The best medicine

A clown who has been visiting a Sydney nursing home for the last 12 weeks can’t stay, but he hopes the laughter will.

Dr. Peter Spitzer and nurse Sue Harris present Pam Fitzgerald and husband Pat with two funny photos yesterday.

By Stephen Easton

With a tinge of sadness, staff and residents at Prime Life’s Beechwood Residential Aged Care Facility said farewell yesterday to Al Elderfield, the clown who has visited them weekly for the past three months to gently lift spirits and bring some much-needed silliness to dementia care.

To mark the end of the humour therapy intervention, the 12 randomly selected participants were all presented with a framed photograph from a light hearted photo shoot at the facility in January.  They were encouraged to dress up and strike a pose for the high-quality shots, which the friendly clown snapped via remote control so he could join them. 

The last visit from Mr Elderfield, otherwise known as Humour Foundation medical director and co-founder Dr Peter Spitzer, is also the start of a new chapter for the facility and nurse Sue Harris, who has been trained to continue making humour therapy a part of daily life at Beechwood, located in the south-western Sydney suburb of Revesby.

“I feel really positive about the future,” Ms Harris said.  “I’m going to think of ways that I can take it into the rest of the nursing home.”

“Generally speaking, it’s been really good for everybody, even those who aren’t involved with the program.  Everyone is influenced because I walk around wearing something silly every day.”

It’s all part of SMILE, or Sydney Multisite Intervention of LaughterBosses and Elderfields, an NHMRC-funded collaboration between the Humour Foundation, the University of New South Wales and the Dementia Collaborative Research Centre (DCRC).  

SMILE is the world’s first large-scale randomised trial to gauge the effectiveness of humour therapy in residential aged care, bringing professional performers from the Humour Foundation into 36 nursing homes and hostels around Sydney.  

Dr Spitzer said the idea behind the photo shoot at Beechwood was to give dementia care residents a recent event to remember, inspired by the studio shots of the family often hung on the walls of their rooms.  

“There was the anticipation of an interesting event that they were going to take a part in; they’ll look at the photograph and it’s recent, not 50 years ago.”

“Family and friends come in and ask about the photo, so then we have conversation happening.  We’ve left them with something that has some meaning for them.”

An amateur performing artist since medical school, Dr Spitzer named the SMILE clowns ‘Elderfields’, as they all belong to the fictional Elderfield family, and are very different to the Humour Foundation’s Clown Doctors who work mainly in hospitals.

“There are some issues about coming into a facility like this, where there’s dementia, in full clown,” he said.  “Some people say it’s too scary, and you might be demeaning the situation.”

“One thing about a professional performer is they’re trained and they have the professional capacity to tap into someone, so our work is not just entertainment, it’s actually engagement.”

The Elderfields all rely on nurses and allied healthcare staff that undergo training for the role of ‘LaughterBoss’ to continue their work, hopefully long after the study has finished.

Sue Harris is Beechwood’s LaughterBoss, which Dr Spitzer describes as “a modern day equivalent of the court jester”.  She has already begun bringing fun and laughter to residents outside of the original 12 chosen for the study, as well as getting senior staff and a visiting psychiatrist involved.

“LaughterBoss Sue knows everyone and everything, so she’ll tell me what’s going on when I come in,” Dr Spitzer said.  “She’s the one that’s now going to continue with elements of the program when we’ve finished our study here, to have play, fun, mischief and engagement.”

“One of the last things to go in aged care and dementia care is a sense of humour.  The point is there’s not enough staff or training to open the door to that.”

“It’s a partnership – we’re not taking anything away from anyone.  This humour business doesn’t replace anything; it’s still dependent on good quality care being present.  It’s an add-on.”

Tags: aged, ageing, beechwood, care, clown-doctor, dementia, elderfield, humour-foundation, laughterboss, peter-spitzer, smile,

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