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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