I recently competed the ‘Dementia awareness’ certificate provided online by the Alzheimer Society.
As promised in my previous blog, I will write a blog for each chapter of the certificate.
The first chapter explained what Dementia is, what types of Dementia exist as well as illustrated its symptoms. You can read about ‘Dementia… and how the Magic Mad Hat approach can help’, here.
Chapter two is about ‘Understanding the Symptoms’ and chapter three explains how to ‘Care about people with Dementia’.
Types of Symptoms:
- Cognitive Symptoms: These are related to thinking or memory.
Great association, accepting and easy concentration games / exercises can help to overcome cognitive symptoms and build up confidence.
- Planning & organizing
The Magic Mad Hat uses techniques used in Improvised Comedy and clowning which encourage the person to apply their creative thinking abilities, while not over thinking every step. Such as creating a story together. It is not important if the story makes any sense. The importance lies in ‘following’ what the previous person said and to add something spontaneously. This exercise helps the person to ‘plan’ ad hoc to the present situation as well as reinforces the cognitive abilities while creating with others. It also enables the participant to feel more relaxed as there is no such a thing as ‘failure’ and every sentence can be integrated into the new story. The person associates through listening and plans / creates an ‘event’ (story) with others.
With warm-up games, such as the Word ball – where one word at the time is ‘thrown’ to a person, who then throws another word to a different person in the circle, can get the brain going. It is not important what word is said; sometimes a sound can be enough. The benefit of playing this game is that, the person reacts ad hoc and comes up with word/ sounds without having to think. It stimulates the brain activity creatively, can make the person laugh and therefore makes it easier for the person to express themselves through association. I have seen massive improvement in ad hoc and quicker responses, if this game is played regularly. The fear of ‘Failure’ or embarrassment falls away and the person gains more confidence, therefore words, sounds as well as sentences come up easier. I have heard some of the most impressive expressions from people who struggled badly in the first couple of session. I have observed people who, at the beginning took almost a couple of minutes to come up with a word, are not ‘shooting’ out words without any delay.
One great exercise is ‘Talking Gibberish’. Two people talk to each other in gibberish, while the third person translates it for them (or to the audience). This is a fun game, taking away the insecurity of not being able to express yourself verbally and correctly. It encourages the person to use all means, such as sound or facial expressions to communicate as well as to be understood. Losing the ability to communicate with your loved ones can be very traumatic and frustrating. However, certain games can help to overcome this frustration and also establish new means of interaction/ communication with family and carers.
- Complex Actions (Buttoning a shirt, Using knife & fork)
With simple games, such as mirroring each other, the person is more likely to be present and able to focus. The Magic Mad Hat approach cannot ‘cure’ any neuron-muscular disorders, but it might help to see the issue from a lighter angle.
It’s never really pleasant when one is not recognized by a family member or loved one. The comedy games & exercises are re-awakening the cognitive abilities in general, and therefore reinforcing the recognition capacities.
- Planning & organizing
- Non – Cognitive Symptoms: refer to the behavioral and psychological symptoms of dementia (BPSD). These can be common and problematic in clinical practice.
- Psychotic symptoms
The Magic Mad Hat approach encourages everyone to stay in the present moment engages the participants in fun interactions while being creative. Delusion might be integrated in the interaction. Or the person might forget his/ hers delusion for a moment.
As with the delusion, the idea is either to integrate the hallucinations into the game/ exercise or alternatively engage the person into the ‘present’ moment while creating new moments. In that way, the person will be able to deal better with any type of hallucination. It might ease the fear of the hallucination.
The Magic Mad Hat comedy sessions are fun, interactive and creative. They are also ‘challenging’ as they encourage people to be spontaneous without thinking. I am hosting a weekly session at the Millman resource center, and the best feed-back I have received was: “Your class is the only class they (the elderly) don’t say ‘Oh god’ and are really looking forward to”.
It is fun and animating. I personally make sure everyone is involved and fully part of the session.
‘Humor production improves our creative (problem solving) cognitive capacity, strengthens our memory, enhances social communication skills, and our ability to think on our feet. All of this vigorous mental activity, combined with the many benefits of a merry heart, help us be happy, enjoy the world around us, and delay or avoid the onset and impact of devastating neurodegenerative diseases (various forms of age, genetic, disease, free-radical and toxin-related dementia).’ (http://www.joyfulaging.com/HumorTherapy.htm)
The main ‘tool’ of the Magic Mad Hat approach is playfulness and fun. Allowing the participants to be young, ‘careless’ and joyful again.
- Psychotic symptoms
Being able to be playful and creative in a non-judgmental and supportive environment can help to overcome certain anxieties. Improvised Comedy is known to be highly beneficial for people suffering from anxiety. Being able to be interactive while staying in the present moment can help the person to relax and feel safe.
