Photo: Caring Clown Program - Ryerson University: The Chang School/Ryan Fung.

When Lynda Del Grande resumes her teaching schedule this fall, she’ll be welcoming a group of students who are quite unlike the pupils she taught in junior school and high school in North York earlier in her career. But it’s not just the make-up of her classroom that’s changed. It’s the subject matter, too.

Del Grande will be teaching her new crop of students (who are 50 years of age and older) a creative mix of clown skills, which they will use to better the lives of people living with dementia in long-term care centres. Just don’t expect the stereotypical Chuckles the Clown variety of performer.

“These aren’t the Chuckles the Clown variety of performer. Caring Clowns are trained to engage and cheer up people living with dementia.”

The course Del Grande teaches (which she also created) is the Caring Clown program, part of the Programs for 50+ at Ryerson University’s G. Raymond Chang School of Continuing Education. The three-course program (which has run from November to May each academic year since 2008) is for adults who want to make a difference by bringing joy, laughter and fun into the lives of long-term care residents.

Care clowns can connect to dementia patients in a meaningful way. Photo: Caring Clown Program – Ryerson University: The Chang School/Ryan Fung.

Not your standard clown

“But I’m not teaching my students to become your typical clown,” she says. Don’t expect a gaggle of freshly groomed Bozos and Weary Willies to graduate from the Caring Clown program. Del Grande, who holds a master of education in adult education and has worked as a teacher, life coach, certified laughter yoga leader and therapeutic clown, describes her kind of clown as more like “your eccentric cousin.”

“As a caring clown, I developed the ability to bring laughter and joy and derived much pleasure in the process. Our clown presence is healing, empowering
and uplifting.”

Caring Clowns don’t wear corsages that squirt water, over-sized Elton John glasses or giant floppy shoes. “They don’t use a lot of makeup or clown costumes or deliver predictable comedic routines but are more apt to liven up their everyday street clothes,” explains Del Grande. “They’re focused on being authentic and non-judgmental, and are very careful not to appear patronizing.”

She and her students take clowning seriously – so much so that they’ve earned the praise of long-term care experts, such as the staff at Baycrest Health Sciences, who see the positive impact Caring Clowns have on  residents who live with various degrees of dementia.

Students in the Caring Clown program are introduced to clowning techniques, which they develop over the three courses, and are briefed extensively on various aspects of ageing and dementia. “We work closely with – and tap into the expertise of – Toronto-area homes, where our students get hands-on experience during supervised practicums.”

“I teach the trainee clowns how to be spontaneous and reconnect with their playfulness,” says Del Grande. “Our interactive classes involve a mix of lectures, journaling, peer feedback, role play, improv and other creative activities that develop imagination, spontaneity and musicality.”

Laughter proves to be the best medicine for long-term care residents with dementia. Photo: Caring Clown Program – Ryerson University: The Chang School/Ryan Fung.

Said program graduate Audrey Lowitz: “As a caring clown, I developed the ability to bring laughter and joy and derived much pleasure in the process. Our clown presence is healing, empowering and uplifting.”

Being sensitive to the longterm care residents, their energy levels, moods and how they respond to music, humour and props is a priority for the Caring Clowns. “Everything we do is geared to the long-term care home and its residents,” says Del Grande. “Some residents will sing along, others will tell a joke, and sometimes an individual living with advanced dementia will simply open an eye and smile. We look for small changes. Hearing a resident singing as we’re heading out the door at the end of a visit tells me we’ve made a connection.”

Improving lives one chuckle at a time

Long-term care experts around the world are increasingly turning to variations of Caring Clowns, sometimes called medical clowns or elder-clowns.

BMC Geriatrics Journal recently reported on a Switzerland-based study titled Strategies for diversity: medical clowns in dementia care: “The strategies employed by medical clowns in activities with older people with dementia appear to support social interaction. The medical clowns used the social and material environment in culturally responsive ways to strengthen individuals’ sense of self, while contributing to a sense of togetherness and interaction among residents in the common spaces.” The study also reported that “agitation levels decreased significantly in nursing homes where medical clowns worked with humour therapy, compared to homes where no cultural activities took place.”

Similarly, the Canadian Institutes of Health Research reported on a pilot study titled Elder-clowning in long-term dementia care, spearheaded by the University of Toronto and Baycrest Geriatric Care, in which a pair of elder-clowns visited 23 long-term care residents with moderate-to-severe dementia. During twice-weekly visits over a 10-week period, the elder-clowns used improvisation, humor and empathy, along with song, musical instruments and dance to engage individual residents. The study found that elder-clowning reduced behavioural and psychological symptoms of dementia and improved overall quality of life.

And benefits to the student-trainees? “The program is transformational for the students,” says Del Grande. “I’ve observed reticent adults tapping into their playful side, unleashing their creativity. And for me? Clowning keeps me feeling and looking younger. People don’t always realize there’s a physicality to clowning. It’s by no means a sedentary activity.”  She also acknowledges another bonus of the program. “There’s a wonderful sense of community among the graduate clowns who connect over their desire to make a contribution, to make people happy. That’s part of the magic of clowning.”

For more information on the Caring Clown program at Ryerson University, visit www.ryerson.ca/ce/caringclown