Japanese expressive dance to help people with dementia tune in to memories and emotions
11 Sep 2023
The Straits Times
SINGAPORE - Living with dementia can be isolating, as the progressive cognitive decline often leads to a sense of disconnection from the world, loved ones and even self-identity.
But when people with dementia move to music or a favourite memory, it appears to stimulate emotional connections between them and their caregivers – even in those who have lost the ability to speak.
This is where Totsu-totsu dance holds the key. It is an experiment in day-to-day bodily communication, with moves that are slow, wavering and even hesitant – unlike dance forms that aim for perfection.
“I call it Totsu-totsu or ‘faltering’ dance because it is not sophisticated, yet it has potential,” said Mr Osamu Jareo, the choreographer behind the movement.
No words are needed. Instead, people are taught to convey their favourite memories, everyday stories, emotions and even subconscious thoughts through the expressive dance.
Dementia Singapore is working with the Japanese experimental dance choreographer for this new dance therapy initiative.
Mr Jareo, who was in Singapore for an introductory session in August, took staff and volunteers from the social service charity through the paces and held workshops for people with dementia and their caregivers.
He returned on Saturday to conduct a session at Our Tampines Hub with four people with dementia and their caregivers, who had participated in Dementia Singapore’s previous arts-based programmes such as creative dance.
Participants were selected based on interest and capability.
Dementia includes impaired short-term memory, language, problem-solving and reasoning abilities, and affects sufferers’ ability to perform everyday tasks and functions including communication, which can leave them frustrated, isolated or withdrawn.
Expressive dance helps draw people with dementia out, and they can release pent-up frustrations through unrefined and spontaneous bursts of movement, Mr Jareo said.
He first conceived Totsu-totsu in 2009, when he started conducting dance workshops and performances for the elderly residents of Japan’s Graceville Maizuru, a nursing home in Kyoto.
Dr Hong Liyue, a geriatrician from Alexandra Hospital, said dementia sufferers have difficulties finding the right words to express themselves.
“They are easily upset or frustrated because they are unable to express their emotions.”
She added: “Music and dance can be helpful in such circumstances, to allow them to express their feelings. People living with dementia also find it easier to recall memories when they hear pieces of music or perform certain movements that had significant influence on them in the past.”
Dr Kalyani Mehta, who has been conducting gerontology research for more than 20 years, said the childhood memories invoked through specific types of music and dance can stimulate the brains of the participants.
“Both dementia patients and their caregivers can participate in a group, and this helps the patients to relax as well as reduce the stress and anxiety they may feel. Time spent in these activities can uplift the spirit of the people with dementia, and they may be easier to manage later in the day,” she said.
Dementia Singapore’s director of advocacy and communications Bernard Lim said benefits were observed by the organisation during Totsu-totsu sessions by Mr Jareo and his troupe in August, as well as their videos of similar sessions in Malaysia in 2019.
“We noticed how non-verbal and even non-physical exercises, like when the dance required participants to only maintain eye contact, encouraged new lines of communication. We were also able to witness a marked improvement in the mood of some participants who were having an emotionally tough week.”
Some 92,000 people are estimated to be living with dementia in Singapore today, and the Ministry of Health expects this number to increase rapidly in the future as the population ages.
While dementia predominantly affects older adults, it can also impact younger people like former engineer Lee Kim Han, 55, who has young onset dementia.
His dementia started two and a half years ago after he was retrenched, said his wife of almost 25 years, Madam Serene Toh.
“He took it hard and isolated himself at home, refusing to go out. Six months later, he started showing signs of dementia – he was increasingly absent-minded and was uninterested in conversations,” Madam Toh said.
She put it down to a bad attitude at first, but realised something was wrong when he started forgetting words and giving up mid-sentence.
“A neurologist confirmed this after his brain scan showed significant shrinkage of his brain. Things progressed really fast from there,” she said, adding that the Covid-19 pandemic and the circuit breaker did not help.
She struggled to understand what her husband wanted or how to help him.
“I was so frustrated that I would scream at him,” shared the 52-year-old, who gave up her job “in the production line” to become her husband’s sole caregiver.
It was 10 months ago that she reached out to her Pioneer MP, Mr Patrick Tay, as a last resort, and was referred to the Dementia Social Club, a social support group for people living with dementia and their caregivers set up by Dementia Singapore.
“We attended an introductory class in expressive dance in August. Mr Jareo showed him how to express his feelings with Totsu-totsu and Kim Han opened up. He became happier and willing to interact with others, and his moods became more stable,” Madam Toh said.
Loved ones, whose efforts to care for dementia sufferers can take a toll, would also benefit from Totsu-totsu.
Mr Jareo said: “Through dance, we no longer have roles. By moving their bodies together, both the person living with dementia and his caregiver learn to coexist.”
Dr Chen Shilling, a board member of Dementia Singapore and a physician with a special interest in dementia and intellectual disabilities, noted that the Totsu-totsu approach, which utilises the principles of improvisation, “opens the door to possibly finding deeper connections”.
“With no wrong or right steps or set moves to memorise, it leaves participants open to discovering new ways to connect (with family members and caregivers),” she said.
Mr Lim said Dementia Singapore intends to collaborate further with Mr Jareo and his team.
“We’ve grown in our understanding of how arts-based programmes are increasingly being used to help with their well-being, to engage their minds and improve their moods,” he said.
“Aside from craft work – which also creates a sense of achievement – dancing has proven to be particularly beneficial in delaying the effects of dementia. The process of combining music and movement to freely express themselves keeps participants in the present, physically and at a social level.”
Source: The Straits Times © SPH Media Limited. Reproduced with permission.
ALL views, content, information and/or materials expressed / presented by any third party apart from Council For Third Age, belong strictly to such third party. Any such third party views, content, information and/or materials provided herein are for convenience and/or general information purposes only. Council For Third Age shall not be responsible nor liable for any injury, loss or damage whatsoever arising directly or indirectly howsoever in connection with or as a result of any person accessing or acting on any such views, content, information and/or materials. Such third party views, content, information and/or materials do not imply and shall not be construed as a representation, warranty, endorsement and/or verification by Council For Third Age in respect of such views, content, information and/or materials.