Jeff Raz distinctly remembers the moment he realized clowning could ease anxiety and enhance the lives of adults. He and a student of his were in a hospital elevator, having just entertained sick children. “A charge nurse grabbed us, saying, ‘I need you,’” he recollects. She took my student to the skilled nursing unit, where she tried to entertain these long-term care adults, but they only wanted to tell her jokes. My student thought her endeavor was a failure. By the same token, I realized that I had so far failed to engage people suffering from dementia, and others, by thinking that I was performing instead of being tuned in to their needs. Thus began my understanding of what needs to be done for this audience.”
That was more than 10 years ago. Today, Jeff, a theater artist and professional clown, who has worked with groups including Cirque de Soleil and Ringling Brothers, is the board president of Medical Clown Project (MCP), which he co-founded with his wife, Sherry Sherman. The two undertook a pilot project at California Pacific Medical Center (CPMC) in San Francisco, under the auspices of Rob Sarison, then director of CPMC’s Swindell’s Alzheimer’s Care Program.
“Medical clowning is less about performance and more about attunement to the underlying psychosocial needs of residents and their families,” defines Rob, who is now [Frank Residences assistant executive director] at San Francisco Campus for Jewish Living (SFCJL). He instituted MCP at SFCJL’s Jewish Home & Rehab Center (JHRC) in January 2019.
Twice a month, two clowns from MCP, wearing lab coats perhaps, or other costume, hats, a little bit of makeup, and “something kitschy,” perform in JHRC. Accompanied by a Life Enrichment staff member who knows the residents, the clowns begin to make a connection with the residents through eye contact or maybe lightly touching them, says Rob. Once a connection is established, the clowns use a combination of comedic improvisation, classic clown skills such as juggling and acrobatics, and music – playing a ukulele or encouraging sing-alongs – to involve the residents.
“Clowns adapt their repartee to fit the person,” Rob details. “Some people interact with the clowns, while others, who are nonverbal, may sit straighter in their chair. You see their eyes light up. The clowns are using imaginative play as a tool to stimulate the resident’s brain activity.” Says Jeff, “There gets to be a genuine connection with those you see often. When there’s someone who has been nonresponsive, but this week they’re dancing with you, that’s a pretty big moment.”
Judith Dancer, JHRC’s Director of Life Enrichment, also happens to be a professional clown. We spoke with Judith about her experience working with the Medical Clown Project and the benefits medical clowns have for older adults.
How did you learn about the Medical Clown Project? Had you worked with them prior to SFCJL?
I first saw the Medical Clowns at Alma Via, where I used to work, at the height of the pandemic…they were only outside of the building in full regalia. However, I have known of one of the co-founders, Calvin Kai, for some time, as we both had worked with a clown program in East Oakland that taught clowning to grade school kids.
As someone who is a clown yourself, and also with a background in life enrichment for older adults, what do you think are the key benefits of medical clowning for older adults?
The benefit of engagement with clowns is coming into a liminal space with them and allowing the imagination to open and create a new perspective maybe not yet seen, felt, or heard. It is a great form of expression.
Do you have any anecdotes about how the Medical Clowns have had specific impact/benefit for our residents or a particular resident?
I remember one of our residents, Helene, going right into the clown reality created by the two visiting clowns and how easily she could be with them doing tricks and creating as much FUN as possible. It really is all about expressing and receiving LOVE!
Sometimes residents are just not interested. Jeff recalls one man standing up and saying, “This is terrible. I hate this. I hate clowns.” Jeff’s response: “Me, too. Let’s get out of here.” He took the resident’s hand and they walked into the hallway. “You have to go with their story,” he acknowledges.
Clowns must undergo serious training before they can become medical clowns. According to Jeff, they must have five years minimum experience as professional clowns in circuses or theater. They learn about being with, as opposed to performing for, older adults; cultural issues; hygiene regulations in a medical facility; and compliance with HIPAA (the acronym for Health Insurance Portability and Accountability Act, a U.S. law that provides privacy standards to protect patients’ medical records and other health information).
“Medical clowning is incredibly hard,” he says. “I would come off a shift and be more exhausted than if I had performed two Cirque de Soleil shows. But even though you’re exhausted, there’s never a question you’ve done some good in the world that day.”
Portions of this article were previously published in Jewish Senior Living Magazine 2019-2020.
It is through the support from our generous community of individuals and foundations that we are able to bring programs like the Medical Clown Project to our residents.