The Contribution of Clowning to Improve Care for the Elderly - Reflections from Paediatric Practice

The important interaction between emotional well-being and physical health has long been recognised, particularly the benefits of laughter and happiness to duration and quality-of-life. The evidence for the benefits of therapeutic clowning in paediatric practice is increasing exponentially year-on-year, especially its use as a substitute or adjunct to medication for procedures or investigations that are either frightening or painful.
Elderly people and children share many characteristics including dependency on others and a fear of strange environments and they often lack the ability to fully participate in complex decision-making, this being particularly true for people with dementia.

Clowning in paediatric care is generally short-term and largely uses interactive methods to engage and distract the child during medical care, whereas clowning in elderly care often occurs may occur over a longer period of time to enable the individual to adjust to new circumstances.
Elder clowns interact with older people using historically appropriate improvisation, music and storytelling which calms and reinforces their cognitive function, connection with their surroundings and other people resulting in an improved quality of life.

This review examines the evidence base for therapeutic clowning with children and the elderly and concludes that there is future potential for therapeutic clowning in residential and hospital settings for older people, but further research is required to understand what works best to create a sustainable service that is cost-effective.

Keywords: Clowning, therapeutic clowning, clown doctor, paediatric, elderly, literature review.