It is recognized that dementia rates are rising around the world. According to the World Health Organization, 50 million people already suffer from dementia and 10 million new cases are added every year. India itself has about 4.1 million cases, like World Alzheimer’s Report 2015 Notes. Experts believe this number may be higher, as many cases go undiagnosed, with people attributing forgetting to old age. In such a scenario, the clowns in the clinics or the clowns working in the healthcare spaces can be harbingers of joy for the elderly. Studies show that they induce positive emotions and a sense of well-being among patients.
Fernandes is one of the few clinic clowns trained in India. After practicing for over 30 years in Canada, she moved to Auroville and co-founded MeDiClown Academy in 2013 with her husband, Hamish Boyd, also a therapeutic clown. The work of the Academy involves training and conducting seminars for individuals and organizations. The couple also visit people of all ages in hospitals and homes for the elderly in all cities. “Music is a huge part of what we do,” says Fernandes. “Brings back beautiful memories for the elderly.”
Once in an older person’s room, look at the pictures on the wall, a favorite pillow or dress, which can be used in conversation. Once a connection is established, Fernandes recreates the stories relating to those objects through his clowning skills.
For example, an elderly woman with dementia once told Fernandes that at nine she would walk to the village school with her four sisters. “One day, when we got to school late, we hid and said the milk pot had broken at home and that delayed us,” Fernandes recalls. The teacher believed the five sisters and gave them a glass of milk each. In the evening, she told her mother, that she was angry with the children for lying. Fernandes took a cue from the story and staged it for the lady with her colleagues. “Seniors love to go back to their childhood and they love the freedom to laugh and be silly with clowns,” he echoes to Boyd.
Such exercises are significant for people with dementia; they often feel lost because they can’t remember things. “Families continue to check facts and dates, without realizing the trauma and turmoil they can cause,” Fernandes explains. “The role of their narratives, under their direction, gives them the power to be in control without being challenged by their memory. We never tell them that something could not have happened, as surprising as it may seem.”
Clowning in hospital settings was first initiated in North America in 1986 by Michael Christensen, co-founder of the New York-based Big Apple Circus. Karen Ridd (Robo the Clown), a child life specialist, simultaneously founded Canada’s first therapeutic clown program at Winnipeg Children’s Hospital. The practice then spread to Europe.
Since the 1990s it has played a particularly significant role in Germany, where one in five citizens is over 65 and nearly 10% of seniors have dementia. Take Arnsberg, a city of 73,000 that is considered a model for the inclusion of the elderly. She has nine clinic clowns trained like Julia Wille, who goes by the name Clown Mia Mumpitz and visits retirement homes at least once a month.
The process also has therapeutic value for clowns. Wille, 46, discovered his vocation to be a clown more than four years ago, during a long period of clinical depression. “I saw a photo of a clinic clown in a newspaper and I immediately figured out the way to go by myself,” she recalls. He works in an assisted living facility in Arnsberg but has worked as an honorary clown in aged care facilities. “I’m in good mental health without drugs,” he says.
One merry July morning, Mia Mumpitz walked into Helena Desol’s room at Sant’Anna’s house with a strong and affectionate “Hola”, a red clown nose covering hers, her hair pulled back into a ponytail and defined lips with red sheen. Desol, born in Spain, who is 80, lost the ability to speak a few years ago, but screamed for joy at seeing her. Like a long lost friend, Mumpitz held her in a hug. Desol has wrapped his left arm around Mumpitz – it’s his good side, ever since he suffered a paralytic attack.
Mumpitz then started singing, got his hands on his waist and started footwork. Eyes full of joy, Desol swayed back and forth in his chair and hummed.
“About a third of the 90 residents in St Anna suffer from dementia and benefit from clown visits,” says Dagmar Freimuth, social service leader in St Anna. Wille’s clown kindly convinces the elders to participate in his activities. “Sometimes, though, a gentle touch is enough to reduce their agitation and anxiety caused by dementia,” says Wille.
One of St Anna’s residents stopped talking to everyone after his sister died, but opened up after clowns cajoled him, Wille recalls. “An old lady always kicked me out, no matter how hard I tried to talk to her, but one day I just happened to sing a song from her childhood and that’s it. Now I’m always welcome in your room, “Wille smiles.
Johannes Föster, who trained to become a clown in the clinic three years ago at the age of 72 and now volunteers as Clown Berti in Arnsberg, intervenes with another story. There is a woman, says Föster, who would never reply to clowns, but the last time she saw him in the room, she said: “Have a nice day!” Föster smiles, “I think he’s coming back”.
Fernandes has seen similar results in India, where the medical clown is still in its infancy. There are only a handful of individuals and groups working in Mumbai, Chennai and Bengaluru. Like Sheetal Agarwal, a former teacher who started clowning in 2016 and founded Clownselors, now heads a team of 15 regular volunteers in Delhi. Then there’s Humanitarian Clowns, which has had 250 volunteers visiting hospitals and nursing homes over the past eight years in Vellore and sometimes Chennai.
In general, however, the absence of training institutions means that the clinic’s clowns are untrained and do voluntary work. That’s why, in August 2019, MeDiClown Academy launched its first 600-hour course on medical clowning with 11 students, to educate participants in art, storytelling, yoga, music and improvisation. “We want the medical clown to become a respectable profession in the country,” says Boyd.
Students learn patient psychology, deal with care facilities, and work in tandem with a medical team. “However,” Fernandes points out, “the most important thing for clowns is knowing how to connect with their heart.”
Priti Salian is a freelance journalist who has covered human rights, social justice, development and culture in India, Germany and Uganda.