Newswise — Some Alzheimer's patients who take part in a drama therapy group respond to the make-believe activities in dramatic and surprising ways. Older people in mid- to late stages of Alzheimer's sometimes become very alert, cognizant and "with it" during the time they are doing drama group. And then they may become lost again.

Kansas State University's Sally Bailey, a registered drama therapist and past president of the National Association for Drama Therapy, attests to this uncanny response to play-acting.

People who are not always "with it" in reality still know when they are pretending, she said. They can tell the difference between reality and imagination. "We don't know why, and the phenomenon has not been much studied, but people can become crystal clear."

The response might be a vestige of early childhood development. By age 3, all humans engage in dramatic play and know about pretend. "We're all actors," Bailey said. Regardless of its origin, the residual inner child can be coaxed out to play again, and the dramatic playtime improves the quality of life for Alzheimer's sufferers.

Drama activities are first of all, concrete and sensory. They include improvisation, theater games, storytelling and enactment, and always a movement component. The goal is to stimulate the senses, muscles and nerves, to spark a sensory memory, to prime the pump and turn on the imagination.

"All the stimulation ends up in the brain, getting things connected all over. The activities can help patients orient themselves in the present and use their remaining cognitive skills for as long as possible. Aerobic activity in a group also breaks the social isolation prevalent in care facilities.

"Drama therapy is just very, very useful," Bailey said.

In spring, Bailey might bring flowers and spring scents and seeds to drama group, and present topics about growing. "I might play music like 'April Showers,' or other songs or poems the people might recall from their youth."

Likewise, in late autumn, she brings the famous Norman Rockwell painting of Thanksgiving to her drama group. That painting elicits personal memories of Thanksgiving: patients recall sounds, smells, tastes and other things associated with that day.

"I bring candles of cinnamon and pumpkin pie spice, fake leaves and long scarves of fall colors. I play fall-type music, and we dance with the leaves falling around us from the imaginary trees. It's real, and it's also pretend," she said.

Creative arts therapies -- art therapy, music therapy, drama therapy -- are being incorporated into care facility programming throughout the nation, part of a movement to change the "culture of care" to less of a medical model and more "person centered," a new idea everywhere.

"What we now believe is important in long-term care is improving the patient's quality of life," she said. "If, for 30 minutes twice a week during drama group, a patient is re-oriented to person, place and time, that is a big improvement of their quality of life."

Drama activities seem to wake up in people that part of the personality that captures joy and wonder, said Bailey, which is what keeps us young at heart and young in our minds and wanting to stay alive.

She has taught drama therapy techniques to social workers and to administrators of long-term care facilities, nursing homes and adult care facilities in Kansas. In addition, she taught a drama therapy component to staffers of six Arts and Inspiration Centers in Kansas. Alzheimer's Association sponsors these respite centers to provide "time off" for caregivers who live in the same household with a person with dementia.

In hope of expanding drama therapy programming to benefit more people, she is applying for grant funding in order to write a basic drama therapy manual, a tool that could be used to design programming for day care centers, nursing facilities or retirement communities. She is assistant professor in the K-State department of speech communication, theater and dance. Bailey formerly worked as drama therapist with recovering drug addicts and patients with developmental disabilities.

"I miss the clients," said Bailey, "but I love teaching people to become drama therapists."

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