Using Improv with Dementia, Part 1

Improvisational theater, or improv, is where the dialogue, action, story, and characters are created collaboratively by the players as the improvisation unfolds in present time, without a script. Sounds a lot like real life, doesn't it, where we don't have a script and we make up the conversation as we go along. It is actually a lot like dementia caregiving too, where the LO lives always in the here and now, and the caregiver doesn't know what will happen next. Just as with improv, caregivers have to take what's offered and run with it. We don't get to chose WHAT we get, but we can choose how to react.

The following video compares improv acting to working with dementia. They talk about Alzheimer's but it works with LBD too.

 from TEDMED

When your loved one presents you with a hallucination, a delusion, or a false memory, what do you do? In improv, there are some guidelines. It doesn't take much adaption for them to work for caregivers too.

Listen. This is the first requirement. Easier said than done, especially when LO's reality doesn't match yours. Take a deep breath, and just listen. Listen with your ears, eyes and heart. Be especially careful to "hear" the emotions involved. People with dementia become driven by their emotions.

Say "Yes, and..." That is, agree, in action if not in words, and add something non-conflicting that moves the action on. An improv actor accepts what's offered and goes with it. When Annie saw children coming out from behind the TV, Jim let his actions show that he accepted Annie's reality when he looked to see where the children were coming in, and then he moved the action on by ushering them out the door.

Accept the reality given to you. Your LO's reality is the only one that counts. Don't explain, defend or argue for YOUR reality. This is not YOUR play, you don't get to set the scene; your LO does. When Jake's wife accused him of infidelity, he didn't defend himself. She had set the scene and cast him in the role. Like a good improv actor, he went with the flow and told her, "I'm sorry, I won't do it again."

Be in the moment. Improv is all about what is happening this minute--and the feelings involved. So is dementia. Your LO lives in the here and now. When Jake's wife accused him of infidelity, he knew that all that mattered was that moment, when his wife was fearing abandonment, and voiced it her delusions. It didn't matter that they'd been married for 50 years and he had never been unfaithful. That's in the past. He knew that she could only deal with right now. And so he entered her reality and then, like Jim with the children, ushered out her fears, "I won't ever do it again."

Focus on the emotion. A lot of acting involves making emotions believable. As dementia progresses and thinking becomes more difficult, it is replaced with a focus on emotions. If you, like Jake, pay less attention to the words and more to the feelings that led to them, you will probably be more successful.

This isn't all! Next week's blog will be about some more ways that we can use improv acting guidelines with dementia caregiving.

For information about Lewy body disorders, read our books:
A Caregivers’ Guide to Lewy Body Dementia
Managing Cognitive Issues in Parkinson's and Lewy Body Dementia

Helen and James Whitworth are not doctors. As informed caregivers, they share the information here for educational purposes only. It should never be used instead of a physician's advice.