Improv for Caregivers

UT Southwestern Psychiatry Residents Learn the Impact of, “Yes, and…”

Sitting in front of roughly 20 UT Southwestern psychiatry residents, Andrea Baum M.Ed., LPC, Stomping Ground’s co-founder, told her story. She revealed that when she was fifteen years old, her father suffered a severe hemorrhagic stroke and was later diagnosed with dementia causing significant neurological issues. She spoke of the turmoil, strain, and heartache that she and her family experienced over the years as they struggled to care for him. She expressed her desire to help others in the same situation as her and explained that she dedicated her time in grad school, and her career after, to do just that. 

Andrea shared her story as part of a special Improv for Caregivers workshop for psychiatrists at UT Southwestern Medical Center hosted by Stomping Ground Comedy Theater. Working together, the two organizations sought to arm psychiatrists with practical training, empathy building, and communication tactics for interacting with their geriatric patients suffering from dementia. Led by Andrea Baum and Lindsay Goldapp (co-founders of Stomping Ground), the psychiatrists spent the next two hours engaging in exercises and discussions designed to teach them the knowledge and skills that Andrea wished she had learned the easy way.

People with dementia experience a decline in memory and executive function. Sometimes they struggle to remember basic things, perform routine tasks, and stay engaged with those around them. Other times, they intensely fixate on certain thoughts or desires, including things that are out of touch with reality.

During these moments, most caregivers’ first instinct is to fight the person with dementia head-on. Failure to respond to questions or commands can be perceived as the person with dementia not listening. Refusal to perform basic tasks can be perceived as being uncooperative. A caregiver may feel compelled to quash the distorted realities of their loved one or patient and forcefully decline their impossible demands. All too often, caregivers (and even some doctors) wind up confronting, arguing, and talking down to the person with dementia, which only serves to make them withdraw even more.

Instead, Andrea recommends responding with empathy and respect. As she points out, people with dementia are often more present and perceptive than they appear.

The Psychiatrist Residents of the workshop were offered perspective on the mindset of those with dementia and the unseen impact that their caregivers’ emotional state has on them; they experienced first-hand the stress of overstimulation and the discomfort felt when interacting with people who have cold and unwelcoming body language.

They were then introduced to better ways to de-escalate tense moments and redirect unhealthy fixations. Instead of fighting their patients’ sudden obsessions and distorted realities, the residents were taught how to “yes and” them and find creative solutions that leave everyone happy. In addition, they learned verbal and non-verbal communication skills to aid in smoother interactions with those with Alzheimer’s, such as mirroring, shifting listening, and responding to the reality of the patient.  

For many in attendance, it was among the best advice they’ve ever received. “Our residents have shared that this [was] one of the most impactful experiences in all four years of their didactic training. [It was] invaluable in helping our residents develop a deeper empathic awareness and enhanced skills in communicating effectively with patients with dementia and their loved ones.”

“The [workshop] was very empathy-building. The exercises were fun and engaging and helped everyone put themselves in the shoes of a person with dementia or their caregiver,” said one participant.

“As an aspiring geriatric psychiatrist, this workshop gave me tools that I can utilize in my future practice,” said another. “I think this workshop is a fantastic resource for caregivers of those with dementia.”

This is one of the many ways in which Stomping Ground uses improv to improve lives and connect the community. Examples of other Improv for Life programs offered by Stomping Ground include Improv for Anxiety, Improv for Autism, and Improv for Healthcare Professionals.

Co-Instructors Andrea K Baum LPC, M.Ed and Lindsay Goldapp with workshop participants.

Tyler Vornberg

Stomping Ground Alumni & Volunteer