A Little Improv Can Go a Long Way with Dementia

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Credit: Tom Magliery

Most days, dad sleeps a lot. But today, he’s wide awake. He’s on the phone, yelling at me. He’s so angry, but there’s sadness in his voice, too. “I don’t have any money, I don’t have a car. I don’t even have any shoes,” he tells me. “And I’ve got to go down and see mom and dad.”

Now, my dad is 92 and his parents have been gone for decades. He has money in bank accounts that he doesn’t remember how to access, and he has a car he’s no longer able to drive. These days, his shoes mostly stay in the closet. He wears his slippers when he has the energy to walk down to the dining room to eat with his friends Leo and John, or when he gets the urge to bust out of the skilled nursing wing where he lives. He heads straight for the locked doors until one of his caregivers redirects him.

I can sense his frustration as the dementia that grips him continues to increase. Confusion rolls in like a fog. Words fail him. And I imagine he just wants to find something familiar that he can hold onto. Since my mom died two years ago, he’s become unmoored, slowly drifting farther and farther away. After being together for 67 years, he can’t get used to being alone.

Sometimes when I call, he tells me of his plans to marry a nurse or one of his aides. “We’re having the wedding before the end of the year,” he’ll say emphatically. “So you better hurry up and get over here.”

Since we are so far away from each other, the phone is our main means of communication. Often, the sound of my voice calms him down, but today it’s not working. Nothing I say helps. I feel useless and small. I shut down and he rails on. I’m reminded of when I was a little girl and he would get angry. I would close my eyes and picture him as a giant bear or a roaring lion. Strong. Powerful. Now the dynamics have shifted, but I can’t always process the change I’ve made from daughter to caregiver. Even though I know I’m a grown woman and he’s an old man, I still have to push down my fear at his words and his reproach, and remind myself he’s the one who feels powerless now.

Suddenly, the conversation takes a turn. “Did you even know that I won $8 million?” he demands.

I tell myself not to argue with him. And I try to remember to treat it like improv. Yes, I mean improvisational comedy, the form of live theater where the storyline, character and dialogue are made up in the moment.

I’m a big fan of the hilarious Tina Fey, creator of the sitcom 30 Rock and so much more. In her memoir, Bossypants, she lays out some cardinal rules for improv comedy. I’ve discovered these guidelines can also help when communicating with someone you love who has dementia. In both situations, you try your best to work with the situation you’re given, no matter how crazy it may seem. The end goal: Understanding, connection, and if you’re lucky, a little shared laughter.

Rule number 1: “Agree. Always agree and say yes.” Tina Fey notes that in the real world you won’t always say yes to everything. And that’s true with someone who has dementia, too. But yes is often better than no. It does no good to argue whether or not your dad has really just won $8 million when he tells you so. He believes he has. In improv, the rule of agreement reminds you to “respect what your partner has created” and to at least start from an open place. “Start with yes and see where that takes you.” Maintaining respect for your loved one with dementia and staying open to what they’re saying goes a long way.

Rule number 2: “Say yes AND …” In improv, you’re supposed to not only say yes, but also add something of your own. This idea of contributing and “staying in the scene,” really staying present in the conversation, also helps with someone who has dementia. Say dad is still talking about winning that $8 million. Instead of trying to force him to realize his belief is untrue, ask him what he would do with the money.

Rule number 3: “Make statements.” This is a positive way of saying don’t just sit around raising questions and pointing out obstacles. Whatever the problem, be part of the solution. Instead of insisting that there’s no way Dad hit the jackpot, now imagine what you would do if you won that kind of money. Tell him about it.

Rule number 4: “There are no mistakes, only opportunities.” Things don’t always go your way in improv and you have to learn to be flexible and adapt. Dementia? Same. Sometimes, the “news” of Dad winning $8 million leads to a great conversation about his capitalist hopes and dreams. Other times, you end up getting accused of stealing his shoes.

Having a parent with dementia can feel a lot like the movie Groundhog Day. Events are likely to repeat themselves. So when things go wrong, I try to keep my sense of humor and remind myself that chances are, dad and I will have this talk again soon. And at least then, I’ll have another opportunity to get it right.

