Improv training: A new approach to dementia care

When you think of improv, you might picture a stage filled with laughter and spontaneity. But a unique program is using this art form to improve life for care partners and individuals living with dementia.

A new approach to dementia care

Dementia care can be emotionally and physically taxing, with traditional strategies often feeling rigid and limiting. The Improving Care Through Improv program—created and organized by experts from Emory University, Georgia State University, and local artists and educators—provides a creative alternative to conventional dementia care training by teaching care partners improvisation skills to foster empathetic and effective communication.

"Improv encourages caregivers to meet patients where they are, fostering empathetic and responsive interactions," says Ted Johnson, MD, MPH, chair of the department of family and preventive medicine at Emory University.

In partnership with Dad's Garage Theatre Company in Atlanta, the program uses improvisation techniques to equip caregivers with communication tools to navigate the complexities of dementia care.

One core technique taught is the "yes, and…" principle. This method encourages caregivers to validate patient's feelings and experiences rather than confronting them with harsh realities. Individuals living with dementia commonly hear "no," are ignored, or dismissed. Having the validation of "yes, and…" can be comforting.

"If a patient insists their deceased spouse is coming home, instead of correcting them, the caregiver might use improv techniques to steer the conversation toward cherished memories, thereby reducing anxiety and fostering connection," says Johnson who also co-leads the program with Candace L. Kemp, Ph.D., professor of gerontology at GSU, and Amanda Lee Williams, an Atlanta-based theater artist, educator, counselor, and 2002 Emory University graduate.

Workshops are designed for professional caregivers, as well as students in Emory's School of Nursing and those enrolled in other health professions and certified nursing assistant programs around Georgia, including the Technical College System of Georgia.

Personal connections

Amanda Lee Williams, an ensemble member at Dad's Garage, uses her 20 years of improv knowledge and her personal experience caring for her father, who had dementia, to guide the program.

"I had somewhat lost my relationship with him because he became kind of a different person with dementia. But as I started using these improv techniques, I created a new relationship with him," she says. This personal connection drives her passion for the program, as she recognizes the impact these skills can have on both care partners and their loved ones.

"In improv, we focus on flexibility, adaptability, empathy and creative thinking," says Williams. "Applying that same empathetic approach—meeting people where they are rather than trying to pull them into your reality—leads to more meaningful and successful interactions."

Science meets spontaneity

As part of the program, Williams and Kemp are working with the Emory Integrated Memory Care program to study how improv training can effectively support dementia care—aiming to transition its use from being an evidence-informed practice to an evidence-based practice.

Kemp is the lead author of a recent study published in the Journal of Applied Gerontology that demonstrates how improv techniques can help care partners. The study identified four key approaches used by effective care partners that align with improv principles: knowing the person, meeting people where they are, being in the moment, and viewing every encounter as an opportunity for meaningful engagement.

The study suggests improv training is a fun and engaging way to teach these skills, with benefits for both care partners and individuals with dementia. "You can't change the person living with dementia, but you can change yourself and how you react and respond," says Kemp. "The improv mindset allows care partners to approach interactions with creativity and collaboration to allow for better care interactions and relationship encounters."

Expanding the program's reach

With only 27% of the necessary geriatric specialists in Georgia to meet the needs of its rapidly aging population, programs like Improving Care Through Improv play an important role in equipping caregivers with practical, empathetic skills. Over the past two years, the program has expanded to nursing homes, assisted living communities, and professional conferences.

To learn more, visit www.improvingthroughimprov.com.

Provided by Emory University