Julie Pasqual and Ambrose Martos look nothing alike even though they call themselves the Love Twins—Darlene and Dennis Love. They’re part of a group of performers who work for Vaudeville Visits, a program at Saint Barnabas Medical Center in Livingston, N.J., which is run by Healthy Humor, a national nonprofit that primarily sends clowns to pediatric units in hospitals.
Vaudeville Visits is meant for people in geriatric residential care facilities and elders in critical care, and its performers clown around but are not dressed as clowns. Instead, they play iconic characters meant to be easily recognizable to patients, including a cow girl, a used-car salesman and “Melvis” — supposedly Elvis Presley’s brother.
“The patient’s eyes lit up when she saw us,” Pasqual recalled. “She clapped her hands when we played and asked if we knew that song Frank Sinatra sang. She began singing a few lines, ‘I have dreamed that your arms are lovely. I have dreamed what a joy you’d be.’ I immediately recognized it. Ambrose found it on his phone. She reached for Ambrose’s phone and brought it close to her face gazing at the image of Frank Sinatra, and sang every word as if to him.”
“She remembers,” her caregiver said, smiling. “See, she remembers!”
The two performers and caregiver watched as the woman was transported back in time. “When it was over,” Pasqual said, “she looked up at us and said, ‘thank you.’”
Ambrose kissed her hand. The Love Twins bowed and danced out of the hospital room.
Vaudevillians, not clowns
Healthy Humor’s founders, Deborah Kaufmann, Dina Paul-Parks, and Karen McCarty, have more than 60 years of combined experience in health care clowning, mainly in the Big Apple Circus’s Clown Care Unit. When the circus went bankrupt in 2016, the three pooled their resources and formed Healthy Humor. (The Big Apple Circus returned the following year.)
They felt it was especially important to maintain the Vaudeville Visits program, which the Big Apple Circus started in 2004, because there are few such programs for patients with dementia.
A 2016 study published in the Journal of the American Geriatrics Society reported that clowning reduced moderate to severe behavioral symptoms of dementia. The study involved teams of two clowns working together, going from room to room to visit patients in Toronto’s long-term care geriatric homes.
“We found that after the residents interacted with the clowns for 12 weeks, there was a significant reduction in their neuropsychiatric symptoms,” said Pia Kontos, a scientist at Toronto Rehabilitation Institute and the lead author of the study. “Our study found elder clowns were just as effective as medication in bringing down aggression levels in seniors with dementia.”
She said that the clowns’ wearing vintage outfits likely helped evoke memories for the patients. “I thought, intuitively, this would be pretty magical, and it was.”
Music Also Improves Memory
A 2018 study in the journal Dementia and Neuropsychologia found music improves memory in Alzheimer’s patients.
Dikki Ellis and Ilene Weiss, also known as Dapper Dan and Miss Beatrice, got a firsthand look at how music evokes memories. They entered the room of a 97-year-old woman.
They sang gospel tunes, some Sam Cooke, and several Drifters songs. The woman talked to the vaudevillians about going to the Cotton Club in Harlem and meeting Cab Calloway. “I could tell,” Ellis said, “she was a ‘looker’ in her day. At one point Ilene gave her a small tambourine. She said she wasn’t very good on the tambourine, but really got into it. It cracked all of us up. It was so sweet and lovely. She complained of shortness of breath. As we left, she got so excited saying we got rid of her shortness of breath. She told the doctor we cured her.”
“What makes Vaudeville Visits work is that the program uses humor from the past, something the patients are familiar with,” said Theresa M. Redling, medical director of the Center for Geriatric Disease and Health Management at Saint Barnabas Medical Center and clinical assistant professor of medicine at Rutgers New Jersey Medical School. “If you go to any adult day program or long-term care facility, the music playing is not from today; it’s familiar to the audience. They relate to it, just like vaudeville.”
Characters reach back to patients’ younger days
A few years back, vaudevillians dressed as familiar characters such as John Wayne, Marilyn Monroe, and others from the period of their patients’ younger days. “It’s someone familiar,” said Andy Sapora, a vaudevillian in the program who is part of a chef duo calling themselves ‘Chef-Boy-I-Gotta-Pee.’
Sapora and Martos wear chef hats and matching mustaches. They carry a large pot with a lid, tongs, ladles, and a ketchup bottle that squirts red yarn. Martos had a felt chicken puppet with long yellow legs that hang out of the pot. They walked in and out of patients’ rooms saying they couldn’t find their chicken. At one point, they pulled out a fish, and triumphantly announced they found the chicken. Most of the patients responded, “That’s a fish!”
“Each time we visit a new patient,” Sapora said, “we stand at the entrance and ask if they’d like a visit? We also watch how we enter a room. We try to be gentle, polite, and funny. But what’s funny to one may not be funny to others. It’s important to read the room.”
Sometimes the humor can be edgy. It’s never mean. Even the staff enjoys these visits. “It’s fun for them to hear their patients’ laugh,” Sapora said. “And the spouses enjoy it, too. In one room, the wife was skeptical. Her husband didn’t speak. We stood at the entrance of the door and asked if we could come in. The wife got up and said, ‘he has dementia.’ Despite being sad, she said we could enter. We played our instruments. (Sapora sometimes travels with a tuba and sousaphone.) We told sardonic jokes and the man shook his head. He seemed fine having us there. And the wife enjoyed our visit, too.”
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