Caring for People with Dementia
- Relationship centered care:
The person with Dementia is seen and treated as a person rather than focusing on their illness/ abilities they might have lost (See more in my previous blog).
I personally make sure to be fully aware of the people in my sessions. I make sure to attend everyone with time and care. No one is rushed to do anything, nor is there any pressure to do anything the participant might not want to do. With a lot of empathy and patient I make sure everyone is understood, accepted and integrated. As a matter of fact participants help, encourage and support each other while having fun.
Participants are sitting in a circle and I make sure the environment is safe, non- judgmental and welcoming.
- Family, Friends & Carers
Family, Friends & Carers have knowledge and experience of the person. The Magic Mad Hat encourages family members & carers to take part in the sessions. Not only will they have a fun time, but also the sessions are supporting the relationship which can be slightly put on strain. The person with dementia and the family member or carer are spending quality time together and create unforgettable moments.
- Six Senses Framework is a widely recognized method for providing high quality elderly care.
The Magic Mad Hat applies some of the important points of this framework.
I make sure all health and safety requirements are in place. Usually my sessions are contacted in sitting. Further I reassure the participants that they don’t have to do anything what they might not want to do. In addition I have full awareness of everybody’s needs and requirements. I make sure everyone feels secure, safe, integrated, accepted as well as welcomed.
All my sessions are group sessions and everyone is welcomed with open arm and a huge applause. I reassure that everyone’s input is important in order to get the game going.
Further I encourage family members as well as carer to take part, to feel part and to integrate with the person with dementia more. My sessions are mind-loosening, creative and super fun. It is a great way to connect on a deeper level with the person with dementia.
Since the day I started to offer sessions to elderly people including those with dementia, I keep telling care homes and community center that it is SUPER IMPORTANT to continue these sessions on a weekly basis. It is a bit frustrating for me that the elderly people ask me to come back, but the care homes don’t call me back. I only can assume that they expect some miracle results in the first session and cannot see the bigger picture. The bigger picture is that with regular session the participants significantly improve their cognitive abilities. Furthermore, they more and more lighten up and are more approachable. I have been hosting weekly sessions at the Millman Resource centre and I am astonished the improvements I can see. So much so, that I have to come up with more demanding games. My first session literally just consists of silly games. These are essential, for the people to get to know me as well me to get to know them. I have seen what differences my approach can make when applied regularly and I truly hope care homes etc are going to consider the continuation of these sessions.
The Magic Mad Hat sessions provide a massive purpose to the people with/ without dementia. They are interactive, fun, animating, creative and social. In addition they stimulate the brain activities vie spontaneous reacting and being in the present moment. However, it only can have it full beneficial effect when done regularly. The participant finds stimulant and purpose as well as joy.
As already mentioned above – I have observed significant, and I really mean mind blowing significant, improvement in cognitive responses in my regular group at Millman resource centre. The beauty of it all is the see the happy faces of the participants when they realise, that they are improving, that they are managing task, which we firstly thought would never be possible. Why is it possible? Because of repetition. Because they have confidence in me and because they are more confidence with themselves.
In addition, I reassure, I applaud them and I help them all the way. I make sure they laugh about ‘failure’ which enables them to take a step further.
everyone in any group is important to me. I make sure everyone get the same attention, gets the same help as well as I take all ‘dislikes’ into consideration. I and the group are a team….
- The Six C’s in Dementia Care –Here I only will mention how the Magic Mad Hat ‘ticks’ the boxes.
- Care – It is important to get to know the individual. I make sure, to connect and interact with each individual. I am listening, understand as well as let them be, i.e: Sound & Movement exercise: Some rather tell me a little story – sure why not…There is no judgement and there is no right or wrong.
- Compassion– I truly love what I am doing. To see the people smile, laugh and shine again can be a very rewarding experience. I truly hope to be able to spread this joy and share the beauty with more elderly people. I have observed that it doesn’t take much to make a person smile, a bit of attention, a bit of love and compassion…
- Competence – I know what I am doing and I know what results can be achieved. I am aware of the need and requirement and I swiftly ‘improvise’ accordant.
- Communication – I make sure everyone understands what we are going to do and why. I am also aware, that my approach is brand new in the care for elderly. Therefore I put an immense effort in explaining everything – sometimes it is just important to do it… I also communicate to management and explain the benefits.
- Courage – I understand it takes courage to try something new. It takes courage to do something unusual, but at the same time it is an important step for a better, healthier and happier being. The Magic Mad Hat approach is to improve the quality of life and its approach is new, but it is possibly the most harmless and highly beneficial way.
- Commitment – I have committed myself to provide my service to as many care homes as possible. I am committed to provide the best service and can assure you, that if used on a regular basis the quality of life for peole with dementia is going to improve significant. My fees are so low you can pay me from your petty cash – so really there are no excuses.
For more information and bookings, please contact me.