“I made you a small room in my heart”: how therapeutic clowns meet the needs of older adults in nursing homes

ABSTRACT

Therapeutic clowns are increasingly common in nursing homes, where residents often encounter factors that can undermine their quality of life and dignity. We aimed to understand the strategies of successful therapeutic clowning with a diverse older adult population, and the unique contributions of elder-clowning to the nursing home experience. Using an interpretivist descriptive methodology, twenty-three (n=23) experienced therapeutic clowns from eight countries were interviewed to understand the needs of nursing home residents met by elder-clowns, and strategies and techniques the clowns use to address them. Participants identified five major needs: to escape routine; for reassurance of worth; for meaningful, personalized social interaction unrestricted by communication barriers; to have culturally meaningful opportunities for reminiscence; and to have a space where residents could be unapologetically themselves. The artistic and emotional strategies used by the therapeutic clowns to address these needs illustrate how creativity, imagination and relational presence can provide nursing home residents with a sense of being known and belonging. Elder-clowns also positively affect the nursing home staff and enrich the interpersonal interactions in the residence. Through their focus on the social and emotional needs of residents, elder-clowns can play an important and distinct role in creating an optimal nursing home experience.

KEYWORDS:

• therapeutic clowning
• nursing home
• elder-clowning
• loneliness
• social isolation
• arts-based intervention

Disclosure statement

No potential conflict of interest was reported by the authors.

Supplemental data

Supplemental data for this article can be accessed online at https://doi.org/10.1080/17482631.2023.2238989

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.

Notes on contributors

Ludivine Plez

Ludivine Plez, MSc in Occupational therapy, first got involved in research as a research assistant at McGill's Child Language Development and Disorders Lab. She discovered the field of elder-clowning in the context of her Master's research project. Now a school-based occupational therapist in the US public school system, she applies insight from this research project to create playful, child-led opportunities for success and growth for her students.

Melissa Holland

Melissa Holland is a therapeutic clown and co-founder of the Dr Clown Foundation based in Montreal, since 2002. She has a BFA and a B.Ed. respectively from Concordia and McGill Universities. Through her studies she discovered and fell in love with the art of clown and was trained by several clown masters. While living in Scotland, she was hired by the Hearts and Minds organisation as a clown-doctor, and discovered her vocation. Melissa works regularly as a therapeutic clown with children and the elderly in health-care settings as well as Co-Artistic Director in development, promotion, training and research for the Dr Clown Foundation. She was a pioneering member of the Canadian Association of Therapeutic Clowns, and the North American Federation of Hospital Clown Organisations.

Priyanka Kulasegarampillai

Priyanka Kulasegarampillai, B.Sc, M.Sc.A, is an occupational therapist specializing in private practice. She works with individuals with mental health diagnoses and individuals recovering from car and work accidents. Her ultimate goal is to address both physical and mental barriers, facilitating their return to work and engagement in other meaningful activities. Her approach combines evidence-based therapeutic techniques with empathy and understanding, creating a supportive environment for her clients to open up about their experiences, and equipping them with preventive strategies to foster long-term well-being.

Thun-Carl Sieu

Thun-Carl Sieu, BSc, MSc, is a McGill University alumnus with a focus in Rehabilitation Sciences. As an Occupational Therapist and Case Manager at the Jewish General Hospital's Outpatient Psychiatry department, he coordinates care for patients with psychotic disorders, striving to optimize their therapeutic outcomes. His professional interests intersect mental health and occupational therapy, particularly emphasizing improved quality of life and functional independence.

Stefanie Blain-Moraes

Stefanie Blain-Moraes is an Associate Professor at McGill University, where she leads the Biosignal Interaction and Personhood Technology lab. She hold a Canada Research Chair (Tier II) in Consciousness and Personhood Technologies. Her research focuses on the assessment of consicousness and development of novel assistive technologies for minimally communicative persons. She also focuses on arts-based engagement and knowledge translation with the target populations of her research.