by Jason Bronowitz, inspired by classmate Dr. Nicola Olsen, ASU Theatre for Youth
Reimagining the future of nursing through the arts and performance
Tara Rynders, a nurse with an MFA in Dance, is an Advanced Grief Recovery Specialist and nurse in Denver, Colorado. Her practice focuses on caregiving of the hill and dying and her creative passions blend nursing research and arts-based resiliency methods. The recipient of the Nightingale Luminary Award in 2019, Rynders uses "art, movement, and play-based theater to help decrease burnout and secondary traumatic stress." Her academic research focuses on compassion fatigue and burnout in health care providers.
Rynders was impacted by the epidemic of compassion fatigue. When caregivers devote all their energy to their patients, they are quick to burnout. I've seen this in my own role as a pediatric hospice chaplain. Health care providers often struggle to balance their own needs with the attention given to their patients. In speaking with nurses during the COVID pandemic, I heard stories of outrageous hours they were working, often because of the nurse shortage, but also for the financial benefits of additional bonus money being offered to nurses willing to work. Through performance, storytelling, and allowing them to express themselves, Rynders' organization aims to bring levity, calmness and relaxation to healthcare professions.
Learn more: https://www.theclinicperformance.com/
This year, Mirabella at ASU opened as a retirement community in the heart of the ASU campus in Tempe. Aimed at integrating the community with the university, many retirees opted to live here to maintain a presence on campus, engage with students and university programs, and to remove as many obstacles as possible to doing so. One particular initiative, the Musicians-in-Residence, brings ASU music students to live with and engage with community members through artistic performance.
All of the Mirabella residents are 62 and older — except for some of the newest ones. This past summer, four students from the ASU School of Music, Dance and Theatre moved into the building as “musicians-in-residence.” They’ll live there rent free through the academic year in exchange for weekly performances and interactions with their neighbors.
The program is unique, Beagley said. “We scoured the country for musicians-in-residence programs at life-care communities to see if there was a blueprint from which we could start. And really, there wasn’t anything that approximated what we had in mind,” she said.
“So we had to use our imagination to think about what was possible when we have a community here on campus that’s across the street from the School of Music, Dance and Theatre.”
“One of the pillars of our school is community engagement, and the musicians-in-residence program at Mirabella at ASU fosters just that,” Landes said. “It is critical that our students understand the importance of engaging with the communities around them and learn to communicate about music with passion and energy. To us, community engagement also involves reciprocity — we look forward to learning from Mirabella at ASU residents through intergenerational musicmaking and teaching.”
Students in ASU's Interdisciplinary Solutions for Social Impact (ISSI) lab on Impacting Inequality: Inequities and Wellbeing studied the impact of isolation on older adults in Spring 2021. The student team of Jason Bronowitz, Angeline (Angie) Taylor, Nicola Olsen and Miles Green studied how reminiscence theatre could play a role in alleviating loneliness among older adults.
Isolation and loneliness in the age of the Covid-19 pandemic has increased dramatically among the elderly.
Summarizing the issue
The elderly are not allowed person-to-person contact with family members or loved ones at skilled nursing facilities in this post COVID-19 pandemic environment. Elderly in such facilities are also not allowed extended time with nurses. Through interviews and additional research, this study has found that nurses are only allowed an allotted amount of time per room, per patient to cut down on contact time. One nurse in Phoenix that was interviewed discussed how “nothing can replace a hug” during this federally mandated quarantine that has lasted from March 2020 until the current day (April 2021).
For this solution-based research, we have defined the elderly as those who are 65 years-old or older that are eligible for Social Security due to being retirement age. According to the United States Social Security Administration, the threshold to collect Social Security based on retirement is 65.
Geriatric psychiatrists Dr. Maureen Nash and Dr. Vimal Aga said that an AARP study revealed that 17% of people 65 and older feel isolated while 26% risk early death due to loneliness. Also, nearly half of all women 75 and older live alone (Porter, 2021). Nash said, “Those statistics highlight what we in geriatrics know, loneliness kills” (Porter, 2021). She added that there’s a difference between isolation and solitude among the elderly. Solitude, she said is when a person chooses to be alone and can have social support if and when they need it. “But loneliness magnifies everything for seniors who may be struggling with a variety of challenges especially during the pandemic” (Porter, 2021).
As a result of our research, we have defined key terminology for our intervention. We have defined engagement as the attention, curiosity, interest, involvement and passion shown by senior citizens toward the Reminiscence Drama: a play based on the lives of several older individuals, based on interviews with them and/or their families. The term connectedness is defined as illustrating older Americans as a resource to society today with greater potential for the future. The term senior citizens is defined in accordance with the U.S. Social Security Administration. As a result, we define the elderly as those who are 65 years-old and older and are eligible for retirement.
PROPOSED GOAL: As a result of our research, we address elder isolation in skilled nursing facilities through intergenerational participation in reminiscence theater. We address isolation through participatory arts engagement that celebrates the lived experience and wisdom of older adults in our community. We value intergenerational community connection as we transition out of pandemic social isolation and reintegrate into socialization.
Reminiscence Drama
As a group we noticed that the interventions we were finding were not as socially connected as we hoped. I began digging into the world of theatre to see what might exist there. So I went in search of practitioner reflections on performance work with older adults in general. I had an interdisciplinary breakthrough connecting my theatre world to my group's topic, "isolation for older adults." That is where I came across a performance style called "reminiscence drama." The basic tenet is using elders' memories and lived stories to create and share a performance with the community. Seniors telling stories to others (e.g. professional theatre companies, school children, or other groups of seniors) to then perform those stories lends itself to celebrating the wisdom of older adults. "This developmental dimension of old age opens up a new creative action aimed at improving the lives of older people and, in turn, changing society’s attitude towards ageing" (Kosti, 2019). Angie noted,
The article's idea of exploring ageing as a cultural value makes so much sense. When I was an education reporter, there was a WWII veteran who came to a classroom for an historical lesson. He dressed in his full Marine blues. Each of his medals were on his chest. I was absolutely fascinated and so were the students. His stories of service went beyond what they learned about in history that week.
As a group we decided that “reminiscence drama” filled the social gap we saw in current initiatives. Reminiscence drama mitigates the negative effects of loneliness relying on two foundational theories. The first is Robert Butler’s (1963) "theory of ‘life review.’” Butler argued that, in order to reach a satisfying level of enjoyment of life, older adults must develop mechanisms to renegotiate lived experience by remembering “to acquire a sense of personal identity and appreciation, so as to be reconciled with the concept of loss" (Kosti, 2019). The second is Erik Erikson’s (1950) “ego-integrity” which deals with the basic need of humans to reconcile successes and failures in life, and to move forward with courage towards the inevitable end.
Most of the articles we found were practitioner focused talking about how reminiscence theatre was conducted, with whom, for how long, and the challenges of implementation (Kosti, 2019; Foster, 2020; Nicholson, 2012; Hanna, 2008). These practitioner focused articles contained powerful qualitative quotes from older adult participants like, “It was an honour to watch my story on the stage. I’m so happy! I feel that my life was worth it!” (Kosti, 2019). These qualitative outcomes reflect the positive impact we hope our intervention will also have. One article revealed methods and measures used to assess impact Reminiscence Drama in an Ageing World by Katarina Kosti and we are using this article as a particular focus for what we hope will be a mixed methods approach moving forward.
References:
Kosti, K. (2019). Reminiscence Drama in an Ageing World. Critical Stages: The IATC Journal, 20.
Porter, L. (2021). For seniors, pandemic has added issues with mental health, isolation, depression. KGW8. NBC News, Channel 8.