Improv and Memory Care
It’s a situation we’ve all been in if you’ve cared for someone with Alzheimer’s: a loved one feels as if they need to go to an appointment or need to go to church to play the piano. We kindly and patiently tell them that they don’t have an appointment or it's not Sunday and instead of calming them down, it makes them more irritated and insistent on the need to leave. The person caring for them begins to lose patience and compassion as the person with dementia begins to spiral into a fit of rage. While this situation is a heartbreaking one, one like it can be avoided by using the foundational principle of improvisational comedy. This may seem a little surprising, but you may be amazed by some of the wisdom this goofy art form can give those of us who love a person with dementia.
“Yes,”
The first and most important rule of improv is known as “Yes, and...” This first means that you listen to what your scene partner says and agree with them. If your scene partner were to sit down and say “How long is it gonna take this waiter to get here?” and you reply with, “We’re not at a restaurant, we’re in church,” your scene has been undone by what you’ve said. However, if you reply “I know, we’ve been waiting for over an hour”, you’re communicating to your scene partner that you’re on the same page.
If you’re caring for a person with dementia and they tell you “I need to go home to let the dog out.” and you reply with “You don’t have a dog anymore, you live with me” you may be trying to help bring them back to reality, but it will likely just make them more confused and frustrated. They’ve spent all of this time getting their jacket on, putting their purse together, and finding their shoes to go home to let their dog out and you’re telling them that they’re wrong? How rude! However, if you’re able to agree with them, you do not undercut their whole reality and are able to get on the same level as them. You could try saying “I know your dog needs to go out around this time.” This is not telling them to leave, but it is validating their feelings.
“and…”
The “and…” part of “yes, and” is when you take what your scene partner has already told you and add to it. In the above example, if you were to reply to “how long is it gonna take our waiter to get here?” with “he’s probably avoiding you because you keep singing to him,” now you’re getting somewhere!
If you take the above example of a person with dementia saying “I need to go home to let the dog out” and you reply with “I know your dog needs to go out around this time. We have a dog walker coming by to take care of it. He’s all good, why don’t you have something to drink and work on this puzzle with me?” You’ve validated their reality, solved their problem, and redirected them to a calming activity.
While “yes, anding” someone with dementia may be a hard task, especially if they are your family member, overall it is a kinder, more productive way to treat them. Sometimes it may seem easier or it may seem like you’re treating someone better by telling them the truth of their reality, but to them, it’s confusing and disorienting. Taking a couple of cues from improv, we can improve our care for our loved ones. If you’re interested in learning more, this kind of thinking is also known as Validation Therapy, which was developed by Naomi Feil. We’ve included a great Ted Talk by her below, as well as a great summary overview.
https://www.youtube.com/watch?v=ESqfW_kyZq8&t=27s
https://best-alzheimers-products.com/validation-therapy-and-alzheimers.html
