne Cameron Cutri

            I work as an assistant activities director at a long term nursing and rehabilitation facility. There, we have patients who have blindness, have had a stroke, have various degrees of cognitive loss, intellectual disability, mental health issues, physical issues, brain injury, stroke and many others. With an BA in Art Therapy and a year’s worth of graduate Art Therapy courses, I try to approach what I do with at least wellness and coping skills in mind, including sensory driven activities for the memory challenged.

            I have acquired quite a collection of adult coloring books. Mind you, not all coloring books are created equal. With the recent craze and the misused claim that it is art therapy, there has been some controversy around the subject. I have to say that I had similar reactions when I read peer reviewed articles analyzing pre-drawn mandalas and color usage, through computer software, evaluating mental state. I have read Jung and know the value of creating one’s own mandalas, and the balancing gestalt from doing so, as well as fleeting emotions and color choices. Any well-trained art therapist knows you don’t assess a person by one drawing.

            But when approaching adults with various backgrounds, some little more than an 8^th grade education, or dealing with the use of one side of their body, or someone who is highly creative, but doesn’t have a strong hold on what is considered normal reality—it’s quite a challenge. To come up with dignified art activities that are therapeutic; in the sense of giving the patient joy or pride in what they do, as well as tenderly nudging coping skills, is difficult. These populations are not separated by diagnosis, they are all together, separated only by areas of the facility.

            At any given time, scheduled activities may be effected by the area that they are given.   Most areas are a thoroughfare of travel for nurses, visitors, OT, PT, housekeeping and their loud buffers, who are moving from one wing to another. Needless to say, it can become very distracting. Nurses may interrupt with medication, or the patient may have discomfort because of their condition. Almost all the patients need assistance in completing certain tasks. So I have come to rely on coloring pages or images I have drawn myself as a starting point to more challenging activities. I like the Dover publications quite a bit, because often there is information about the images, and lends itself to discussion and reminiscence. For instance, the “Language of Flowers” coloring book, is an example. The flower images and their meaning led an room-bound patient down memory lane to her own garden. It prompted her to have a lengthy discussion about it, wanting to color those pages. These images also can be used as reference images for others to create a painting from, or to stimulate ideas.

            An 11 x 17 pre-drawn outline of a tree, that can be photocopied and mounted on poster board, was a start for another project. Using pre-cut colored paper shapes, patients have created paper mosaics to fill in the tree, along with affirming words or symbols collected from magazines, to create a positive visual reminder for them.  I have used a graphic of a 12 pointed star, enlarged to fit a 12” round cardboard. This was my measuring instrument that would later be used for a woven mandala tapestry. Another time we filled in a simple outline of stained glass- type images with colored rice. I have copied hundreds of images from coloring books, or free online pages for the residents. Many not only very skillfully color the pages, they add to them. One patient, in her eighties, shows tremendous concentration and stamina coloring mandalas and designs for hours and hours in the activity room. Her color choices are wonderful, and it gives her a purpose and a focus. Another elder, adds to the images, making spiritual meaning of each one of them, adding words and quotes.

            The point is that, it is a question of intent. My intention is to bring meaning, purpose, joy and a sense of accomplishment to the patients. As well, I want them to understand the power of the creative impulse, and the creative act as a way to overcome obstacles. Coloring pages or my own pre-drawn outlines, give them a safe place to start to explore. These steps build on themselves, getting the patient closer to taking a risk to paint, draw or create a collage without a pattern. Then the true magic of the imagination can begin to unfold.