Improv and Dementialand (aka There Are No Scripts in Dementialand)

I have a friend named Drew Dotson. She lives in Atlanta and performs at an improv  comedy theater. Not only does she perform improv (and does so amazingly well), she teaches improv. If you’re not familiar with improv, think of Whose Line is it Anyway, only the Drew I’m talking about is more impressive than Drew Carey.

Drew also has a family member with dementia. It was during a conversation with her that I came to see a connection between improv and dementia. To be fair, I can’t take credit for that realization. I think Drew actually said, “Dementialand sounds a lot like improv.”

I did some thinking. I pictured Drew and I traveling around the country doing trainings for dementia care based on principles of improv. I was thinking of all the hotels we’d stay at, the free continental breakfasts we’d share, the bonding time and snacks we’d have on the road as highly sought after public speakers….

A day later I Googled “dementia care and improv.”

Bubble burst.

Unfortunately, or maybe fortunately, the idea wasn’t unique. In fact, there’s a TedTalk out there on the topic:

It’s the TedTalk that Drew and I could have done had we had our conversation a bit earlier–but that’s okay. The bit of information out there linking improv to dementia care has helped me to understand why spending time in dementialand has been valuable for me…and made me a better person.

As dementia progresses, interactions with people can become more unpredictable. I have had to let go of my expectations of that interaction, just like you have to enter an improv scene without expectations of where the scene might be headed.

This is very much in contrast to the rest of my day, which is often taken up by university meetings with agendas emailed out in advance. At work meetings, I am known for efficiency. In fact, a colleague once mentioned to another colleague that I was “brusk” during meetings. I probably should’ve been insulted, but I took it as a compliment to my efficient nature. We stick to the agenda. We get through the agenda. We conclude the meeting.

Visiting dementialand means dropping any agenda at the door. It means letting go of any expectations of what will be accomplished during the interaction. I’ve even started to think of interactions with people who have progressed dementia like scenes in improv theater. I am participating in the scene, as is the person with dementia. I cannot allow myself to dictate the scene.

Just like in improv, all players have to have equal status–even if some of those players have limited verbal communication skills. I can’t write the script in advance. If I try to do that (and I have), the scene usually turns into a disaster. There are certain areas in my life where I lack flexibility. Dementialand is not one of those areas. You don’t survive in dementialand if you are rigid and inflexible person.

In my limited knowledge of improv, I understand that the first rule is to SAY YES! Don’t say no to a suggestion. Agree. Go with it. Wherever the scene goes, you follow. As a college professor, I often have to keep a class on track during our class meeting time. I have to judge whether or not where I think the students are headed on that particular day is useful for their learning. And then I might have to right the ship. I can’t always say yes. I can’t always go with it. Back to the agenda, so to speak. I also have to correct and clarify any information from other players (in this case, students) that might be factually inaccurate. Dementialand is different.

Case in point…I was spending time with a group of people with moderate dementia last week. We were doing an exercise where we were trying to name different types of flowers–an exercise that was dictated and moderated by me.

And then, out of the blue, this conversation evolved:

Person #1: I have a question for you. Do you take calcium pills?

Me: In fact, I do. I take one every morning.

Person #2: On TV they said that calcium makes your bones break.

Me: I hadn’t heard that. I’d better be careful then. I’ve taken them for a long time now.

Person #2: Don’t ride your bike. A car will hit you.

Person #1: Not always. You don’t always get hit by a car when you ride your bike. I know people who ride their bikes and never get run over.

Person #2: ALMOST always though. Maybe not ALWAYS.

Person #1: Then don’t ever ride your bike, Elaine. We love you and don’t want you to break.

It was the nicest thing anyone had said to me all day. Maybe all week. If I had tried to dictate the scene and make them continue to list types of flowers, I never would have heard it.

Sometimes when I ask a question in dementialand, I don’t get an answer to that question. Sometimes I get information that is tangentially related to the question I asked; sometimes I get information that is completely unrelated to the question I asked. If these were answers to my college students’ essay questions on an exam, they wouldn’t score well. I would be handing out loads of Ds and Fs like candy. But this is dementialand; not a college class. The rules are different. My role is different.

I have found that I learn the most when I listen, really listen, to the response to a question I ask someone with dementia–even if the response isn’t actually an answer to my question. I need to let go of my question, which I often realize wasn’t all that important anyway.

When I ask someone about their wife and they tell me about their dry skin, that’s not a fail. When I question someone about whether they are enjoying the weather and they tell me about their brother who died in the war, it’s okay. Sometimes I ask a question and get an answer that is based on their reality rather than my reality. In other words, their answer makes no sense to me. I’ve learned to roll with that rather than allow it to end the scene.

In fact, sometimes the conversations that make the least sense are the most fulfilling for me. I had a great conversation with a guy with younger-onset Alzheimer’s a few weeks back about the drawstring on his pants. He seemed to think they were worms and snakes crawling out of his stomach, although he wasn’t at all bothered by them. Then he pleasantly warned me about the bugs that he could see crawling around under my scalp. (And yes, I was somewhat itchy the rest of the day.) The connection happens when I tune in to what someone wants to tell me rather than trying to script the conversation.

When you follow improv rules in dementialand, dementialand becomes a more positive, rewarding place. It makes interaction easier for those with dementia, but (and I’m being selfish here) it also makes things a lot for fun for me.

2 thoughts on “Improv and Dementialand (aka There Are No Scripts in Dementialand)

  1. Really helpful to see this written out, Elaine. I’m more of the organized, agenda-based type, but am finding that relaxing into the day at hand is much better for both my spouse and me than clinging to whatever the plan was. Things still get done, but the atmosphere between us is greatly improved, which affects everything. Thanks for exploring this so nicely.


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