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197 thoughts on “A Little Improv Can Go a Long Way with Dementia

  1. I really liked reading this; my mother also had dementia and I was her main caretaker for about five years. She only went into the nursing facilities after a bout in the hospital, once for pneumonia and another time for a deep vein thrombosis, running the full length of her left leg. Those were two times that I actually had a small break from the job of caretaker although I still felt compelled to go visit her often.
    It will be one year since she passed away this coming July 23.
    I am so glad I also “humored her” and would use the Improv technique as well, after I realized there was no sense arguing with her or trying to force her to see a reality that she did not see. We just let her talk and added a few words to the conversation that kept it going along.
    I am so glad for what I did for my mom; I have no regrets.
    One thing I felt was my “duty” was to help her maintain her dignity when she couldn’t do it herself. I thought, if I was in this situation, what would I want my daughters to do for me. Of course, her hygiene was a really big one. I put her make up on her everyday and fixed her hair so she looked okay. Mom always looked nice and as she forgot that this was an important thing to her, I kept that up. The thing that “saved me” was taking her for daily car rides. It was easier to talk to her as we were driving around for some reason. She LOVED to get out in the car and there were regular places we’d go to and drive past. It was nice when she remembered the familiar sites.
    Yours was a wonderful post. I loved the theme you chose of the Improv and it helped me understand what that actually is. I knew it had to do with theater but didn’t know the exact meaning. It gave this writing a light and happy background on a subject that could remain dark and dreary. I think you are doing great and wish you the stamina and peace of mind (and humor) to carry on as you are.

  2. Your rule no 1 is right on…trying to correct a person with dementia by telling them their memories are wrong causes them a lot of anxiety and makes them worse…your sharing this will help a lot of people iwh

  3. Halo. Thank you! My father is the same way and reading about how you feel is as if you are writing about me and my sisters. We live in indonesia but apparently Alzheimer’s and dementia has the same effect to anyone regardless where they come from. My father is only 80 and hopefully will be around some more years. Yes my sisters and I feel like little girls again and get confused realizing our father is not the lion he always was before. In indonesia there are not yet good homes for the elderly so my father stays with my brother and his wife. My brother is the angel of the family, we girls just provide. We try to visit when we can. Sometimes together more often one at a time. And once a month we sisters get together after a visit to Ayah (father) and cry together feeling confused. So thank you for writing on improv. We will try this and hopefully we won’t be crying so much and start having great times again with Ayah our dad.

    • It sounds like you all love your father very much and that’s the most important thing. It’s good that you have each other for support and I wish you all the best on your journey with your dad. Let me know how it goes with trying improv. Thank you so much for writing.

  4. I like this! My wife has had many family members with dementia due to a very special gene that runs deeply within her family. Thanks for the advice on how to deal with it in case it ever arises.

  5. Reblogged this on Good to Glow and commented:
    Such a great blog.

    Both my grandfather (dad’s dad) and granny (mum’s mum) had dementia towards the end of their lives.

    My granddad had It worse, it was onset by his night terrors (he was in World War 2 and saw some horrid things that I daren’t ask him about). He would wake up shouting for my nan and saying odd things in his sleep. Eventually we sent him to a lovely nursing home and he lived out his days there.

    • My dad is also a WWII veteran and he often goes back to that time now that he has dementia. Sometimes he thinks he’s on a Navy ship and asks where we’re heading. I just tell him I need to check with the captain. Thanks so much for writing!

  6. Stumbled upon this piece and it went straight to my heart. We moved Dad from his home (600 km) to our little town to care for him. It was a wonderful and sometimes hairy three years. He passed away last week and there are so many things I still want to say to him.

    Thank you for this amazingly positive blog. And for the memories. (Dad was also engaged to one of his caregivers. He never won the lottery, but he did have Russians spying on him.)

  7. When my grandmother would ask if the stove was off (over & over again) we just smiled and said yes. Then when my aunt started forgetting things, I had to be her caregiver (until her death 3 years later). Now mom is heading in the same direction and I have to live in her reality at the time. One time she said she had to look for grandma at Aunt Grace’s…Grandma died over 25 years ago and Aunt Grace was in an Assisted Living facility (fortunately mom never left the house). Another time mom was looking for the baby (me, I’m 63). Improv is GREAT explanation.

  8. This helps me a lot. My mom has just been diagnosed with dementia. She and I are really close. She really loves my kids. They have fun together. I am nervous of what’s to come.

  9. My granny had Alzheimers and ended up dying from it when i was about 11 years old. But before she became bad and had to be permanently hospitalised, I believe the family did a lot of improv with her. So it bizarre reading this awesome post now! I believe the improv can be beneficial in a way because it causes the afflicted person to undergo less stress. I miss my granny 😦 Thanks for writing this. Tried to press the Like button, but it isn’t working, So I’ll just say I liked it here 🙂

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