Needs Addressed

Utilizing the stress and coping model as a theoretical framework, this program aimed to increase positive dementia caregiving experiences by increasing listening and communication mastery while reducing caregiver burden, low mood, and depression. By promoting positive coping skills, Improv to Improve provided caregivers with the tools, skills, and ongoing resources to deal with uncertainty, explore how self-expression (improv acting) can be a form of self-care, and learn how such communication skills can strengthen their caregiving relationships and build confidence. Improv skills also greatly assist with creating and supporting positive relationships between the family caregiver and the care-recipient, even as the care-recipient’s neuropsychiatric symptoms decline.

Additionally, interprofessional teams of students were created to address gaps in existing UAA curriculum. Interprofessional education (IPE) helps to prepare a collaborative health workforce that can respond to the complexity of needs in a diverse older adult population (Interprofessional Education Collaborative, 2016). IPE is when two or more professions come together to engage in learning from, with, and about each other to improve communication, collaboration, and the quality of care (WHO, 2010). IPE curricula generally include team-teaching models with professionals from different disciplines and focus on student learning outcomes such as how to respectfully work with other professionals; effective communication with patients, families, communities, health professionals; and appropriately assess the healthcare needs of patients and populations in light of one’s own scope of practice and those of other professions. By teaming up health sciences students with theatre actors and improv teachers, we have created a truly novel and innovative interprofessional experience for the undergraduate research assistants.

Framework and Methods

Experienced improv teachers from Scared Scriptless developed a caregiving curriculum of improv games and techniques in collaboration with Dr. Howell and staff from Alzheimer's Resource of Alaska (ARA). The Scared Scriptless teachers then led the 6 week improv caregiving curriculum with support from Dr. Howell, ARA staff, and 2 undergraduate research assistants.

This 6-week training taught improvisational games and exercises to caregivers in weekly sessions to 6 family caregivers. Each 2-hour session with the caregivers was held at Cyrano's Theatre Company and included:

1. teaching the basic rules of various improv games,
2. having caregivers play through these exercises and practice new communication skills,
3. ending each session with a reflective discussion of how these skills and experiences may increase connection to the care-recipient and may apply to alleviate some family caregiver challenges.

The program was evaluated by comparing baseline data (before program) to outcome measures (immediately following completion of the 6-week course) with the caregivers using the following tools:

• Beck Depression Inventory-II
• Zarit Burden Interview
• Neuropsychiatric Inventory Questionnaire

These tools were also used to evaluate the only other published study in the gerontological research literature utilizing improv training with dementia caregivers (Almen & Caldwell, 2019; Brunet et al., 2019). These instruments helped to determine the feasibility, effectiveness, and replicability of implementing improv training for dementia caregivers in other locations, such as Alaska, by comparing our results. The project was shown to be effective with a small sample of caregivers; read more about this exciting project from our publications, below!

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Publications

• Howell, B.M., Piech, A., and Wolfe, C. (2022). Pilot of a communication program for dementia caregivers using improvisational techniques. Gerontology & Geriatric Medicine 8, 1-3, doi: 10.1177/23337214221123733
• Howell, B.M., Dahl, E.S., Piech, A., and Farris, A. (2022). A Community Education Curriculum Using Improvisational Theatre Techniques for Informal Dementia Caregivers. Journal of Arts & Humanities 11(9), https://doi.org/10.18533/jah. v11i09.2293