Many newly diagnosed Alzheimer's patients go through the stressful phase of realizing they are losing their memory while still having enough insight to know that, over time, they will no longer be able to care for themselves.
So a team of researchers from Chicago — a city known for improvisational theater — is testing a new idea of whether unscripted theater games can affect the well-being of these patients.
"Improv is all about being in the moment, which for someone with memory loss, that is a very safe place," says Mary O'Hara, a social worker at the Cognitive Neurology and Alzheimer's Disease Center at Northwestern University's Feinberg School of Medicine. "Maybe thinking about the past and trying to remember makes the person a little anxious or even a bit sad because their memory is failing. And maybe thinking about the future too much is also anxiety-provoking. So being in the moment is such a safe and a good place to be."
The Northwestern researchers are working with the Tony Award-winning Lookingglass Theatre Company. There are already theater programs that use improv for Alzheimer's patients in the later stages of the disease, but this collaboration is unique because it's for early-stage patients.
"There's no experience required, there's no script, there's no memorization," O'Hara says. "They bring to it just their creative potential. And they are so successful at this."
Christine Mary Dunford, with Lookingglass, leads the group of novice performers in very simple improv games.
One "of the basic tenets of improv that [is] perfect for working with people with dementia [is] the concept of yes," Dunford says. "So, fundamental to all our work is that whatever answer someone comes up with, the rest of us are going to be able to work with it."
Researchers don't expect these games to stop or slow the progress of Alzheimer's disease, but they are investigating whether engaging the creative abilities of these early-stage patients improves their lives.
Before and after the eight-week program, participants and their families are asked a series of questions, checking to see how the course changes their answers.
"We're asking people to tell us how they're feeling about their physical health, their mood," says Darby Morhardt, a research associate professor at Northwestern. "How do they feel about their memory? How did they feel about their family, about their relationships? And also, how do they feel about their current situation as a whole and their life as a whole?"
"When we think of people with Alzheimer's and other dementia, we think about people who are losing skills on a daily basis," says improv coach Dunford. "But here, they're learning some new things, too.
It gives them a feeling of — a sense of self-confidence that they were able to accomplish this. And in this disease, there's not a lot of opportunity to feel a sense of accomplishment."
RENEE MONTAGNE, host:
This is MORNING EDITION from NPR News.�I'm Renee Montagne.
And today in Your Health, performing improv as a way to help cope with Alzheimer's disease. It may be hard to imagine the stress of knowing that you're losing your memory and being aware of that, over time, you will no longer be able to care for yourself.
In Chicago, a city known for improvisational theater, researchers are testing whether unscripted theater games can benefit newly diagnosed Alzheimer's patients. Reporter Julianne Hill has the story.
JULIANNE HILL: At 10:30 on Monday morning, about a dozen people file into an improvisational theater class.
Unidentified Woman #1: Well, here they come.
(Soundbite of laughter)
HILL: Among them, a pretty blond in her 50s, a woman who's a retired biologist and wears big glasses, and a retired professor.�
Unidentified Woman #2: Hi everybody.
Unidentified Man #1: Hi.
Unidentified Woman #2: Happy Monday morning.
HILL: The course is held in a conference room at Northwestern Memorial Hospital and it looks like any continuing education class.
Unidentified Woman #2: Shall we do a little yes and or pass the clap? What do we feel like today?
Unidentified Woman #3: Let's do yes, you. Let's do yes, you.
Unidentified Woman #2: OK. So...
HILL: But these players are different.
Unidentified Woman #3: Yes, you? Yes, you.
Unidentified Man #2: Yes, you.
(Soundbite of laughter)
HILL: Everyone in this ensemble has dementia. Mary O'Hara is a social worker at Northwestern's Cognitive Neurology and Alzheimer's Disease Center.
Ms. MARY O'HARA (Cognitive Neurology and Alzheimer's Disease Center, Northwestern): Improv is all about being in the moment, which for someone with memory loss is a really safe place. Maybe thinking about the past and trying to remember makes the person a�little bit anxious, or even a bit sad, because their memory is failing. And maybe thinking about the future too much is also anxiety-provoking. So, being in the moment is such a safe and a good place to be.
HILL: Northwestern's researchers are working with the Tony Award-winning Looking Glass Theater Company.
There are theatre programs using improv for Alzheimer's patients in the later stages of the disease, but this collaboration is unique because it's for early stage patients.
Ms. O'HARA: There's no experience required. There's no script. There's no memorization. They bring to it, just their creative potential. And they are so successful at this.
Ms. CHRISTINE MARY DUNFORD (Looking Glass Theater Company): OK. So we're going to take an object and we're going to transform it into three things that it's not.
HILL: Christine Mary Dunford, with the Looking Glass, leads this group of novice performers in very simple improv games.�
Ms. DUNFORD: Some of the basic tenants of improv that are perfect for working with people with dementia are the concept of yes. So fundamental to all our work is the idea that whatever answer somebody comes up with the rest of us are going to be able to work with it.
