Living with Dementia Magazine, December 2008

By Caroline Graty

A theatre company in South West London is casting people with dementia as brave warriors, noble Greeks and star-crossed lovers.

A London-based theatre company is helping to challenge perceptions of people with dementia by taking interactive performances of plays into care homes for older people.

Actors from the company have noticed how involving people with dementia in performances can increase their self esteem and challenge assumptions care staff may have of them.

Artistic Director Chris Gage joined the company, Ladder to the Moon, three years ago. At the time, it was involved in a range of activities including street and youth theatre. Chris decided to focus the company exclusively on theatre for older people in care settings. He says,

'There are plenty of other companies doing youth and street theatre but none working in care homes in the UK. We aim to access people's playfulness, to create something that enables them to laugh and enjoy themselves in the moment and to express themselves.'

The company works with care home residents in two ways. It creates bespoke residencies, during which actors visit a home each day for up to three weeks to perform a story which unfolds over the period. It also produces hour-long adaptations of classic plays, such as Shakespeare's Romeo and Juliet, which are taken on tour to different care homes. Residents, staff and visitors are all invited to participate.

Plays are chosen which explore universal themes with which people can easily identify and are adapted to focus on a single plot line. Chris says,

'We try to engage with hard-wired emotions, so love is always a strong element of whatever story we're doing.'

Leading roles
People with dementia are cast in leading roles and guided through the story by the actors. Singing and dancing are integrated into the play to enable people to join in. While in character, the actors ask for audience members' views, perhaps about what dress to wear to the ball or whether to fight the villain. Chris says,

'We are telling a story, but we always give space for people's contributions. We give attention to what they suggest and work it into the story.'

The actors are sensitive to the needs and abilities of people with more advanced dementia, using eye contact or physical contact to engage with them during a performance. A sensory element is also built into the productions. Chris says,

'In The Tempest we used a long piece of cloth that represented the sea. It went around the room and people held it and moved it. Some people weren't able to actively participate but they played with the cloth in their laps.'

As well as offering the opportunity for fun and laughter, Chris believes the performances can boost people's self-esteem. He says,

'We cast people as kings and queens or lords and ladies and they are given respect and attention. The actors also ask people for help, which is something that I don't think happens a great deal to residents in care home settings.'

Although they may not always remember the experience, the productions allow people with dementia to enjoy themselves in the moment. Margaret Redway, Manager of Rosemary Lodge care home in Wimbledon, said,

'At the end of one performance here a lady said, 'What was that about?' But during the performance she had really enjoyed being involved and having her opinion asked.'

Challenging perceptions
Being part of the performance can also help people with dementia to express themselves, often surprising themselves and others. Chris says,

'We print off short extracts of the script for people to read at key moments in the play. On the last tour the actress gave a script to a man with dementia. A care worker told her not to bother because the person couldn't read and didn't speak. However, she went ahead and 20 seconds later he spoke the entire text.'

This is one of the reasons that care home staff are encouraged to participate in the performances. Chris says,

'It can change staff members' perceptions of what people are capable of and what is possible within the home.'

Sally Knocker is Communications Director at the National Association for Providers of Activities for Older People (NAPA) and has recently joined Ladder to the Moon's board. She says,

'The company offers much more than a standard theatre performance. By being spontaneous and responding to audience members who want to join in the actors truly involve people. People with dementia can be particularly prepared to be playful because they can be more disinhibited and this is sensitively handled.'

For more information about Ladder to the Moon, call 020 7228 9700 or visit www.laddertothemoon.co.uk