Six months after leaving my previous position as a dance/movement therapist with the elderly with dementia, I am enjoying the opportunity of bringing dance therapy into sites which have not previously had it. Why every site for folks with dementia doesn't have a dance therapist is truly beyond me! People seem to understand instinctively that the elderly respond well to music, but they seem to miss the point that the elderly HAVE TO move to maintain physical and emotional well-being. There is no vitality without the body, and dance therapists are all about engaging people's vitality.
This past week, a group of people with varying levels of dementia and I had a wonderful time, as I led a dance therapy group in a new site, using movement as the medium for psychotherapy. As I was blowing up a huge balloon, a 60 something year old woman told me that the balloon was big enough. As she began to say, “But you’re not going to listen to me”, I turned around to face her, and showed her that I was knotting the end of the balloon. With an air of surpise, she said “but you did listen. No one ever listens. No one thinks I know anything.”
I moved around the circle, shaking hands and making eye contact with each person, telling them my name and asking them theirs, and if they couldn’t tell me, I told them I was glad to meet them even if they couldn’t tell me their name.
As I sat down, I began with arms open, asking them to join me in that movement. I asked them what my movement might mean. The woman beside me, who was quite articulate, said “a circle”. When I asked what kind of circle, she announced indignantly, “a round circle”. I agreed that we were creating the shape of a circle with our arms. Another woman said "a hug". I told them that this was my way of welcoming them, and hoped that they welcomed me as well.
Paul Raia, PhD and Joanne Koenig-Coste, MEd of the Massachusetts Alzheimer's Association, wrote an article about Habilitation Therapy which can be found at http://www.alzmass.org/newsletters/prior2000/habilitation_therapy.htm. In their paper, they state that "the aim of habilitation therapy is not to restore people with a dementia such as Alzheimer's disease to what they once were (i.e., rehabilitation), but to maximize their functional independence and morale." They go on to ask , "When cognitive capacities involving memory, logic, reason, decision making, judgment, language, attention, perception and motor control are all being gradually lost to the disease, what remains? What cognitive capacity can we then use as a channel to the brain?" The answer they come to is that "The collective experience of caregivers tells us that the capacity to feel and exhibit emotion persists among people with Alzheimer's far into the disease process. What is lost is the insight into what may have triggered a particular emotion, or how to control it. The ability to feel emotion, then, may be our best inroad to the Alzheimer mind."
Dance therapy affords us the opportunity to engage in an emotional relationship with others, both verbally and non-verbally, in the immediacy of the moment, which is all that people with dementia may have (or any of us, for that matter).
In light of the Thanksgiving holiday, I played "Thanks for the Memories", and a few people sang along. When I asked what people were thankful for, 4 or 5 people answered “God’s love” “family” and the like. I told them I was grateful that I could still move, and we tried moving different parts of our bodies to music. Mostly, they moved their arms a little bit, close to the center of their bodies. A minimum of energy was expended. I handed out 3-color crepe paper streamers to each person, and asked them why I might have chosen the colors I did. Brown for the turkey, orange for
pumpkins, squash or carrots, and yellow for lemon meringue pie.
With "Hey Good Lookin'" playing on my i-Pod, we moved our arms in a circle as though we were cooking, and people contributed ideas for what they enjoyed eating on Thanksgiving, and ingredients for making it a joyous holiday. Some could respond verbally, others only with their movement and their attention.
To encourage a greater range of expressive movement, I brought out the balloon. Now people began to be a little more active. There was one woman, Eleanor, who until now kept asking repeatedly “Are we going to have lunch?” At first I told her that
she’d already had lunch, but when she replied that they hadn’t given it to her, I changed my response, saying that no, we wouldn’t be having lunch until
later. When I tossed the balloon to Eleanor, she hit it to me suddenly, with great strength and directness. I then began tossing to each person just as she had, suddenly, with strength and directness, asking them each to “give me whatcha got”. With the balloon, I was able to include those who were not sitting in the circle, including one man who looked
pretty high functioning who came over to join us in balloon toss. I also tossed the balloon to a woman who was dancing all around,
but didn’t want to join us because she couldn’t sit down. She told me
her “oars aren’t quite in the water”. I told her not to worry, mine
weren’t either. Eventually, I turned back to
Eleanor again, and told her that I was very surprised at how much strength she'd demonstrated. As I tossed it to her again, I asked others if they knew she had that
strenth in her? They all laughed, and she again returned the balloon to me with vigor. She told me proudly that it was the Canadian in
her. She didn't ask about lunch again.
Now that they were using a bit more energy and interacting with each other more non-verbally, I brought out the Octaband to increase their engagement with each other. It took time for me to put it on each person’s wrist. There was one woman sitting at a table nearby who could speak, but not English. She had wanted to remain at the table because she was working on coloring a place mat for Thanksgiving. When I asked her to join the circle to use the octaband, she smiled agreeably and moved to the circle. I also invited the woman who’d been dancing outside the circle, who said she didn’t think she’d be able to sit. I told her that was alright, there was a space in the circle where she could stand. As I was putting the bands over people’s wrists, she sat down just outside the circle, but beside me. When I got to her, I asked her if she could either stand up, or sit down next to me, because the octaband arm wouldn’t reach her. She sat beside me, and remained sitting for the rest of the time without any restlessness evident. As I sat down, people were moving their arms a little bit, but there was a lot of room for improvement. One woman's face was lit up though.
I began leading us, just moving the arms rhythmically, light and bouncy. Once we had that down, I asked if we could raise it all together, and we did. So then I had us go way up and way down. Then we began pulling on the arms. After a bit, I asked us to rest our arms a bit, and kick our legs. Now everyone was involved and energetic. Our movement became increasingly vigorous, as I returned to lifting the arms way up and way down, and bending the torso as we leaned over to bring the octaband down. I followed their movements, inviting others to do the same. We moved up and down and in and out. I was working up a sweat, and they agreed that they, too, were warm. We counted to 3 and let go of the octaband.
Now it was time to begin to cool down a bit, relax after all that vigorous movement, and begin to prepare for our ending. I showed them all turkey feathers, asking them what they were, and handing each person a feather. I told them that the feathers came from the turkeys in my neighborhood, and that I had washed them to make sure they were clean. When we all had them, we used them gently on the skin of our arms and our faces. We were moving with slow, light, self-nurturing movements now. When they began to tire of that, I us moving them as though they were fans. After doing that for a short time, I brought us back to gently stroking. One woman asked if she could keep her feather as a memento. I told them all they could keep them if they liked.
As it was time for us to end, I began singing “Happy Trails”. Some joined in the singing, some with lalala. When I asked if they knew what tv show it was from, noone could name it until I began “Ro....” someone said Roy Rogers. One woman who had not spoken, had engaged with focus but with minimal energy, and had previously shown no affect, said “I know that name”. When I asked her “You remember Roy Rogers?”, she smiled and said “Yes. I think I do.” “And do you remember Dale Evans?” and her smile grew even wider. Some of the others remembered also.
We ended with our arms open wide again, and this time we wrapped them around ourselves with hugs and love for everyone in the circle, and one woman reminded me “and God’s love, too.”
