Dementia and Improv
It seems a strange combination at first. Dementia and improv? What does the loss of memory have to do with the type of comedy based on making things up on the spot?
It turns out, quite a bit. In recent years people have discovered that the combination of dementia and improv can prove really helpful for both seniors and caregivers. Many of the features that define improv comedy can be put to good use when dealing with loved ones struggling with Alzheimer’s and other forms of dementia.
How Improv Works
Improv is a form of comedy based on improvisation. The goal is for everyone in a troupe to play off of each other in ways that are supportive and make it easy for the other people to continue the scene (ideally while always being funny).
To help people internalize the best methods for keeping a scene going and supporting your fellow troupe members, comedians have developed several rules of improv. Here’s a taste of some of the most important:
- Say “yes, and…” This doesn’t literally mean to say those words, so much as always accept the premise set up by your fellow players and keep it moving forward.
- Don’t block. Don’t ever deny the premise and stop the action.
- Don’t ask questions. Questions make your partners do more work to fill in the gaps. You want to do the work to make it easy on them, rather than making them do more work.
- Focus on the here and now. Keep your attention entirely on what’s going on in the scene you and your partners have created.
Maybe as you read through that list you started to gain some idea of how improv tenets can be applied to working with dementia patients.
Why It’s Helpful to Dementia Patients
Patients with Alzheimer’s and their family members are often told that they should work to keep their minds active, but knowing just how to do that proves challenging. A growing number of organizations and assisted living facilities have seen the potential in improv rules to both help dementia patients keep their minds active, and give them some time off from feeling the effects of the disease.
A lot of it comes back to the importance of focusing on the “here and now.” When you think about it, we spend so many moments in life focused on the future or the past. For someone struggling with memory issues, being given a space to be fully in the present is a gift.
Improv provides seniors with an opportunity to be creative, have fun, and do it all in a fairly pressure-free environment. They may not remember the fun they had afterwards (although family members can make a habit of reminding them to give them a chance to relive it), but in the moment they get to enjoy some carefree entertainment.
Improv won’t help slow the progress of the disease or reduce its effects (at least we don’t have any evidence that it does), but as long as we don’t have a cure for Alzheimer’s, the best thing caregivers and loved ones can do is work to make every day someone lives with the disease as good as it can be, in spite of the difficulties. Researchers have found evidence that improv does actually help with that.
How It’s Useful to Caregivers
Speaking of living with the disease, patients aren’t the only ones dealing with the symptoms of Alzheimer’s every single day. Caregivers and other loved ones are challenged on a regular basis with situations that are hard to manage effectively. Over time, caregivers learn tips and techniques for responding to their loved ones’ confusion and fits in ways that (hopefully) manage to minimize how upset their loved one becomes each time, and that help keep the task of caregiving from becoming too overwhelming and draining.
But getting to that point is hard. For most caregivers, it will feel like a nearly constant uphill battle. One woman with prior experience in improv, once she was tasked with taking care of her mother after an Alzheimer’s diagnosis, realized she could put the skills she’d learned from her improv comedy experience to use in communicating with her mom.
In an interview on This American Life, Karen Stobbe describes how being an improv comedian equips you with a lot of practice stepping into someone else’s world and figuring out how to play along – something many caregivers realize (often slowly and after much difficulty) helps make conversations with a loved one who has dementia much easier and more pleasant for all involved.
Click play to listen to the interview:
When your loved one mentions siblings that aren’t around anymore, you don’t have to say “actually Charlie passed a few years ago” – it’s better to instead play along, “I think your brother’s busy today, why don’t we go to the park instead?”
When your loved one is living within a world of memories, reminding them someone they love has passed means they either experience the grief all over again, they’ll think you’re lying to them, or they’ll think you’re calling them a liar. All of those are eventualities that make an already fraught moment worse. If you instead use the moment to start a conversation about whatever’s on their mind, you can nudge them away from the frustration and distract them from whatever they felt they needed to do to begin with.
Some people may feel a little uncomfortable with this at first, as if you’re being dishonest with your loved one. Over time you’ll realize that talking to them this way creates a better experience for both them and you, which will ultimately make the approach feel more moral than hitting them with difficult (old) news over and over again.
How to Get Started
If you’re a caregiver or staff member at a memory care facility, you can review the tips and resources on Karen’s website In the Moment to help you incorporate improv principles into your dealings with an Alzheimer’s patient.
If you think improv would be a great experience for your loved one, it may take a little work to get them started. Some cities already have improv troupes for seniors with dementia, so try doing some web searches to see if anything turns up in your area. If there’s not one already, you can see about putting one together.
If your loved one is currently in an assisted living or nursing home, talk to the staff about bringing in an improv troupe to work with the seniors and ask around town to find one that’s interested in helping out. If they still live at home or with you, you might still tap into the local assisted living homes for a potential interested community that can try out improv with your loved one.
Improv won’t remove the challenges that come with living with dementia, or with living with someone with dementia, but it can help make days a little easier and more enjoyable for each of you. That alone makes it worth trying.