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How clowns can take the edge off of ageing

Clown Doctors

In terms of ageing well few phenomena can compete with being a clown. The most ancient "clowns" have been found in the Fifth dynasty of Egypt, around 2400 BC.

Unlike court jesters, clowns have traditionally served a socio-religious and psychological role, and traditionally the roles of priest and clown have been held by the same persons.

Confirming a view from ‎Elizabeth MacKinlay Director of the Centre for Ageing and Pastoral Studies at St Mark's National Theological Centre, Canberra, that laughter, spirituality and ageing have inexorable links. Whereby laughter might even be part of the spiritual dimension.

While some horror story writers have used clowns as central characters of mayhem and evil they’re better known as purveyors of unrestrained joy and laughter. One reason why clowns, the ‘specialists’ in delivering humour ‘therapy’, are at the forefront of making older people laugh. Their brand of medicine produces powerful outcomes indicating that laughter is one of the best anti-ageing secrets. 

A number of studies on older people with dementia living in nursing homes concern the effects of humour therapy and quality of life. For example, it was found that agitation levels decreased significantly in nursing homes where medical clowns worked with humour therapy, compared to homes where no cultural activities took place.

Findings from other studies confirm that medical clowns had a beneficial and effective impact when working with persons with dementia, integrating skills such as drama, music and dance. Humour can stimulate social interactions in dementia care.

Positive emotions and laughter may enable people with dementia to cope better with their illness, improve immune defence, increase pain tolerance and decrease stress response. Such results point to effects that resemble intervention studies involving psychosocial interventions where social activities reduce aggressive and depressive behaviour among older people with dementia.

Stress has been shown to accelerate ageing and disease, anything you can do to reduce stress has to be good. So how about laughing more?

Recent research has shown that laughter really does help us in managing stress. Adopting a humorous view of life’s difficulties can take the edge off every day stressful situations.

Laughter prevents tension building up and stops the release of damaging stress hormones into the body.

We are probably all aware that not being too serious about everything helps us to keep some balance in our everyday lives. But laughter is more potent medicine than that. Not only does it deliver a sense of perspective but it can actually help to promote clear thinking.

Being able to laugh stress away is one of the smartest ways you have to protect yourself from the harmful effects of stress, essential for anti-ageing health.

A sense of humor also allows us to see and understand life’s little quirks and provides us with moments of true delight, even in the darkest of times.

Laughter causes synchronized contraction of facial muscles, increases respiratory rate, blood flow and the release of adrenaline in blood and ultimately leads to joy and happiness. It is the cheapest medicine for preventing many diseases and fighting against them. Laughter also decreases the heart beat rate and blood pressure while it increases oxygen intake in tissues by making the individuals take deep breaths. Hence, laughter can benefit both mental and physical health.

LAUGHTER really could be the best medicine, albeit a complementary one.

Combine it with yoga, minus the downward dogs and active wear, and it appears it not only can improve your mood, it also has the potential to lower blood pressure.

La Trobe University researchers set out to assess the effects of laughter yoga, a group therapy combining deep breathing, clapping and chuckling, on 28 people living in aged-care homes.

“A growing body of evidence indicates the health benefits of laughter,” she wrote in the Australasian Journal of Ageing.

“These include reducing stress, blood pressure and stress hormones; increasing muscle flexion and triggering the release of endorphins — the body’s natural painkilling chemicals that produce a general sense of wellbeing.”

Commencing in early March, the programme will involve four hour visits by a Clown Doctors duo to each of Selwyn’s rest home and hospital care facilities on a rotational basis over an initial period of twelve months. The Selwyn Foundation is pioneering the work of this unique diversional therapy programme and is the first provider in New Zealand to engage Clown Doctor services in the residential aged care environment. 

The Clown Doctors New Zealand Charitable Trust provides a high quality, professional service in medical clowning. The Clown Doctors are not party clowns, but experienced professional actors, drama teachers, performing artists and musicians. Each practitioner has completed comprehensive medical clowning training in the performing arts, medicine and health science, psychology and gerontology, social science and cultural studies, with the training provided by the International Institute for Medical Clowning at Steinbeis University, Berlin.

Through one-to-one engagement with individuals in a healthcare setting, they use alternate modes of expression, entertaining performances and enhanced communication techniques such as movement, gesturing, gentle touch, mirroring, dance music and rhythm to reduce stress, anxiety and loneliness and enhance the quality of life of those who may need an emotional boost. Their dress is often reminiscent of a specific era in people’s past - they may, for instance, wear clothing from the 1940s - and the only thing that distinguishes them as a clown is their red nose!

The initiative supports the Selwyn philosophy of providing spontaneity and, thus, reducing boredom. By interacting with residents in a humorous way, the goal is to offer enabling environments that enhance the residents’ enjoyment of life and self-image, whilst at the same time offering compassionate, respectful and person-centred empathy.

The agreement with The Selwyn Foundation builds on a successful pilot Clown Doctors programme that took place at Selwyn Village (Point Chevalier, Auckland) in 2015.  

The Foundation’s CEO, Garry Smith, says: ‘Feedback from our residents and staff alike indicated that residents very much responded to the Clown Doctors, opening up and talking about their life experiences and joining in the banter and general camaraderie.'

‘But the visits are not just an entertainment activity - there are considerable therapeutic benefits to be gained. International research has proven the positive effects that humour and laughter have on health and the immune system, and the Clown Doctors’ positivity and spontaneous approach definitely lift people’s spirits.’

Clown doctors in action

The Clown Doctors NZ Charitable Trust started in New Zealand in Christchurch in 2009 and expanded to Auckland in 2010 and Wellington in 2012. It's mission is to ‘bring joy and laughter’ to those in need, and it currently provides services within children’s wards and hospitals in these centres, as well as in older person’s health units in Christchurch’s Princess Margaret Hospital.

Clown Doctors’ founder and Executive Trustee, Professor Thomas Petschner, says: ‘Each Clown Doctor is trained to understand the complex physical and mental health needs of older people, and to help seniors cope with changes in their physical and mental abilities, dementia or depression.'

‘Working in conjunction with care staff, they endeavour to achieve a range of positive effects for residents. These include increasing overall wellbeing, reducing any feelings of loneliness, helplessness, boredom or stress, helping them through any difficult or emotional times and, generally, providing a fun environment for all.’

At the start of each visit, the Clown Doctors are fully briefed within the care facility and then, in character, visit individual residents in their rooms and in other communal areas, and may also involve visitors and staff in their programme. They conclude each visit by completing a written report for evaluation purposes, which includes staff feedback.  

Thomas Petschner, says: ‘Each visit unfolds differently, evolving from the circumstances of the moment and the needs, interests and abilities of each resident, and visits can be tailored to an individual’s specific needs at any given time.’

The clown doctors aren't traditional clowns. They are experienced actors, drama teachers, performing artists and musicians.

Each of the clowns has completed comprehensive medical clowning training in the performing arts, medicine and health science, psychology and gerontology, social science and cultural studies, with the training provided by the International Institute for Medical Clowning at Steinbeis University in Berlin.



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Date published: 18 April 2018

Review Date: 18 April 2022