The sad truth is that dementia patients don’t just lose their mental acuity -- many also lose control of their behavior

With Dementia, A Little Humor Goes a Long Way The sad truth is that dementia patients don’t just lose their mental acuity -- many also lose control of their behavior. As many as 70% to 80% experience agitation, symptoms of which include irritability, pacing, rummaging, yelling, cursing, hitting, biting and kicking. These symptoms are often treated with antipsychotic medications, but such drugs have terrible side effects, including sudden death in dementia patients. And while the drugs may indeed quell symptoms of agitation, they don’t seem to make patients feel any happier -- and, after all, shouldn’t that also be a goal? The good news is that a new Australian study presented in August 2011 at the National Dementia Research Forum in Sydney, Australia, has shown that humor therapy -- which I’m happy to say is exactly what it sounds like, as we’ll see below -- can reduce symptoms of agitation in patients with mild-to-severe dementia and do it with no side effects. And the best part of all -- it seemed to make them happier. A STUDY THAT MAKES YOU SMILEHumor therapy has long been practiced with children in hospitals. To see whether it could also help dementia patients, staff at The Humour Foundation in Australia trained health-care workers in humor therapy and then sent them to three dozen nursing homes in and around the city of Sydney to treat several hundred residents. All the residents had dementia, some had agitation and some were taking antipsychotic meds. The workers performed humor therapy for two hours a week for 12 weeks, usually one-on-one with a patient. To learn more about what the health-care staffers did and how effective the therapy was, I contacted one of the lead investigators, Peter Spitzer, MD, medical director and cofounder of the Humour Foundation.Mainstream humor -- like the kind that dementia patients see on TV sitcoms and talk shows -- doesn’t really connect with them, said Dr. Spitzer, so health-care workers had to "find the key that would open the door to the patients’ humor." During each session, the workers would wear red clown noses and attempt to engage patients by using mime, music, massage, touch, stories and magic tricks. In many cases, they would ask a simple question like, "Which way is the bathroom?"… and then, after the patient gave the correct answer, the worker would play the fool and purposefully walk in the wrong direction. This might elicit a laugh -- but there was another positive effect, too. For patients who have already lost so much independence, this type of humorous play can give them a brief but uplifting sense of personal power and control, said Dr. Spitzer. The study didn’t just make patients smile -- its results made the researchers smile. Immediately after 12 weeks of humor therapy -- and even six months after treatment ended -- frequency of overall patient agitation as measured by standard psychological surveys was down by 20%, on average, compared with measurements taken at the beginning of the study. Since the patient population included some people who were already being treated for agitation with antipsychotic meds, the results are promising -- especially because they seem to last, which is remarkable. "These findings suggest that humor therapy may be as effective as antipsychotic drugs in reducing agitation -- while providing more happiness and no dangerous side effects," said Dr. Spitzer. Controlled studies that compare antipsychotic medications to humor therapy need to be done in the future. MAKE A PATIENT LAUGHRight now, one of the few organizations in the US providing humor therapy for seniors in nursing homes is Big Apple Circus’s Vaudeville Caravan in Chicago and Montrose, New York. Dr. Spitzer suspects that as more "psychosocial" research is done with dementia patients, more resources will become available. Dr. Spitzer added that humor therapy could be effective in a residential setting, too. So if you’re caring for a dementia patient at home who has agitation, Dr. Spitzer said to try goofy humor to play and ease symptoms -- even if you don’t have formal training -- so you can bring a smile to your loved one’s face. Source(s): Peter Spitzer, MB BS, Churchill Fellow, a physician in private practice, and medical director and cofounder of the Humour Foundation, Australia.