If you’ve ever watched the television show Whose Line Is It Anyway?, you’ve seen improvisational comedy. Known as “improv,” this theater technique creates short, structured games of communication and imagination, offering spontaneous entertainment to audience members and a unique challenge to participants.
It is, in other words, perfect for caregivers seeking new ways to engage with people living with dementia.
Take Timeline Confusion™, for instance, the trademarked term of dementia expert and caregiver trainer Rachael Wonderlin. This occurs when a person with dementia is confused about the year they are in, and hence how old they are, Wonderlin says. An understandable instinct among caregivers is to correct the person, telling them that we are in, say, 2023, not 1973.
Yet no matter how gently they might attempt to correct that person, they are missing a key strategy in helping that person. The correction itself is the problem, not the style.
“This concept that a person living with dementia may have trouble placing their family member on their timeline is not a reflection of whether or not they care about or love that person — it’s that their timeline is no longer linear,” says Wonderlin, founder of Dementia By Day. “The person living with dementia, their understanding of who people are is off. If they think that they’re 25 years old, they’re probably not going to recognize their adult daughter who’s 65.”
That’s where improv comes in.
The 7 Key Improv Principles That Dementia Caregivers Can Use
Wonderlin’s new book, “The Caregiver’s Guide to Memory Care and Dementia Communities,” offers a look at how dementia caregivers can use improv to meet resident needs. The book includes seven key improv principles The first, and arguably most important, is called “Yes, and…”
Instead of nullifying a person’s improvised experience — or a person with dementia’s lived experience — the improv partner accepts that person’s reality and interacts with them on that basis. Wonderlin calls this Embracing Their Reality™, and it is a key to helping caregivers connect with their dementia patients and residents.
The full list of these vital improv principles:
- “Yes, and…”
- Make your scene partner look like a genius. When a caregiver’s “partner” is someone with dementia, set them up for success. If they are struggling with a task, simplify it by breaking it down into steps.
- Don’t make anyone crazy or intoxicated. Never remind a person with dementia that their memory is wrong. Make them feel heard, understood, smart and respected.
- Avoid asking too many questions. During conversation with dementia residents, caregivers should focus on making them feel comfortable. Asking too many questions, especially around their short-term memory, can derail interactions.
- Listen to your scene partner. Listening is key in both improv and dementia care. A caregiver who does not listen cannot solve behavioral challenges.
- Be patient in the moment. Instead of worrying about what will happen later or what happened before, be present with each resident and celebrate their victories, no matter how small.
- Bring a brick and not the whole castle. When helping a person with dementia solve tasks, bring them one or two pieces of information — not 10.
3 Easy Improv Games Caregivers Can Use with Dementia Residents
The principles are the best practices, and caregivers can learn how to use them through improv games. Here are four of Wonderlin’s favorite improv games to use with dementia patients.
Game name: Birthday gift
- How it works: Pick up an invisible box and hand it to the person next to you. They will open the box and decide what’s in it. Whatever they say is the right answer. Agree and tell them why you got it for them.
- How it helps: Teaches caregivers about flexibility with residents, especially those in the earliest stages of dementia.
Game name: Barney Sells Bread in Bulgaria
- How it works: Each person chooses an alliterative word to create a silly sentence. The first person says a person’s name that starts with A. The next says an action word that starts with A, followed by a location with A, and so on. The caregiver uses a whiteboard to write the sentence word by word.
- How it helps: Teaches caregivers to create community and cohesion amongst a group of patients. “I’ve found that the residents really enjoy it,” Wonderlin says. “It’s just fun. Whatever the person comes up with, you celebrate. There’s no, ‘Oops!’ You correct it and adjust it accordingly. We want them to come out looking and feeling good.”
Game name: Picnic
- How it works: Start by saying, “I’m going to a picnic and I’m bringing…” and go through the alphabet, with each person adding one item to the list, A to Z.
- How it helps: “Picnic” gives caregivers tools needed to assist residents with their memories. Like “Barney Sells Bread…”, caregivers can use a whiteboard to build the picnic list.
Game name: Zip, Zap, Zop
- How it works: With residents in a circle, the caregiver points to one person and says “Zip!” That person points to another person and says “Zap!” with that person pointing to another — “Zop!” — before it begins again.
- How it helps: “Zip, Zap, Zop” includes eye contact and physical motion, both essential for helping residents remain engaged with each other.
Each of these games and the many others in Wonderlin’s book can be adjusted to meet the residents at their respective cognitive level. Every game in the book can help residents feel engaged in the group and good about themselves, while giving caregivers the tools they need to create a safe, warm memory care environment.
“You can use improv to teach caregivers to be better, more empathetic care partners, both professional care partners and family members of people living with dementia, and you can also use it in programming,” Wonderlin says. “I’ve had a lot of success helping people understand tough concepts like Embracing Their Reality™ or Timeline Confusion™. Through this hands-on technique where we’re actually getting people up on stage, we’re illustrating concepts that are really powerful.”
This article is sponsored by Johns Hopkins University Press and draws from Rachael Wonderlin’s newest book. To purchase “The Caregiver’s Guide to Memory Care and Dementia Communities,” visit press.jhu.edu, and through June 30, use code HTWN at checkout to receive a 30% discount.