title: Presence redefined: The reciprocal nature of engagement between elder-clowns and persons with dementia.
abstract: Elder-clowns are a recent innovation in arts-based approaches to person-centred dementia care. They use improvisation, humour, and empathy, as well as song, dance, and music. We examined elder-clown practice and techniques through a 12-week programme with 23 long-term care residents with moderate to severe dementia in Ontario, Canada. Analysis was based on qualitative interviews and ethnographic observations of video-recorded clown-resident interactions and practice reflections. Findings highlight the reciprocal nature of clown-resident engagement and the capacity of residents to initiate as well as respond to verbal and embodied engagement. Termed relational presence, this was achieved and experienced through affective relationality, reciprocal playfulness, and coconstructed imagination. These results highlight the often overlooked capacity of individuals living with dementia to be deliberately funny, playful, and imaginative. Relational presence offers an important perspective with which to rethink care relationships between individuals living with dementia and long-term care staff.
authors.affiliation: Toronto Rehabilitation Institute-University Health Network, Toronto, Canada.|Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
authors.forename: Pia
authors.initials: P
authors.lastname: Kontos
authors.affiliation: Toronto Rehabilitation Institute-University Health Network, Toronto, Canada.|Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
authors.forename: Karen-Lee
authors.initials: KL
authors.lastname: Miller
authors.affiliation: School of Nursing, Faculty of Health, York University, Toronto, Canada.
authors.forename: Gail Joyce
authors.initials: GJ
authors.lastname: Mitchell
authors.affiliation: Independent Consultant, Peterborough, Canada.
authors.forename: Jan
authors.initials: J
authors.lastname: Stirling-Twist
keywords: arts-based; humour; joy; nonverbal communication; relationality; sadness; videography