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In the absence of a cure for dementia, there is an increasing recognition of the need to address its key impacts of social isolation and depression. Playful Engagement is an arts and health partnership that seeks to affirm and celebrate personal identity, boost confidence and support emotional well being.
The Playful Engagement program is an innovative three-way arts and health partnership between Wesley Mission Brisbane (WMB), Griffith University theatre and dementia researchers, and two elderclowns, Clark Crystal and Anna Yen.
The Target Audience
People living with dementia often find themselves isolated and may experience depression, difficulty with self expression and socialising with others, sensory decline and lack of contact with the outside world and an overall disinterest in life and can be unmotivated to do anything about it. This produces stress for the families and carers as they see their loved one disconnecting from the world around them and themselves.
The Playful Engagement program is focused on relationship-based play with people who have mid to late dementia. The program provides playful and humorous contact that is sensitive, safe and respectful and is delivered by elderclowns. The playfulness engages spontaneity, imagination, creative expression, communication and interaction, all of which are instrumental in quality of life at all ages.
The elderclowns are specifically trained in working with people who are living with dementia in residential aged care facilities. They are gentle under-stated clown characters that are presented as siblings, Dumpling and Tiny Lamington, wearing formal 1940s attire. Through personalised engagement that is empathic to the clients’ capabilities, the elderclown characters draw from a range of interventions such as playful contact, friendliness, sensory play, music, dance, reminiscence, and role play. The program aims to refresh and enrich client and family relationships by drawing them together in play and creative mini episodes leaving a positive atmosphere that can last long after the elderclowns’ departure. Encounters can offer further and renewed conversation between loved ones and staff, enhancing residents’ quality of life and leaving an overall positive impact on the institutional environment.
At the core of this playful engagement is responsiveness to the moods and attitudes of the individuals. Rather than using prepared set pieces or conceptualising their work as entertainment, the key to the playful practice is affirming and celebrating personal identity and individual life experience, to boost confidence and self esteem, build relationships and to support emotional health and well being.
It didn’t take long before we, as staff, could see the program was working. When you think about someone with dementia, and then someone with a red nose stands in front of them and they laugh, speak, and sing together, it really is a bit of a ‘wow’ factor says a Residential Aged Care Facility staff member involved with the program.
The Playful Engagement program has been operating for 3 years. It was initially funded by Department of Health and Ageing, and is now part of a 3 year multidisciplinary Australian Research Council Linkage Project. Additional in-kind support is provided by Wesley Mission Brisbane.
The evaluation of the project has developed incrementally over the period of the program. In the pilot there were observations of practice, interviews with staff and some family members, and these outcomes were fed into further practice work. The Australian Research Council (ARC) mixed method study employs multiple data collection methods including: surveys of staff and families; observations completed by members of the research team; video recordings of the interactions between applied theatre practitioners and the participants; interviews with participants (where appropriate), family members and staff; practitioner journals completed by the applied theatre practitioners; social biographies and a range of demographic and medical baseline data.
The emerging findings are indicating strong developments in individuals’ moods and anxiety levels and their capacities to communicate; enhanced benefits for the community of carers in observing changes in the mood of the participant and the impact this has on the institutional environment, and increased appreciation of participants as capable individuals. The emerging findings also indicate that humour, song, spontaneity, role-taking help to support different elements of play including physical, cognitive and social spontaneity, manifest pleasure and sense of humour.
The research is particularly important in providing a tool for advocacy and expansion of evidence- based practice for arts and health workers, and will contribute to national policy on the benefits of arts- health work on the wellbeing of Australians. The benefits for the elderclowns and theatre researchers have been to develop and articulate a best practice methodology for how and why the play works, and to understand the ways in which moments of communication can be translated into meaningful enhancement of staff and family relationships.
The program has also demonstrated that the arts can play a significant role in dementia care, and provide recognition and awareness of the value of creative work in dementia research and clinical practice. A large part of the program’s success is the commitment and openness of WMB staff (at all levels) to accept and respond to the playfulness of the work. The strategic partnership with WMB has strengthened the trust and possibilities essential to the work, and has led to a deepening sense of shared purpose.
The Playful Engagement program, and the partnership between Wesley Mission Brisbane (WMB), Griffith University theatre and dementia researchers, and two elderclowns, Clark Crystal and Anna Yen was awarded the 2013 Queensland State Creative Partnerships Arts and Health Award and was one of six finalists for the National Award announced in November 2013. The Institute for Creative Health is proud to partner with Creative Partnerships Australia in the development and delivery of this Award.
Contact for further information:
Professor Michael Balfour
Chair, Applied Theatre
School of Education and Professional Studies (Drama)
Phone: + 61 7 373 55688