"Laughter gives us distance. It allows us to step back from an event, deal with it, and then move on."
--Bob Newhart
We always hear that laughter is the best medicine. For family caregivers, who struggle on a daily basis to care for loved ones who are sick, disabled or otherwise in need of chronic care, it can be too easy to forget the importance of humor. But new research is showing that not only is it okay to laugh in even the grimmest situations; it might even be good for you.
Laughter, along with an active sense of humor, may help protect you against a heart attack, according to a study by cardiologists at the University of Maryland Medical Center in Baltimore. The study, which is the first to indicate that laughter may help prevent heart disease, found that people with heart disease were 40 percent less likely to laugh in a variety of situations compared to people of the same age without heart disease.
In the study, led by Michael Miller, M.D., Director of the Center for Preventive Cardiology at the University of Maryland Medical Center and a professor of medicine at the University of Maryland School of Medicine, researchers compared the humor responses of 300 people. Half of the participants had either suffered a heart attack or undergone coronary artery bypass surgery. The other 150 did not have heart disease. One questionnaire asked a series of multiple-choice questions to find out how much or how little people laughed in certain situations, and the second one used true or false questions to measure anger and hostility. Miller said that the most significant study finding was that "people with heart disease responded less humorously to everyday life situations." They generally laughed less, even in positive situations, and they displayed more anger and hostility.
The ability to find humor in life may be correlated with a healthy heart, and it also may help people maintain their mental health, especially when faced with difficult situations in life -- for example, being a family caregiver to someone who is chronically ill, elderly or disabled.
In home care, we see a wide variety of illnesses, and every family caregiving situation presents its own challenges. Home care nurses at the Visiting Nurse Service of New York take their work very seriously, yet still try to remind patients and their family caregivers that it's OK to laugh sometimes. "Watching a spouse or parent struggle with a chronic disease can be very painful for family caregivers, but it often presents many funny situations," says Judy Santamaria, Director of the VNSNY Family Caregiver Support Program. "Having to adapt one's life to fit limited abilities and to find yourself reversing roles in relationships you've had your whole life can be very discomfiting, but it can also be funny." It's the premise of the character Maw Maw on the hit TV show "Raising Hope," and watching the family care for their grandmother as she vacillates between moments of lucidity and dementia can be heart-wrenching, but also amusing. (Chloris Leachman, the talented actress who plays Maw Maw, adds to the comedy, of course.)
Should we feel guilty about laughing at this show or in our own caregiving lives? Is our laughter a sign of disrespect or a lack of love for our family member? And do our own caregiving situations present opportunities in which we want to laugh but don't because we're afraid of seeming insensitive?
Even in the most dire circumstances, such as bereavement or hospice, VNSNY health professionals insist that its OK, even helpful, to laugh. Rev. Vincent M. Corso, M.Div, L.C.S.W., C.T., Spiritual & Bereavement Care Manager in VNSNY Hospice care, who works with staff, family and patients before and after a death, says, "It's challenging to find a bright spot in the midst of the impending death of one we love." While caring for a terminally ill patient, Vince recommends using humor to relieve the tension of a difficult chemo treatment or a particularly painful day. "You can rely on your personal history with your loved one -- bring up moments in your life that were funny, and it can be as effective as two Tylenol #3s!"
Vince often reframes a pain-filled situation using a great line from the movie "The Bucket List": "The ancient Egyptians had a beautiful belief about death. When their souls got to the entrance to heaven, two questions were asked determining whether they were able to enter or not. 'Have you found joy in your life? Has your life brought joy to others?'" As Vince says, "It's about reminding yourself that there were joyful moments before the illness, and there can be similar moments during and even after."
Caring for someone with Alzheimer's disease presents many painful moments, but can also present many opportunities to laugh. Jed A. Levine, Executive Vice President, Director of Programs and Services at the Alzheimer's Association, New York City Chapter, said, "Laughter can be an immensely effective tool for a caregiver and their family member with Alzheimer's or dementia. It normalizes the situation and helps to lighten the mood, allowing for a greater connection between the individuals. Just as long as the caregiver is laughing with their relative and not at them, humor can be a wonderful way to ease tension and enjoy the present moment together."
Sheila, a contributor to the National Family Caregivers Association forum on humor in caregiving, who has taken this advice to heart, reports two funny anecdotes: she takes care of her neighbor, who has dementia. Recently, this neighbor complimented her, saying, "Your son is very handsome!" She was looking at a photo of Santa Claus. And one day, her neighbor was screaming, "Sheila! Sheila! Sheila!" Sheila ran into her bedroom crying, "What is it?" Her neighbor's answer: "Someone keeps yelling 'Sheila!'"
Home care staff who work with family caregivers caution that caregivers shouldn't be too worried that others may find their ability to find humor in situations "calloused" or "uncaring" because this may prevent you from finding joy in your caregiving. Being able to laugh is not only good for your health, but it shows you have a practical, realistic approach toward your caregiving role -- and your sense of humor is a critical tool for your good health and attitude.
So, as you find yourself continuing in your role as caregiver, take every opportunity to laugh: Go to a comedy club. Watch funny movies or TV shows with your loved one. Check out YouTube -- you'll find many hilarious videos there. Most importantly, try to enjoy your time with your family member, and if something funny happens during care taking, don't be afraid to have a huge guffaw. These moments may end up being some of the most cherished you have with your family member.
Are there sources of humor that you turn to when your spirit needs refreshing? We invite you to share them below, along with any other comments or questions you may have about the topic.
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For more on the importance of good humor in caregiving, check out our Day in the Life blog.