Caregivers learn to care for themselves through improv program

Aging can come with a bevy of benefits like wisdom and senior discounts. However, it can also come with a host of health issues such as dementia.

In the United States, it is estimated that one in nine people, or 10.8%, aged 65 and over have Alzheimer’s disease, the most common form of dementia. That number increases to 33.3% in those 85 and over.

The U.S. has more than 8 million people in long-term care. Of those, about 1.2 million are in nursing homes. The rest are receiving care at home or some other setting. One in five adults in the nation provide at-home care to a friend or family member suffering from some malady.

Stress from caregiving can lead to issues in the person providing care like depression and other psychological issues, exhaustion, weight gain, anger and resentment and many other problems. So, who cares for the caregiver? Often, a person has to find a way to do it herself.

Sometimes, it comes down to a change of mindset and adding tools to the caregiving toolbelt. A new program through a partnership between Saint Alphonsus Memory Center, Boise Contemporary Theater and an improv troupe called Recycled Minds helps to do just that.

The program, called Improv to Improve Dementia Care, teaches caregivers the concept of “Yes, and,” the basis for improvisation, along with other skills that will help them to essentially go with the flow.

“We’re an outpatient clinic to help with early detection, diagnosis and treatment of dementias of all types, not just Alzheimer’s type,” said Dr. Kara Kuntz, director of the Memory Center. “We have seen in our clinic there’s this need to help teach caregivers communication skills, how to be more present to de-escalate stressful situations, how to find more joy in caregiving, and some self-care around being a caregiver.”

Dementia patients can become easily agitated since, more often than not, they are living in the moment. If a patient believes his friend is coming over, when in reality that friend might live across the country, a caregiver through the program learns to not contradict the patient since that could lead to agitation and a more stressful instance of caring for that person.

Kuntz first learned about improv as a tool for dementia care from her colleague Dr. Abhilash Desai, a geriatric psychiatrist. After that, Kuntz met Benjamin Burdick, the artistic director of BCT, through a mutual friend. She shared her idea about using improv in dementia care and Burdick offered the use of BCT in downtown Boise.

“Outside of our productions, we have a lot of education programs, and we do some adult acting programs, but sort of lamenting the fact that we don’t have anything for older adults, seniors,” Burdick said. “It feels like a very … underrepresented group. That’s when Kara had this idea and we have theater space, and we love to be community partners with whomever we can.”

The program, now in its second year, has space for about 25 people and runs one day a week over the course of three weeks. Along with its other partners, Saint Alphonsus is collaborating with Boise State University to survey the participants in the improv class to gage its effectiveness on caregivers.

Kuntz was introduced to Sean Hancock, founder and co-owner of Recycled Minds with his wife Colleen Hancock, through the grant-writing process. Her writer, Evelyn Mason mentioned that he could be a good fit in guiding the classes.

“I shot him an email and he’s immediately a “yes” kind of guy. We partnered up in making this happen,” she said.

For Hancock, he said his group is always looking to help out with such programs.

“The nature of improv is to make others look better, to be in the moment,” he said. “That’s getting out of your head and being present, being vulnerable, and trying to allow the joy to be discovered versus trying to force your own agenda.”

Improv, Hancock stated, is like building with others “a brick at a time,” and that process helps instill positive character traits.

“People take improv classes thinking that they either want to get funny or that they want to develop more in this art form,” Hancock said. “They end up realizing they become better people because they end up building more relationships and being more patient and being more kind and transparent, and a lot of just really good things that make for good humans. And in the process it’s fun. I think what’s difficult about dementia is people aren’t exactly who they were a year ago or three years ago, so we’re trading correction for playfulness and I think that’s been a healthy kind of discovery.”

Kuntz built on Hancock’s comment by reemphasizing that it’s not necessary to correct what a patient might say or do.

“In our clinic, we say connect instead of correct,” she said. “This playfulness, silliness, improve skills, learning how to be in the moment, allows people to relearn how to connect. Caregivers are so good at identifying tasks to do, appointments to take people to, thinking about what their parent was like in the past, anticipating needs that are going to occur, and they are not very good at being in the present because they are overwhelmed.

“And then, conversely, their loved one with dementia is losing the ability to be in the past, in the future, and is being more in the present,” Kuntz continued. “Their cognitive abilities are making it such that executive function future planning is declining over time, but their ability to be in the moment, to be present is what’s increasing. … The caregiver has to relearn – or maybe learn for the first time – what this is all about. This is giving them the ability to tap into that.”

Because of the health problems that can arise due to stress from caregiving, Kuntz said it’s not uncommon for a caregiver to die before the patient with dementia. But with the help of caregiver support and education, studies have shown hospitalizations and emergency room visits have decreased by 50% where that help is provided.

C.K. Kortopattis, a volunteer with Legacy Corps, participated in the Improv to Improve Dementia Care last year. Her husband, for whom she provides care, was originally diagnosed with Alzheimer’s. Recently, he was diagnosed with end-stage Parkinson’s, Lewy body syndrome and cancer.

“This program was really helpful to access and be part of the Saint Alphonsus experience,” she said. The program taught her a variety of skills sets in caring for her husband and when providing respite care through the Legacy Corps Aging Strong program for veterans with some form of dementia.

Thanks to the tools of improv, Kortopattis has been able to change her approach to care, relieving the stress that can come with it.

“I’m much more animated,” she said. “Before, I would just be kind and factual. I’ve come to understand when people have the dementias, their world is smaller and it’s more confusing and it’s distracting. How I really benefited from this is to be demonstrative of what he needs, how we need to do it. … I’m much more animated, facially and expressively with him. It’s a wonderful program.”

Though the nature of grant funding is uncertain these days, the program has secured funding with the help of the Alzheimer’s Association and will be able to offer the program again next year.