Drama has been used as an activity in senior centers, day programs, assisted living facilities, and nursing homes for years as a way of bringing creativity and joy into participants’ lives and creating a more connected community. This is true whether the drama group participants have normal cognition or if they have begun to develop dementia.

In fact, because drama engages the imagination and stimulates the senses through embodied, concrete activities, it can bring adults struggling with Alzheimer’s Disease lucidly into the present moment and connect them clearly with memories of their past for the duration of the drama group.

Why Drama?

Drama involves the whole person in an active manner. Scenes can be done with dialogue or in silence (as pantomime), making it adaptable to the verbal abilities of the group. Lots of movement can be incorporated or drama can be successfully done from a stationary position. Memorization is not required as most drama sessions are made up as they go along. The major ingredient necessary for a successful enactment is imagination.

Acting out a memory makes it more real than just talking about it. Through action an abstract thought is given form and movement in an improvised scene. That memory comes alive in the moment and can be re-experienced, shared, and celebrated.

Even without using words, participants become aware of the others around them and start to connect and create social relationships. And best of all, drama is fun!

Typically a drama group begins with a warm-up activity which introduces a dramatic theme to be explored. The group might sing a song, look at a picture, or touch an object that brings up memories, engages their senses, and begins to connect them to each other. Then group members take the memories into action, replaying parts of their past or trying out new adventures they have just imagined.

Expensive equipment is not necessary for a successful drama group. Found props and simple costumes like hats or colorful scarves can be used in dramatizing a story. These inexpensive additions enhance the imagination, help participants get into character, and add more sensory stimulation to the experience.

A drama group usually incorporates all the other arts. A session may move from brainstorming an idea to acting out a scene to singing a song to playing a game to drawing a picture on the same theme. This provides an outlet for individual strengths and allows group members to focus on expressing themselves freely and creatively, rather than on perfecting a final product or performance. A trained drama therapist or drama facilitator can tailor activities to each specific group of participants’ abilities, interests, and attention spans.

Resistances/Concerns:

Beginning participants sometimes worry that they will have to “perform” in a drama group or that they will need special “talents.” In actuality, every one of us is able to do drama from the time we are quite young. Around the age of three all children naturally begin to imitate the people around them and engage in dramatic play. It’s one of the ways we are “hard-wired” to learn about ourselves and our world. Parents usually encourage this exploration by “playing along,” which develops the child’s imagination and cognitive abilities. This means everyone has experienced drama at least once as a young child, and anyone who has raised children, has participated in the process again from the parent perspective.

Drama is like riding a bicycle – once you learn how, you never forget it! What group leaders need to address initially are group members’ fears of failure and being put on the spot in front of a lot of people. This can be gently handled in the beginning by doing activities in which everyone participates simultaneously, while allowing participants to take the spotlight whenever they are ready and providing support and praise when they do.

Most participants, even those who may be confused in general, understand when they are pretending in a drama group and when they aren’t. As far as I know there has been no research to explain how or why this phenomenon happens; however, I suspect that since the ability to use the imagination and to pretend begins early in development, we retain this ability even when certain parts of the brain later in life begin to decline. Since dementia seems to erase skills and abilities backwards, from newest to oldest, the concept of “pretend,” developed at 3, remains when other cognitive functions start to go. As a result, individuals who have been out of touch with themselves or with their surroundings will often become very alert, energized, and cognizant during a drama group.

The Arts and Mental Health

Current research indicates that the Arts have powerful positive intervention effects for health promotion and disease prevention as well as positive impacts on maintaining independence, reducing dependency, and promoting a sense of well-being (Cohen, 2006). Dr. Gene Cohen, director of The Center on Aging, Health and Humanities at the George Washington Medical Center in Washington, DC is in the process of an ongoing research study, begun in 2001, which indicates that older persons who participate in creative arts programs conducted by professional artists show significant improvements in health compared with individuals initially matched by age and health who do not participate in the arts. At the beginning of the study the average age of participants was 80.

Over time those involved in weekly guided arts activities, such as drama, poetry, music, painting, pottery, dance, and storytelling, have had fewer doctor’s visits, less need for medication, fewer falls and less hip damage, more positive reports on mental health measures (the Geriatric Depression Scale, the UCLA Loneliness Scale, and the Philadelphia Geriatric Center Morale Scale), and have been more involved in overall life activities.

Previous research indicates that when older adults experience a sense of control or mastery, they have better health outcomes. Meaningful social engagement with others promotes better health as well. Researchers believe that at a physiological level these types of experience promote stronger immune systems, reduced blood pressure, lower stress hormones, and more growth of dendrites and synapses in the brain (Cohen, 2006). Group participation in the Arts, particularly drama which is a positive interactive group process, provides both a sense of control and meaningful social engagement.

Of particular note: normally a study that indicates less decline of one group over the other would be considered a successful intervention. In this Creativity and Aging Study, the arts group showed an increase in health over time while those who did not participate in the arts showed a decline in physical and mental health as well as in their involvement in other activities.

How to Start a Drama Group

There is probably more written on how to do drama activities with older adults than about any other art form. The books are clearly organized and written in non-technical, user-friendly language. See suggestions of excellent resources below.

The key to a successful group is finding a drama leader who has energy, confidence, and a willingness to play. She can’t be afraid to use her imagination, connect with group members, and even be silly, because the drama group leader is the model for how to take on and play out a role or a dramatic situation. An enthusiastic, empathetic person with background in creative drama or improvisation could learn how to run a drama group.

The best choice for a drama group leader, however, is a drama therapist. Drama therapists are trained to plan and run drama groups with the added skills of understanding the social-emotional, developmental, and health issues faced by participants. They can optimize the dramatic activities to facilitate life review, social connections, conflict resolution, and community building in your organization.

Small groups of six to eight participants work well for a drama group with older adults. This size allows everyone to participate and interact in a comfortable manner. A quiet, open space where group members can clearly see and hear each other without being interrupted is needed. Most drama group sessions last between 45 and 60 minutes, depending on the attention spans of the group members. If group members have mobility, sensory, or cognitive difficulties, the drama group leader needs to have staff assistance so that everyone can be optimally involved.

Recommended Resources:

Clements, C.B. (1994). The Arts/Fitness Quality of Life Activities Program. Baltimore: Health Professions Press.

Sandel, S. & Johnson, D.R. (1987). Waiting at the Gate: Creativity and Hope in the Nursing Home. NY: Haworth Press.

Telander & Quinlan (1982). Acting Up! Chicago: Coachhouse Books.

Thurman A.H. & Piggins, C.A. (1982). Drama Activities with Older Adults: A Handbook for Leaders. NY: Haworth Press.

Weisberg, N. & Wilder, R. (2001). Expressive Arts with Older Adults: A Sourcebook. London: Jessica Kingsley Publishers.

For more on the Creativity and Aging Study:

http://www.gwumc.edu/cahh/

Cohen, G. D. (2006). The Creativity and Aging Study: The Impact of Professionally Conducted Cultural Programs on Older Adults. Final Report: April 2006 downloaded December 25, 2006 from http://www.gwumc.edu/cahh/pdf/Creativity%20&%20Aging%20Study-Final%20Report.pdf

Cohen, G. D. (2006). Research on Creativity and Aging: The Positive Impact of the Arts on Health and Illness. Generations, San Francisco: The American Society on Aging, 30 (1), 7-15.

Cohen, G.D. (2005). The Mature Mind: The Positive Power of the Aging Brain. New York: Basic Books.

Cohen, G.D. (2004). MindAlert Lecture: Uniting the Heart and Mind: Human Development in the Second Half of Life. San Francisco: The American Society on Aging.