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Using Humor to Combat Dementia

Seriously funny: How a comedian breathed new life into a fading Alzheimer's patient

Comedian Sue Ball (right) works with Muriel Klein (left), an Alzheimer's patient, through a program called Laughter on Call at Silverado Beverly Place in Los Angeles, California February 17, 2018. Muriel's daughter Dani Klein Modisett (center) joins in

Brinson+Banks

Dani Klein Modisett (middle) with her mother Muriel and Sue, a comedian who works with Alzheimer’s patients.

En español | My mother’s adjustment to the left coast, after spending most of her life in Manhattan, went more smoothly than anyone expected. Despite her struggle with Alzheimer’s, the first 10 months at her new senior residence in Los Angeles went off without a hitch. 

Then around the one-year mark, something changed. I’d show up and find her sitting away from the group, her head dropped to the side, surrendered to the forces of gravity and a desire to sleep. When people talked to her, she looked blankly into the distance. She had lost interest in food, one of her great passions. I started to doubt my decision to uproot her from the Upper West Side.

I knew there were senior services that provide companionship — programs with names like Visiting Angels, Senior Helpers and Good Company Senior Care. But I wanted something else for my 84-year-old mother. I wanted someone who could make her laugh. I was a professional comedian for years, but when she looks in my eyes, she just sees a daughter she can’t communicate with anymore. I took to social media. “Looking for a funny person with an interest in geriatrics. Paying gig. Part time,” I posted. Within minutes the phone rang, a friend from New York. 

“Call my friend Sue. She’s a comic — was, she’s kind of over it now. She wants to work with seniors.” I phoned Sue immediately. She has one of those rare voices, equal parts warmth and candor. We made a date for her to meet with my mother. 

Introductions

“Mom, this is Sue,” I said, steering her wheelchair so we could sit close together. 

“What’s up, Muriel?” Sue asked. My mother stared ahead. Without missing a beat, Sue moved to make eye contact with her. My mother looked away. 

“You don’t want to talk, do you, Muriel?” Nothing. 

“I get that.” Sue said. “Some days I don’t want to talk, either. When someone gets in my face I think, ‘Schmuck, do I look like I want to talk?’ ” 

My mother turned her head back to Sue and smiled. Sue repeated herself, this time with a little more moxie. “Schmuck, do I look like I want to talk?” 

My mother smiled even bigger, then laughed and blurted out “schmuck!” like a kid getting away with something. She looked at Sue for a reaction. Sue laughed heartily and then, like any comedian, topped her. “Hey, schmuck! Do I look like I want to talk?” she asked, bigger, like a character from The Sopranos

“Schmuck!” my mother yelled back, laughing so hard she almost couldn’t get the word out. I looked around, feeling slightly self-conscious by this schmuck-off: Maybe people nearby wouldn’t appreciate it. Except the two of them were having so much fun. 

A comedian. What a perfect fit for this job. Who better to be in the moment, to draw someone out and, after years of dealing with hecklers, be undaunted by the volatility of a person in the grip of Alzheimer’s, a brain disease with no known cure that affects some 5.7 million Americans? 

They paused to catch their breath. “You want some water?” Sue asked my mother, holding the glass toward her. She nodded. Sue held it up to her lips. I turned my head, catching a tear with my finger — not so much from sadness, but from one of those Oprah “Aha!” moments. It suddenly became clear that when rational thought, memory and language are gone, the only thing we have is the present moment. And the greatest gift you can give anyone in this state is to do your best to fill the moment with laughter. 

I hired Sue to work with my mother for 10 hours a week. Within days of meeting Sue, she started eating again. Even during the hours that Sue wasn’t there, my mother was more engaged with people, waving hello and reaching out for contact with the aides and other residents. She started singing, not actual lyrics, but crooning and smiling. It was nothing short of remarkable.

About a month ago when I was walking down the hall for a visit, I heard Tony Bennett’s “I Get a Kick Out of You” blaring from my mother’s room and then Sue’s distinct voice. I silently peeked in without them seeing. There was Sue, dancing a kind of solo waltz around my mother. 

“What do you think, you like my dancing?” she asked my mother.  

“No,” she shot back. Warm and fuzzy was never her style. 

Sue slowed down her movement and looked at my mother. “Wow, that hurt my feelings, Muriel,” she said. 

And then I heard something that sounded a lot like my mother’s voice. “I’m sorry.” 

“That’s OK,” Sue responded. “I know you didn’t mean to.” 

“No,” my mother said. Startled by this exchange, I forgot I was supposed to be hiding. 

“Oh, hey,” Sue said, seeing me outside the doorway.  

“Hi,” I said. “My mother just said she was sorry to you.”

“Yeah. Yep, she did. Right, Muriel? Only took four months, right, Mutz?” (Mutz is Sue’s nickname for Mom.)

“I don’t think I’ve ever heard her say she’s sorry about anything.” 

“See that, Mutz? You can teach an old dog new tricks!” 

“Old dog,” my mother said, laughing. “Old dog,” she said again. 

“Yep, we’re a couple of old dogs, you and me,” Sue said, laughing with her and then leaning over to kiss the top of her head. “Yet I get a kick out of you!” she sang. 

Seeing this relationship blossom over these months — held together by gales of laughter — has convinced me that so many people, at every stage of life, could use a person with the gift of wit and timing to spend time with, to show them it is still possible to be moved to laughter. To feel, if only for that brief moment of joy, that they aren’t done yet — and that’s a good thing. 

Dani Klein Modisett has launched Laughter On Call to match Alzheimer’s patients with comedians.


Comedian wearing clown nose and playing music entertains Alzheimer's patient

The Humor Foundation

An Elder Clown entertains a nursing home resident with dementia in Sydney, Australia.

The Healing Power of Humor

Humor therapy can be as effective as some drugs in managing agitation in dementia patients. That’s according to research at the University of New South Wales in Australia. The study examined the effectiveness of professional humor therapists, called Elder Clowns, who work with nursing home staff trained in the practice, called Laughter Bosses. They performed weekly humor sessions with individuals and groups of patients, using methods based on improv comedy — much like Clown Doctors, who work in children’s hospitals to lift the mood of the patients and increase interaction.

Another published study conducted at the Osaka University Graduate School of Medicine in Suita, Japan, found that the positive effects of humor can last for weeks after a therapy session.

As dementia patients lose cognitive function, they lose the ability to laugh and smile, especially as a tool of social communication. But some types of laughter are preserved. As the Japanese study explains, some dementia patients will smile or laugh after sleeping well or having a good meal. They also respond with laughter or smiles when they reach a goal or their accomplishment is recognized.

But those with dementia can feel offended by humor, too. Alzheimer’s patients may have a heightened sensitivity to jokes, since they know that they have trouble understanding some things. While you can aim playful put-downs at your friends, a person with Alzheimer’s will likely find such humor humiliating or stigmatizing. — Andrea Cwieka

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