by Rev. Dr. Jade Angelica
It was like following a trail of breadcrumbs – randomly scattered throughout a deep forest. One at a time, I found them, ate them, felt nourished and inspired, and then kept walking with my mother on her journey through Alzheimer's. Eventually the trail led me into collaboration with the creative and dedicated people who comprise the Healing Moments™ Alzheimer's/Dementia Education, Advocacy, and Ministry team.
The trail began during a phone conversation with my colleague, The Rev. Libbie Stoddard. During the summer of 2004, I planned to spend two weeks in Iowa caring for my mother whose illness had progressed to the stage where she could not be left alone. My sibling, who lived with Mom, was going on vacation, and Mom needed a substitute companion. I searched the Alzheimer’s Association website for insights and found many facts and much information about the disease. But what I wanted was a training manual for how to interact with Mom in positive, affectionate, effective ways. My sibling had frightened me, saying Mom was uncooperative and combative, telling me I would need to manage Mom by threatening to take her to the mental hospital if she did not "obey," and/or give her anti-psychotic medication the doctor had prescribed. I felt this was a dreadful and completely unacceptable way for me to interact with my confused, vulnerable mother. There HAD to be another way. Hearing my distress, Libbie suggested that I read Joanne Koenig Coste’s book Learning to Speak Alzheimer’s. I ordered this book overnight express from Amazon.com and read it in the plane on the way from my home in Maine to Iowa.
Joanne Koenig Coste provided the next life-giving breadcrumb. Somewhere over Michigan I read about the “Habilitation Approach” for communicating. The recommendation was for “care partners to place themselves in the patient’s world, no matter where that world is.” At that moment, I made the connection between this type of interaction and the skills I was learning in my improvisational acting class. Which is another whole story! Why I was and am still attracted to improvisation has been a mystery to everyone who knows me, including myself. Outwardly, I’m not the type; I appear to be shy and quiet and serious. Rather than leave anything to chance, I would prefer to be in control of the entire universe, knowing at every second exactly what people will say and do, and knowing exactly what is going to happen next. But Joanne helped me understand that the world of Alzheimer’s is completely the opposite - always unpredictable, always surprising - rather like regular life, if we are willing to acknowledge this reality. That’s why I’m drawn to improvisation - it’s more like real life than most of us will admit.
As I continued to read Learning to Speak Alzheimer’s, it was clear that Joanne was naturally relating to her husband and other persons with Alzheimer’s using the improvisational exercises that were so unnatural to me, and I was working hard to learn. Joanne is what the famous improviser, Keith Johnstone, calls a “Yes-sayer.” She can naturally accept and say “Yes” to whatever life presents to her. I’m naturally a “No-sayer.” Johnstone says there are more of us “No-sayers.” We want things to be different than they are, and we try to make our desires into reality. As I read about Joanne’s Habilitation Approach for communicating and connecting with persons with Alzheimer’s, I said to myself, “Yes, this is an inspired and healing idea!” Although I knew from my own experience, that saying “Yes” is easier said than done, I decided to accept the challenge and try this form of communicating with Mom.
Mom wasn’t uncooperative at all; she was just in a different “zone” ....at times, she was, literally, in a different reality. Using my improvisation skills and techniques, our communications became fun and creative instead of combative. One afternoon, we were planning to visit Mom’s friend who lived in the nursing home. While I was getting ready in the bedroom, Mom rushed to find me, all upset. She said, “We can’t go now, this is the time when Milly always comes to visit.” Dear Aunt Milly – Mom’s sister. She’d been dead for 25 years. In an inspired moment, born of my intention to say “Yes” to Mom’s reality, I accepted that this WAS the time that Milly comes to visit. With the goal still in mind to go on the nursing home visit, I responded appropriately to Mom’s reality, saying, “Well, what would you think if we put a note on the door letting her know where we are and when we’ll be back? We can leave the door unlocked and Milly can come in and wait if she comes while we’re away.” Mom thought for a moment and then said, “That’s a good idea.” Noticing that she was satisfied with this solution, I suggested she get paper and a pencil so we could write the note. In the search for the paper, Mom got distracted from thinking about Milly’s visit and by the time I was ready to go, Mom was ready to go, too. The note was never written and Mom didn’t mention Milly again.
During my two week visit with Mom, I literally slowed down. I walked at her pace; I looked at the things she noticed and showed me; I listened to her garbled speech with great care. This paying attention and careful listening, combined with going with her flow, redirecting her wave when things needs to be accomplished, and laughing...this was how we connected. We were both in the moment - her moment, always, and there we both experienced much joy.
During my time in Iowa, I met with a staff member from the Alzheimer’s Association, and told her about my discovery and my experiments with Mom. She was wholeheartedly enthusiastic about this approach and encouraged me to develop a workshop using improvisational theater techniques to communicate with persons with Alzheimer’s. Her enthusiasm planted the seed for this entire program.
