Abstract Over 25 years, research into participatory arts in dementia care has grown rapidly, yet dominant evaluation practices privilege positivist, outcome-driven methodologies. Such approaches fail to capture the ineffable qualities that make participatory arts encounters meaningful, for example feeling, atmosphere and imagination. These tacit, embodied forms of knowledge are central to artistic practice and to the experiences of people living with dementia, yet they remain marginalised within evidence frameworks favouring verbal, measurable and causal models. This oversight obscures the importance of meaning as constituted through social interaction, encompassing meaning-making, belonging, and relationality, which are vital to wellbeing. Drawing on findings from the IMAGINED project, we explore how participatory arts move beyond words, using dance, gesture and music to create spaces where shared meaning emerges between people living with dementia, carers and artists. We reflect on ethnographic insights of artists and arts organisations delivering dementia-related programmes in community and social care settings, highlighting how artists navigate and cultivate embodied and relational encounters. We present a new evaluation framework co-produced with people living with dementia, artists and arts organisations. This framework promotes reflexivity and co-production, challenges hierarchies of evidence, and supports the articulation of complex, relational and embodied meaning-making in arts and health contexts. This paper contributes a deeper understanding of the role of artists in co-creating meaningful experiences, improving our understanding of why participatory arts are important for wellbeing, how these complex processes can be articulated, and to support with future evaluation in this field.