Sydney Multisite Intervention of LaughterBosses and ElderClowns (SMILE): A randomised controlled trial of humour therapy in residential care
Sydney Multisite Intervention of LaughterBosses and ElderClowns (SMILE): A randomised controlled trial of humour therapy for improving quality of life outcomes in aged persons with dementia in residential care.
University of New South Wales
400 participants
Jul 27, 2009
Interventional
Conditions
Summary
The Sydney Multisite Intervention of Laughterbosses and ElderClowns (SMILE) is a trial of humour therapy in aged care. The study will recruit 36 hostels and nursing homes, and half of these faciilties will be randomly assigned to receive humour therapy (intervention) or usual care (control). The intevention comprises ElderClowns visiting residents on a weekly basis, and volunteer staff in to be trained as LaughterBosses to bring humour into dialy care routines. About 400 residents will be assessed at three timepoints during the trial to test the hypotheis that humour may improve quality of life, engagement, and mood (e.g. depression).
Eligibility
Inclusion Criteria1
- Permanent residents in Australian Government approved and accredited residential aged/dementia care services providing low or high care for residents with dementia, accessible by sealed road, located in greater Sydney.
Exclusion Criteria10
- Younger than 50 years of age
- Less than 3 months since admission to fulltime residential care
- In respite care not fulltime residental care
- Multiple communication impairements corresponding with 2 out of 3 of aphasic, blind, and/or deaf
- Non-English speaking with no bilingual informant available
- In palliative care or terminally ill with life expectancy less than 6 months relative to study commencement at that facility
- Scheduled to move from the facility within 6 months of study commencement at that facility
- Acutely physically unwell at time of assessment
- Floridly symptomatic at the time of assessment (in the psychiatric sense)
- Bedbound and noncommunicative (i.e. vegetative state)
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Interventions
About 400 residents living in 36 hostels and nursing homes will be randomly assigned (at the level of facility) to receive the SMILE intervention or usual care. The SMILE intervention will comprise a 1-day training woprkshop for a staff member nominated by the facility to act as the LaughterBoss for that facility. The training session will be run at a central location off-site in small group experiential learning format, facilitated by an experienced humour therapy practitioner. It will address how to incorporate humour into daily care practices with residents. The LaughterBoss will then partner with an ElderClown (a performer experienced in using humour in health care settings) to engage residents through humour using music, mime, props and other techniques. ElderClowns will visit facilities over 12 weeks for humour therapy sessions lasting 2 hours on each visit, with each facility receiving a minimum of 9 sessions. LaughterBosses will be encouraged to continue to use humour techniques between weekly ElderClown visits and after the program of visits has ceased. SMILE will evaluate whether humour therapy improves resident mood and quality-of-life.
Locations(1)
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ACTRN12611000462987