Identifying the Creative-Expressive Abilities of People Living With Dementia

The Creative Expressive Abilities Assessment (CEAA) Version 5.

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Dalia Gottlieb-Tanaka and Hilary Lee co-developed the Creative Expressive Abilities Assessment (CEAA) tool in 2008, which was the first comprehensive observational tool specifically designed to assess and show changes in the creative expressive abilities of people living with dementia. The tool evaluates the effectiveness of creative programs such as art, music, dancing, singing, reminiscence and storytelling. It successfully shows positive changes in abilities when seniors living with dementia participate in meaningful creative expressive programs.

The authors were convinced that one vital reason why the value of creative expression programs continued to be underappreciated stems from the lack of an easy-to-use instrument for collecting solid quantitative evidence concerning the possible positive effects art programs provide. We wanted to demonstrate the value of these programs, to identify and track changes over time and to justify the existence of these programs when resources are scarce.

 All Photos Courtesy of The Society for the Arts in Dementia Care

The tool was developed using standard psychometric techniques while reflecting in a descriptive language, as well as a quantitative score, how people with dementia can creatively express their emotions, thoughts and experiences when offered creative arts programs as a catalyst for communication as well as other abilities.

Observations can be conducted by assigned observers, or by program facilitators. They can be documented using pencil and paper for scoring or enter the scoring directly into digital forms provided with the CEAA tool’s guidebook on a USB stick.

It can be conducted as often as activities occur and take place before any program is implemented to get baseline data.

Program facilitators can observe clients’ creative abilities in a systematic way and monitor any changes over time.

The tool provides valuable and insightful information with specific details for reporting in meetings with colleagues, administration and families.


The tool is helpful in assessing the abilities of new clients. Facilitators can use the CEAA tool to monitor sessions and evaluate their effectiveness.

It also guides in planning activities that are meaningful for each client. Administrators of care facilities can compare the impact and effectiveness of various programs.

The data serves as a complementary information source for medical reports and assists in planning budgets for effective and meaningful social programs as well as finding the right facilitator for a specific program.


The CEAA tool was designed for distance observation right from its inception to answer unique needs in remote locations in Canada and elsewhere.

This attribute became important especially during covid-19 pandemic which restricted interactions with vulnerable older adults. Detailed planning prior to videotaping participants is crucial and it is outlined in the CEAA booklet.


Dalia Gottlieb-Tanaka, B.A, MArch, PhD. Dalia is a graduate of the Bezalel Academy of Arts and Design in Jerusalem, Israel, has a Master of Architecture degree, and a PhD from the University of British Columbia, Vancouver, Canada. She founded the Society for the Arts in Dementia Care in 2005. Dalia continues to conduct research, deliver presentations and hold workshops internationally on the use of visual and performing arts in health care services for people living with dementia. Contact her at: 


Hilary Lee, OTRMSc.  Hilary has a background in occupational therapy and dementia research and is a global pioneer in dementia rehabilitation. She established a chapter of the Society for the Arts in Dementia Care in Australia after connecting with the Society in Canada. Since 2007 Hilary has served as President of Dementia Care International, the independent organisation that has developed the Spark of Life Model of Care implemented on 5 continents, for which the CEAA forms part of its systematic evaluation process. Contact her at:


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