Beyond Words and Western Frames: Participatory Arts-Based Approaches for Cross-Cultural Dementia Care Research

Dementia care research has been largely shaped by Western biomedical and cognitive paradigms that privilege verbal, linear, and memory-dependent methods of data collection. While these approaches have generated valuable insights, they also reproduce epistemic and ethical limitations, particularly in cross-cultural contexts. Linguistic dominance, culturally mismatched diagnostic and care frameworks, and reliance on caregivers as proxy informants can marginalize culturally and linguistically diverse communities and risk pathologizing cultural difference as cognitive deficit. In response, this conceptual paper advances a participatory arts-based framework for cross-cultural dementia care research that centers multiple ways of knowing beyond language. Drawing on principles of co-creation, shared decision-making, reflexivity, power-sharing, and relational ethics, the framework positions people living with dementia as collaborators rather than subjects. It articulates five interrelated dimensions: (1) modes of expression (visual, embodied, sensory, and performative); (2) forms of participation (co-design, co-creation, and co-analysis); (3) cultural situatedness of meaning-making; (4) relational ethics, including ongoing assent, trust, and reciprocity; and (5) intersectionality across culture, gender, migration, class, and caregiving roles. The paper illustrates how participatory arts-based methods, such as photovoice, body mapping, collaborative art-making, and sensory storytelling, can enable culturally resonant engagement across stages of dementia while addressing power asymmetries inherent in conventional research designs. By foregrounding embodied, sensory, and culturally grounded forms of expression, this framework offers a critical reorientation of dementia care research toward more inclusive, ethical, and culturally responsive knowledge production in diverse care contexts.