How Improv Informs Dementia Caregiving

Video Version Here

 

In the middle stage of his Alzheimer’s disease, my husband, Harvey, would often rummage through our file cabinet, taking out important statements and marking them up with underlining or circling. I would come home from work, gather the papers that were scattered around the house, reorganize them, and file them back. When that behavior continued, I changed the lock on the file cabinet. However, I realized that Harvey’s “paperwork,” as I called it, had given him a satisfaction that I had now taken away. Then, by bringing home blank forms and charts for him to mark up, I entered into his world and employed a more creative and kinder solution.

 

About this time, a friend and I attended a workshop led by a woman who performed improv and was the primary caregiver to her mother who was living with dementia. It was a fresh way to look at interactions with our loved ones, and it’s how I began to think of my creative solutions to problems—as improvisations.

 

The foundation of improv is learning to use, “Yes, and…” statements instead of, “Yes, but…” Think about it, or better yet, try it out. In conversation with someone, try replying, “Yes, but…” and continuing your response by countering their statement. Then substitute that for, “Yes, and…,” and you’ll find that the conversation flows much more smoothly. “Yes, but…” statements put up a roadblock and halt the back and forth we need in casual conversation.

 

I feel like an example here may be helpful. The first statement given below is countered by a “Yes, but…” reply, and the exchange quickly spirals down to nothingness when our responder only uses this type of reply.

 

“Birmingham is a lovely city in the spring.”

 

“Yes, but summer is almost here, and the heat will be oppressive.”

 

“Yes, and air conditioning is a blessing!”

 

“Yes, but my A/C unit is really old, and if it breaks, I’ll be miserable.”

 

While not necessarily employing “Yes, and…” statements verbatim, professional improv players take this principle and apply it to any statement or situation thrown at them. Instead of dismissing a ludicrous premise, they “go with it.”

 

When we apply this technique with our loved ones living with dementia, it gives us a chance to change our initial reactions and words in response to theirs. Our impulse to say, “Yes, but…,” then list why what they said was wrong, can give way to an improvised response.

 

There is a host of reasons why persons with Alzheimer’s say or do things that are way out of the ordinary. They may have lost their filter, and say whatever pops into their heads. They may be responding to a situation they do not understand, so they create inaccurate assumptions and accusations.

 

When we counter our loved ones’ outlandish statements with correction, that only serves to escalate their anger, confusion, or frustration. How much better for us to improvise a kind response.

 

For example, if your loved one requests to go home, the  accurate response may be, “But Mom, you sold your home years ago.” Now, it may be true, but chances are, she doesn’t remember that, and your response only serves to cause her pain as she faces this “new” information.

 

How much better to improvise a kinder reply, “Oh, Mom, your home is so lovely! I always enjoy visiting. Tell me about the tree in the front yard again while we get some ice cream.” For a prior blog post addressing the caregiving principle, “It’s better to be kind than correct,” click here.

 

Improv can teach us to stop, enter the world of a person living with dementia, and think of a kinder and more creative response.

 

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