戲劇治療能夠巧妙地使老人癡呆症病患短暫地回到現實

戲劇治療能夠巧妙地使老人癡呆病患短暫地回到現實

Kay Garrett 2006秋冬報導(任萬寧譯)

一些參與戲劇治療的老人癡呆病患以戲劇化、神奇的方式回應了此虛擬戲劇活動。中後期老人癡呆患者參與戲劇團體的這段時間，有時候他們變得非常機敏、有意識、活在當下，接著他們可能又會迷失。堪薩斯州大學的Sally Bailey是一位通過註冊的戲劇治療師及前北美戲劇治療協會會長，她對這些不可置信的反應証實了戲劇的療效。

她說：「那些不全然活在現實中的患者們還是明白他們什麼時候在假裝。」病人能分辨出什麼是現實，什麼是想象。我不知道為什麼；此現象也尚未被研究，但是患者可以變得非常清醒。此現象的答案可能是早期兒童發展階段遺留下的本能。到了三歲時，人類參與在戲劇遊戲中且已經知道什麼是假裝。Bailey說：「我們都是演員，不管是什麼源由，存留下來的內在小孩能再次被誘導出來玩耍，而戲劇性的娛樂時間改善了老人癡呆患者的生活品質。」

首先，戲劇活動是具體且有感受的。戲劇活動裡總是含有動作，包含了即興、劇場遊戲、說故事還有演出。戲劇活動的目標為刺激知覺、肌肉還有神經，引起知覺記憶、啟動且開啟想像。Bailey說：「所有的刺激最後在腦中讓事情全部連貫起來。這些活動能幫助患者適應當下並儘可能地利用他們剩下的認知能力。 團體中的有氧活動也能斷除在療養院中常見的社交隔離。戲劇治療真的非常有用！」

在即將到來的春季，Bailey預計會帶花、春天的香味還有種子並呈現關於成長的主題給她的戲劇團體。她說：「我可能會放像是April Showers的音樂或其他可能喚起他們年輕記憶的歌曲或詩。像是在今年晚秋，她帶了有名的Norman Rockwell關於感恩節的畫作給了她的戲劇團體。那些畫誘出了每個人對感恩節的回憶:患者回想起了聲音、氣息、味道還有關於那天的其它事。我帶了肉桂香氣的蠟燭、南瓜派的香料、塑膠做的葉子還有秋天顏色的長圍巾。我放了秋季感的音樂，我們隨著從幻想樹落下的塑膠葉子跳起了舞。這既真實也是演戲。」

在美國，一個嶄新的思想正在蔓延。創意藝術治療:藝術治療、音樂治療、戲劇治療正被規劃到療養機構裡。其中一部分改革的趨勢即是療養的文化：減少醫療體系、增強個體化。

Bailey說：「在長期療養中，我們現在相信重要的是改善患者的生活品質。若是一個禮拜兩次三十分鐘的戲劇團體可以讓患者重新適應人、時間、地方這就是對他們生活品質的大改善。」

戲劇活動似乎喚醒了引起喜悅與驚奇的人格，而正是這種人格讓我們心靈上保持年輕並想永保青春。Bailey把戲劇治療的技巧教給了堪薩斯州的社工、長期療養院、老人院的行政人員。另外，她還把戲劇治療教給堪薩斯州六個藝術與啓發中心的職員。阿茲海默（老人癡呆）協會贊助這六個舒緩中心，中心則給予和癡呆患者住在同一屋檐下的護理人員放鬆時間。在堪薩斯州這些舒緩中心分佈在Parsons、Salina、Garnett City、Hays 和Colby。

Bailey是堪薩斯州大學語言溝通、劇場、舞蹈系的助理教授。Bailey之前是一位專精於戒毒和發展遲緩的戲劇治療師。她說：「我想念我的患者們，但我熱愛教導人們成為戲劇治療師。」

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Drama therapy can coax Alzheimer's patients back to reality, briefly

By Kay Garrett

Some Alzheimer's patients who take part in a drama therapy group respond to the make-believe activities in dramatic and surprising ways. Older people in mid- to late stages of Alzheimer's sometimes become very alert, cognizant and "with it" during the time they are doing drama group. And then they may become lost again.

Kansas State University's Sally Bailey, a registered drama therapist and past president of the National Association for Drama Therapy, attests to this uncanny response to play-acting.

People who are not always "with it" in reality still know when they are pretending, she said. They can tell the difference between reality and imagination. "We don't know why, and the phenomenon has not been much studied, but people can become crystal clear."

The response might be a vestige of early childhood development. By age 3, all humans engage in dramatic play and know about pretend. "We're all actors," Bailey said. Regardless of its origin, the residual inner child can be coaxed out to play again, and the dramatic playtime improves the quality of life for Alzheimer's sufferers.

Drama activities are first of all, concrete and sensory. They include improvisation, theater games, storytelling and enactment, and always a movement component. The goal is to stimulate the senses, muscles and nerves, to spark a sensory memory, to prime the pump and turn on the imagination.

"All the stimulation ends up in the brain, getting things connected all over. The activities can help patients orient themselves in the present and use their remaining cognitive skills for as long as possible. Aerobic activity in a group also breaks the social isolation prevalent in care facilities.

"Drama therapy is just very, very useful," Bailey said.

In spring, Bailey might bring flowers and spring scents and seeds to drama group, and present topics about growing. "I might play music like 'April Showers,' or other songs or poems the people might recall from their youth."

Likewise, in late autumn, she brings the famous Norman Rockwell painting of Thanksgiving to her drama group. That painting elicits personal memories of Thanksgiving: patients recall sounds, smells, tastes and other things associated with that day.

"I bring candles of cinnamon and pumpkin pie spice, fake leaves and long scarves of fall colors. I play fall-type music, and we dance with the leaves falling around us from the imaginary trees. It's real, and it's also pretend," she said.

Creative arts therapies -- art therapy, music therapy, drama therapy -- are being incorporated into care facility programming throughout the nation, part of a movement to change the "culture of care" to less of a medical model and more "person centered," a new idea everywhere.

"What we now believe is important in long-term care is improving the patient's quality of life," she said. "If, for 30 minutes twice a week during drama group, a patient is re-oriented to person, place and time, that is a big improvement of their quality of life."

Drama activities seem to wake up in people that part of the personality that captures joy and wonder, said Bailey, which is what keeps us young at heart and young in our minds and wanting to stay alive.

She has taught drama therapy techniques to social workers and to administrators of long-term care facilities, nursing homes and adult care facilities in Kansas. In addition, she taught a drama therapy component to staffers of six Arts and Inspiration Centers in Kansas. Alzheimer's Association sponsors these respite centers to provide "time off" for caregivers who live in the same household with a person with dementia. In Kansas, Arts and Inspiration Centers are at Parsons, Salina, Garnett, Garden City, Hays and Colby.

She is assistant professor in the K-State department of speech communication, theater and dance. Bailey formerly worked as drama therapist with recovering drug addicts and patients with developmental disabilities.

"I miss the clients," said Bailey, "but I love teaching people to become drama therapists."

Fall/Winter 2006