Dementia Special: Delirium, Alzheimer's, Dementia Care, and Supporting CaregiversPage 40 of 51

14. Use Humor Wisely

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Keep your sense of humor. Use it wisely.

Laughter is the most inexpensive and most effective wonder drug. Laughter is a universal medicine.

Bertrand Russell
British Philosopher and Political Activist

Think about how you feel when you laugh.

Laughter has long been regarded as beneficial for human health. Some of the benefits attributed to laughter including improved immunologic and endocrinologic responses and increased pain tolerance. One study found a 20 percent reduction in agitation using humor therapy, an improvement comparable to that of antipsychotic drugs, including reductions of tension and stress (Takeda et al., 2010). The study found this held true well into the late stages of dementia.

Lots of things can seem funny on a dementia unit. We used to blow bubbles and one of the residents would sing “I’m forever blowing bubbles,” a song from her childhood, and laugh at the fun of it. It’s important that the staff understands it is OK to laugh with the person who has dementia, but never at them.

There are a few tricks to giving medications to people with dementia who don’t want them. Because they have little memory of the medications they took over the years and lack the ability to understand why they were necessary, we tried various techniques. The most common was simply to put the medications in pudding or apple butter. We also tried bribery with special treats. These tricks worked most of the time, but there were still some feisty individuals who didn’t quite trust the staff and hated swallowing pills.

It is important that people not lose their rights just because they have dementia. Even though these individuals lack the ability to understand the importance of medications, it is up to us as caregivers to convince them to take their pills. However, if someone flatly refuses to take medication, we cannot force them to do so, and this can be a major problem.

After doing some research, one of our nurses came up with a solution that did work for several of the patients who consistently refused their medications—clown noses! She sometimes resorted to wearing a ridiculous looking red clown nose, which made the residents laugh. We found that laughing people are usually happy people, and they are also more cooperative. Humor helped solve our problem, and because people with dementia have little short-term memory, this trick worked over and over again.

Humor is a tool we can use, much like feel-goods, to change a person’s mood. It’s common sense that people are more likely to allow treatments or take their medications if they are happy.


Grandma was an 82-year-old resident with late mid-stage dementia. She was called “Grandma” by the staff at her family’s request because she had become a grandmother at age 40 and loved being a grandma for most of her life. Unfortunately, she had suffered two hip fractures in the five years before admission to our unit.

When she fell and broke her hip the third time, rehabilitation was difficult. She had little motivation and seemed depressed; the staff was afraid she would become permanently wheelchair-bound.

At the time, a number of rescued turtles lived on the patio that adjoined the dementia unit. At various times staff had rescued the turtles when they wandered onto a busy road near the facility. By summer’s end we had five or six turtles, and the residents were always surprised and pleased to see them in the gardens.

When the cold weather came, they burrowed deep into the ground. The following spring, while Grandma was recovering from her fractured hip, they came out of hibernation.

I happened to be on the unit when Grandma saw one of the turtles lumber across the sidewalk. For the first time in a long while, she smiled. The aide with her picked up the turtle and showed her how to hold it by the shell. Its feet started rapidly pumping air and the aide snatched it back just in time for the turtle to urinate on her shoe instead of Grandma’s lap. Grandma broke out into great gales of laughter. (So did the aide and I!) When the aide put it down and it slowly lumbered away, Grandma wanted to stand up to get a better look.

Each day after that, the nursing assistants took Grandma out on the patio to look for turtles. They would assist her to stand up, and then take a few steps, to follow the turtles. Each day Grandma got a little stronger. By summer’s end, with the help of a walker, Grandma was mobile again. Turtle therapy works!

Laughter lowers the level of stress hormones in the blood and thus reduces feelings of stress. It lessens feelings of depression and helplessness and helps foster a positive attitude. Here are some common sense suggestions to try:

  • A video of babies smiling and laughing
  • Cute pictures and displays, especially at holidays
  • Old movies (Laurel and Hardy, W.C. Fields, Keystone Cops)
  • Wind-up toys
  • Funny stories