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Laughter Lift

September 21, 2011

Humor therapy is as effective as widely used antipsychotic drugs in managing agitation in patients with dementia — and avoids serious drug side effects, a new study to be presented this week at the National Dementia Research Forum shows.

The first major study of the impact of humor therapy on mood, agitation, behavioral disturbances and social engagement in dementia patients found both short term and persisting decrease in agitation, according to lead researcher, Dr Lee-Fay Low, a Research Fellow at UNSW’s School of Psychiatry.

The SMILE study across 36 Australian residential aged care facilities involved the recruitment and training of a staff member to act as a “LaughterBoss” who worked with a humor practitioner with comedic and improvisation skills — not unlike “Clown Doctors” used in hospitals to aid recovery and lift mood in children.

Jean-Paul Bell, the key humor therapist in the SMILE study, has set up the Arts Health Institute (AHI) to train humor practitioners and aged care staff. The Hay´s core program, Play Up, provides a playful relationship with residents and staff in aged care, focusing particularly with people with dementia. The AHI is now focused on translating the knowledge of the SMILE study into residential aged care and continues to work with UNSW’s Dementia Collaborative Research Centre to roll out the program nationally.

Dementia rates are expected to double to in the next 20 years in Australia to about 450,000, mainly due to an ageing population. About 6.5 per cent of people over 65 and 22 per cent of people over 85 have dementia — an umbrella term used to describe up to 60 different conditions causing similar neurodegenerative changes in the brain.

Between 70 and 80 per cent of people suffering from dementia are troubled by agitation, a problem for both patients with the disease and their carers.

“Agitated behaviors include physical and verbal aggression, wandering, screaming and repetitive behaviors and questions. This is challenging for staff and often indicates unmet needs and distress in the residents of aged care facilities,” says Dr Low.

The SMILE study found a 20 per cent reduction in agitation using humor therapy, an improvement comparable to the common use of anti-psychotic drugs.

“This shows humor therapy should be considered before medication for agitation, particularly taking into account its side effects.”

A major 2009 study for the UK Department of Health found serious side effects of antipsychotics, including thousands of deaths and strokes, linked to the use of these drugs in dementia and recommended a reduction in medication rates and specialized training for carers in non-drug therapies.

In the SMILE study agitation decreased not only during the 12 week humor therapy program, but remained lower at 26 week follow up. Happiness and positive behaviors rose over the 12 weeks of the program, however, dropped as soon as humor practitioner visits ceased.

The SMILE Study results will be presented at the National Dementia Research Forum 2011 on Thursday and Friday (22- 23 Sept). A documentary film, The Smile Within, produced by Hot Tin Productions and based on the SMILE Study, will also be screened.

A free public talk “Alzheimer´s and You? Prevention and Treatment of Dementia” will be held tonight (Sept 21 at 6.00-7.30pm) at the Wesley Conference Centre, 220 Pitt Street, in Sydney.

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