Despite steadfast interest in the use of arts therapies (ATs) with individuals who have dementia of the Alzheimer's type (DAT), a systematic review of the literature has not been conducted. This paper aims to critique this evidence base, including music, visual arts, drama, and dance/movement therapies between the years 1990 and 2010, and make suggestions on how it can be strengthened. The review addresses four questions: (1) What is the focus of the empirical base on using AT with persons who have DAT? (2) (How) have these studies been designed and evaluated? (3) What findings are reported? (4) What does this tell us about the potential of AT for enriching the lives of people with dementia? This analysis reveals that systematically designed, documented, and evaluated AT studies are scarce. Information on research design, operational concepts, measurement tools, and methods of evaluation/analysis are vague, if provided. Disagreement exists about the utilization of theoretical concepts and measurement/evaluation tools. The evidence base is further divided between studies focusing on the ‘product’ versus the ‘process’ of art. Shortcomings in dementia-specific research include a paucity of accounts from participants, failure to extend therapies to individuals in the early stages, a lack of application to those living at home, and often superficial attention to the meaningful aspects of doing art. Models investigating subjective well-being, or ‘enrichment,’ rather than objectively measured biomedical approaches privileging the management of deficits, would expand the evidence base and help ensure that those with dementia receive the services they want, since strictly allopathic methodologies will continue to fall short of adequately evaluating what are deeply idiosyncratic psychosocial issues.

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Alzheimer's disease (AD) is a stigmatised condition popularly assumed to be a death sentence for diagnosed individuals. Consequently, people with AD are often deemed incapable (and perhaps unworthy) of contributing to the social discourse surrounding their illness experience. Data from qualitative interviews with 18 people diagnosed with the potential precursor of AD known as mild cognitive impairment (MCI) are examined. Using grounded theory methods, analysis revealed overarching themes of uncertainty concerning definitions of memory loss, MCI, and AD as well as distinctions between normal ageing and dementia. While this confusion over the terminology and prognosis mirrors the lack of scientific consensus about nosology and appropriate treatment regimens, such ambiguity creates social and psychological tensions for diagnosed individuals. Arguably, participants' unequivocal fear of and subsequent desire to differentiate their experiences from Alzheimer's, however, stems from the exclusively negative social constructions of AD. Drawing from Goffman, these findings demonstrate the psychosocial impact of 'framing contests' and how 'courtesy stigma' can apply not only to associated persons but also associated conditions, such as MCI to AD. Given the underlying nosological creep -or medicalisation -of the recent diagnostic guidelines proposing two new predementia stages, understanding the illness narratives of MCI is critical.

Findings suggest that the nursing home environment in these two facilities, as now structured, is an inappropriate setting for end-of-life care.