The program

The CHSLD Résidence Paul-Lizotte was the first facility to host one of our programs.  Martine Dallaire, Recreation Coordinator, believed in our project from the start and was very enthusiastic about trying out this new approach with her clientele.  The Fondation Paul-Lizotte agreed to finance the pilot project, which began in the fall of 2000.  The program has been running ever since, with two hours of visiting per week.  An average of 30 residents (out of 128) are visited each time, which adds up to 1500 visits per year.

At the CHSLD Paul-Lizotte, the residents are 65 to over 100 years old, in widely varying states of mental and physical health.  Some of them are frequently visited by family and friends, others receive almost no visitors.  The patients are divided into those who have difficulty getting around and can no longer live alone, but who are still mentally alert, and those who suffer from Alzheimer’s disease, with cognitive degeneration, especially in regard to memory.  The clowns’ visits seem to benefit the second group of patients the most, creating moments of respite with music, games, memories, communication, and listening.

	While the orderlies expressed surprise at the idea of the clowns’ visits (75% of them), they nonetheless expressed very positive reactions to the program (100% approved it) and interest in its continuation.
	Prior discussion between orderlies and clown-doctors allows them to identify the patients who need company, comfort, or conversation; suggest ways (words, attitudes, songs) to make it easier to approach the patients; and inform the clown-doctors about any special measures to be taken in regard to hygiene, disease, or certain patients’ episodes of pain.
	The clown-doctors must respect the individuality of each patient and take into account advice from the care staff as to which patients would benefit (or not) from their visits (75% of the orderlies have suggested to the clown-doctors which patients it would be important to visit).
	Our visits caused no disruption in patient care and facility operations.  Certain professionals even expressed the desire to be more involved in the clowns’ antics.
	The care team seems to have attributed to the clown-doctors a particular ability to stave off loneliness and sadness among patients.  They are also perceived as mediators, who can defuse certain crises, such as paranoia, anger, etc.
	The clown-doctors’ visits encourage socializing and communication among the residents, which continues even after the team of artists leaves.  The clown-doctors seem to help reduce feelings of isolation among patients and spark their interest in life, two important elements in the prevention of depression, which so often afflicts the elderly.
	The patients with Alzheimer’s disease have proven particularly receptive to the clown-doctors, who favour non-verbal communication of feelings, over verbal interaction.
	The clown-doctors’ visits represent an opportunity to reach out to patients who are often withdrawn and sometimes ashamed, as the early stages of their illness affect their ability to interact socially.   A means of communication can be developed through laughter, fantasy, and touching, especially since these adults, like children, never grow tired of the jokes and songs that are part of the clowns’ performance.
	The care staff has actually noticed a more stimulated, lively attitude in these patients, which encourages them to talk or make comments – reactions that had sometimes become rare.  Using laughter to open a channel toward others is doubtless an avenue we should pursue.

Clown-doctors are part of a movement in humanizing care that encourages dialogue with patients.  Their services are complementary to, but different from, other types of caring, such as pet therapy and music therapy.  They are not simply a form of entertainment, but a means to bringing laughter and communication among the facility residents and its staff.
 

What they have to say

“I soon realized that the team from Dr Clown wasn’t just there to fool around, but to use their characters to break the ice with the patients, reduce their suffering, bring them joy, and expose them to a world of fun and games.”  (A nurse’s aide)

“No matter how dependent or independent the resident is, it is important to go beyond the simple question of care and break the vicious circle of unwelcome isolation and solitude.  The greatest suffering for a human being is, without a doubt, to end his days in loneliness.”  (Martine Dallaire, Recreation Coordinator, Résidence Paul-Lizotte)

“When you come by, when you arrive unexpectedly, our spirits lift a little.  After you leave, people are smiling.  Even if you don’t see a smile on their faces, it’s there, in their hearts . . . Those moments stay with us . . . for the rest of our lives.”  (Mrs. Clé, resident of CHSLD Paul-Lizotte)

”You get the impression you are standing before the gates of Death . . . so for a moment of joy, just one, it is probably all worth it.”  (a therapeutic artist)

“It’s relaxing . . . I would even say it forces us to lighten up.  It pulls us out of our usual routine.”  (a nurse)

“We really appreciated the visits our relative received.  We are very happy to know that his memory lives on through your presence.”  (the family of a deceased resident)

“I found it amazing to see some youth, a smile, a light reappear.  Once you have laughed, anything can happen, you can face the really difficult things.”  (a nurse’s aide)

”I would really like you to be the angels who push my wheelchair into heaven.”  (a resident)

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