When I returned home to Maine, where I was living at the time, I met with psychiatrist there to discuss some of the family dynamics that had emerged while I was in Iowa. When we met, I was surprised to learn that he had previously been medical director for a number of nursing homes in Massachusetts and had evaluated thousands of Alzheimer’s patients. This information distracted me from my family dynamics and I told him about my idea of using improvisational theater techniques to communicate with the Alzheimer’s population. Another surprise came when he told me he had had this exact ideas ten years earlier. He had even tried to have performers from Boston improv theaters come to teach nursing home staff these techniques. Both enthusiastic and amazed that we had met, we continued this conversation over a number of months. His breadth and depth of knowledge, his resonance with my inspiration, and his generosity with time provided the nourishment for this program to sprout.
Will Luera, then the Artistic Director at ImprovBoston had come to Maine to teach classes for my improvisation practice group. Having been impressed by Will’s interpersonal sensitivity as well as his talent, I contacted him to see if he would be interested in helping me develop a workshop for communicating with persons with Alzheimer’s. Previously, I had mentioned to Will that I was discovering spiritual components in improvisation, and he was fascinated. Now I hoped he would help me incorporate these spiritual components for healing into the creation of an Alzheimer’s workshop. Intrigued by the potential of such a creative and alternate application for the craft he loved, Will said, “Yes, Let’s!” right away. He was on the next train to Maine; we ate soup, walked by the ocean, and gave birth to the Healing MomentsTM programs for persons with Alzheimer’s and their families, friends and caregivers. Thirteen years later, Will, now the Director of Improvisation at Florida Studio Theater remains committed to the idea that improvisation has potential for healing. We are planning to collaborate on offering Healing Moments programs in the Sarasota, Florida area beginning in 2017.
This improv form of communicating – this way of being in the world – opens doors to spirituality. When I met my mother in her improvisational reality, we both experienced healing.
Some of the spiritual elements I discovered in Mom’s presence and integrated into the Healing MomentsTM Alzheimer’s Programs are:
All of this....moment by moment.
Then life disrupted the progress of the program and I wandered around for a long time in that dark forest without finding any bread crumbs. The outline for the Alzheimer’s program Will and I developed, was tucked away, hibernating in my filing cabinet. Years passed. I moved to Massachusetts, began the intensive fourteen-month workshop program at ImprovBoston University and the Doctor of Ministry program in Faith Health and Spirituality at Andover Newton Theological School.
Eighteen months after I filed away the Healing Moments Alzheimer’s program, a friend from my class at ImprovBoston University, invited me to Christmas dinner. My friend’s mother and her sister both worked in nursing homes with Alzheimer’s patients. Hearing about the Alzheimer’s/Improvisation workshop, they became very excited....an excitement that felt infectious and rebooted my enthusiasm for the project. They gave me names to contact at the Alzheimer’s Association ....and I began making calls immediately.
Already aware of the benefits that this type of communication provides to persons with Alzheimer’s, staff from the Alzheimer’s Association in Massachusetts were excited to notice that care-partners who meet persons with Alzheimer’s in improvisational reality could enhance many areas of their own lives as well as their loved ones’ lives. Our program was launched!
When Dr. Brita Gill-Austern, Professor of Psychology and Pastoral Theology at Andover Newton Theological School in Newton, MA heard I was developing this program, she was so enthusiastic about the innovative nature of the project, and the potential for healing in the face of an incurable disease, she and the program she heads, Faith Health and Spirituality, voted to provide us with a grant to fund the start-up costs of the program. She also invited us to make a presentation for her Pastoral Care and Counseling class for the section on Aging. We said, “Yes, Let’s.” The presentation was so well-received, Dr. Gill-Austern asked us to provide a day-long workshop. We said, “Yes, Let’s” to this, too. The workshop, “Meet-In-The Moment: Saying Yes to Alzheimer’s” was offered at the Andover Newton campus on October 27, 2007.
Since then, many creative and compassionate people have been drawn to participate in leading the Healing Moments Alzheimer’s Programs. The healing properties of the artistic craft of creative drama resonates to the core with every member of the Healing Moments’ team. This deep connection to the mission of the project has called together a dedicated team of healing professionals who seek to create educational environments all across the country in which connections are made, and healing can happen.
In 2014, Healing Moments began a collaboration with researchers from the University of Iowa, Department of Neuropsycology; and for over two years we have been offering workshops for dementia family caregivers and gathering data about how the work of Healing Moments affects them and their loved ones.
I feel great joy and gratitude because a flash of inspiration in an airplane somewhere over Michigan has manifested into a program that is helping persons with Alzheimer’s and the people who love them and care for them. And I feel awe, because I know that if any one of the bread crumbs had been missing or missed, this program would not be.