October 14, 2004

Where’s the humor in care giving?

By Vivian I. Silva,
Gerontologist/MSW
Special to the Times

An 80-year-old woman with Parkinson’s disease lived alone and refused to use her walker. Her caregiver worried that the next time she fell, she’d end up in the hospital. She wanted to know how to help her. I suggested finding a way to use humor.

At our next meeting I asked if there was a way we could help make her walker “user friendly.” She just didn’t like using it. After explaining that the next time she fell, if she broke an ankle or her leg, she could end up in the hospital and then to a skilled nursing facility. As long as she knew the consequences and still refused to use her walker, there was not much we could do.

This homebound woman watched a lot of television. I asked if she had a favorite TV personality. She replied, “I just love that Dan Rather!” I asked, “Do you have a picture of him we could tape to your walker so you’d be more willing to use it?” She broke into a smile and then laughter. Soon we were all laughing and she relaxed. The caregiver learned a non-threatening way to communicate with this fiercely independent client.

Mark Twain said, “The human race has only one really effective weapon, and that’s laughter. The moment it arises, all our hardness yield, all our irritations and resentments slip away, and a sunny spirit takes their place.”

Let’s look at what humor is not used for. It’s not to degrade or make fun of someone. We’re unique individuals so humor won’t be the same for everyone. For example, my father howled when watching “The Three Stooges;” but for me, watching my father is what made me laugh.

One definition in Webster’s Dictionary is “that mental quality which gives to ideas a ludicrous or fantastic turn, and tends to excite laughter or mirth.” Researchers are finding that laughter is healthy for us because of the following reasons:

Laughter:
- increases white-blood cell activity
elevates levels of cortisol and epinephrine (immune system)
- exercises internal muscles (good for bedridden patients too!)
- heart rate goes up
- feelings of relaxation
- stimulates the production of the alertness hormones catecholamines (which cause the release of endorphins in the brain—natural pain killers)

Bill Cosby said, “If you can find humor in anything, you can survive it.” Humor can be used as a survival tool because of the following:
- attitudes can change
- relieves tension or uncomfortable emotions
- a sense of control over our environment
- use for self-protection
- pleasurable experience for the moment which takes away anger and fear
- connects family, friends, patients and caregivers
- can bring sense of peace and joy
- allows respect for self and others

Since caregivers often find themselves exhausted and stressed, how can we find humor in caregiving? What are some practical things we can do?
- recognize what makes you laugh
- relax—it’s OK to be spontaneous
- start looking for the absurd, silly, incongruous activities that happen around you
- play with small children
- read the comics
- read a funny story
- watch a video
- ask the person you are caring for what makes him/her laugh
- write down funny things they can remember about childhood, earlier years, etc.
- be unpredictable (bring in a bright balloon or wear a funny hat—in other words, challenge yourself to be silly)
- tape humorous family history and stories

The one receiving the care might be bored and may feel like a burden. As you bring laughter into your life, you in turn may brighten their day. Share joke books and research humor Web sites such as www.laughways.com, or read books on humor such as “Compassionate Laughter: Jest for your Health” by Patty Wooten or “The Healing Power of Humor” by Allen Klein to help build your “humor library.”

Vivian I. Silva, Gerontologist/MSW is the director of Geriatric Advisory Program at Almaden Valley Counseling Service. The service educates and advises adult children of the elderly on elder issues and provides individual and family consultation. For more information call (408) 975-2988 or e-mail vivsilva@aol.com.