Unidentified Man #3: This is a red, five pound, mackerel.
Group: Yes, it is.
Ms. DUNFORD: My favorite moments are when they're delighting each other and they have a lot of fun. You know what I think my favorite exercise of all time is? Yes, it is. Because they take an object and they transform it and they always surprise themselves and everybody else. And it's always magical and it's always exciting.
HILL: Researchers don't expect these games to stop or slow the Alzheimer's disease process.�But, they are investigating, does engaging the creative abilities of these early-stage patients�improve their lives.
Before and after the eight week program, participants and their families are asked a series of questions, checking to see how the course might change their answers.
Darby Morhardt is research associate professor at Northwestern.
Ms. DARBY MORHARDT (Northwestern University Professor): Well, we're asking people to tell us how they're feeling about their physical health, their mood, how do they feel about their memory. How do they feel about their family, about their relationships, and also how do they feel about their current situation as a whole and their life as a whole.
HILL: In the class, Dunford tells the players to stand in a circle for a listening game called chord.�
Ms. DUNFORD: We're going to close our eyes and we're just going to hum on the same sound. After a while when it starts feeling really good, anybody who wants to can change the pitch or add a different kind of sound.
Group: (Soundbite of humming)
HILL: After about two minutes, the chord morphs into nature sounds.
(Soundbite of barking)
(Soundbite of meowing)
Ms. DUNFORD: OK. Let's come to a close. Oh, my gosh. OK. So let's talk about it. What was that like?
Unidentified Woman #4: Fun. It was fun.
Ms. DUNFORD: OK. So what happened that was fun?
Unidentified Man #4: Spontaneity.
Ms. DUNFORD: Spontaneity.
Unidentified Man #4: That's right. Animal sounds I never thought I had.
(Soundbite of laughter)
Ms. DUNFORD: We're never trying to be funny. I don't think we've ever even mentioned that word, comedy. We're just an improvisation group. We're the memory ensemble. We're an ensemble of people working together. So it ends up being funny quite often, but just as often it ends up being touching or moving or provoking.
What should we name the song we just made?
Unidentified Man #5: Chubby Chaos.
Ms. DUNFORD: Chubby Chaos.
HILL: When we think of people with Alzheimers and other dementia, we think about people who are losing skills on a daily basis, but here theyre learning some new things too.
Prof. MORHARDT: It gives them a feeling of sense of self-confidence that they were able to accomplish this. And in this disease, theres not a lot of opportunity to feel a sense of accomplishment.
HILL: The group plays sculptor, molding one another into an emotion.
Ms. DUNFORD: One of you is the sculptor and one of you is the clay.
HILL: The players, like Wolfgang, each bring a lifetime of experience into the room.
WOLFGANG: I was a professor of Hebrew studies, Old Testament, at this university here, I mean up in the northern suburb. What is it? See, I have Alzheimers and thats why I dont remember these things. But, you know, its one of the big universities here in this area.
HILL: Caregivers are not invited to participate.
Prof. MORHARDT: This really an opportunity for the persons with the illness to be together. Theres not a lot of options for them in the community, to get to know one another and be within and to have their own program. And it also gives caregivers a much needed break as well.
HILL: Wolfgangs wife Mary Beth waits for him outside the classroom.
MARY BETH: It's an opportunity for us to enjoy something, to get out for the day, and do something partly together and partly separately. My hopes for my husband is that he maintains this very sweet disposition. Some people with Alzheimers don't, but I think that he's definitely going in that direction, and theres still so much of him snd we still have a deep relationship. The hardest thing for me is that - it cant really grow.
Ms. DUNFORD: Now lets put your body like this one and see what thats how somebody else feels hope? Feel that?
HILL: It's too early in the study to know whether this course is affecting the quality of life of these patients. But for his part, Wolfgang feels things have changed for himself and his fellow players.
WOLFGANG: I think we all have become more thoughtful in terms of the world in which we live. And it will then indirectly show itself in our interactions within our family, with our grandchildren, you know, wife, etcetera, etcetera, and also in the wider world.
HILL: The session closes with some questions.
WOLFGANG: I'm wondering how I should describe to a friend what we are celebrating.
Ms. DUNFORD: What were celebrating or what were doing?
(Soundbite of laughter)
JANET: You know, a lot of times in our situation, you know, were sitting talking about our problems and our difficulties. And here we are not talking about our problems and our difficulties. We are having fun and enjoying ourselves.
WOLFGANG: True. True.
EVELYN: Were normal.
WOLFGANG: Normal. That's right.
(Soundbite of humming)
HILL: For NPR News, Im Julianne Hill.
(Soundbite of humming)
(Soundbite of music)
MONTAGNE: Youre listening to MORNING EDITION from NPR News. Transcript provided by NPR, Copyright NPR.