Section 5: Special Considerations and Special PopulationsSpecial Considerations and SkillsThis section will include special considerations and skills for caring clowns. It is assumed that you have already learned the basic skills mentioned, and that this information will add to your current knowledge and clowning experience.
Balloons and Caring Clowns
Outside of a hospital, using balloons is a different story. Many nursing homes do not have the concerns that hospitals have about allergies or resident’s putting the balloons in their mouths. Always ask about balloon policies and if there are any residents with latex allergies before your bring your balloons to the facility and ask again once you get there. Jalapeña has never had a problem with balloons in nursing homes. In fact, she has volunteered in nursing homes where the staff has invited her back to teach them how to make balloon animals so that they can continue to spread the cheer when she is not around. If there are young children visiting their grandparents in a nursing home, always hand the balloon to the parent or guardian with the child and warn them about the dangers of balloons. As you hand the balloon to the adult, you could say, “Do not let your child put this in his/her mouth. Balloons can get stuck in a child’s throat or lungs.” It is a good idea to have a back up or alternate give-a-way for younger children. The clown can pretend to blow up, tie and manipulate a small plastic duck for the young child. That way the child does not feel left out if there are older children receiving balloons. It is recommended that all clowns who work with balloons carry performers liability insurance. This can be ordered through an agency or organization such as Clowns of America International (see the resource list in Appendix A for more information). Your local Clown Alley should also be able to provide you with information about performers liability insurance.
Magic for Caring ClownsWhile any magic is appreciated, a number of caring clowns have recommended using simple magic tricks that do not require participation and that can be kept in a pocket or small bag. Some examples of magic tricks that caring clowns can use during visits include the wilting flower, sponge balls, disappearing scarves, or the glowing red thumb. ‘Bob-the-Magician’ Gibbons uses “simple magic that doesn’t need to be handed out for inspection” because having patients handle props can quickly increase the spread of germs. While most clowns/magicians will ask an audience member to blow or manipulate a prop to get it to work, Bob-the-Magician will have patients wiggle their fingers or rub their hands together, if he thinks they are physically able to do this, in order to make the magic happen. Involving a family or staff member in wiggling his or her left foot or hopping like a chicken is another way to make the magic happen. The patient can help decide what the family or staff member, or you the clown must do in order to make the magic happen. Other ways to involve the patient, without him or her physically handling your props would include having the patient make all of the decisions as to which color or which rope you should use. That way you can handle all props without fear of spreading germs.
Caring Clown Make-Up
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It is good practice to discuss your give-aways with your supervisor as well as head nurse of the floor you plan to visit. Balloons are a key example of why it is so important to make sure you know the hospital or nursing home’s opinions about your give-aways. Most hospitals do not allow balloons due to latex allergies and the potential dangers of a balloon getting lodged in a child’s throat or lungs, causing suffication. Frequent handling or exposure to latex appears to be the cause of latex allergies. Doctors, nurses and long-term or frequent patients are likely candidates to develop latex allergies and many hospitals have non-latex areas. Most balloons are made with latex and are not allowed in hospitals.
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TIP: When working with younger (under 12) or elderly clowns, encourage make-up sticks/crayons and Auguste clown faces, as opposed to the full professional application of clown make-up. Some clowns prefer a more simple face for hospital and nursing home clowning. By using the make-up crayons, and possibly a little bit of blush or glitter, these caring clowns are able to spend less time applying their make-up and more time visiting the patients or residents. |
Caring Clown Costumes
Caring clown co
stumes should be welcoming and inviting. Caring clowns should dress neatly. This does not mean that a caring clown can not be a Hobo clown. “Dr. Stubs,” also known as Michael Christensen, founder of the Big Apple Circus Clown Care Unit® is a Hobo clown. But caring clowns need to remember that they will be within zero to ten feet of their audience so they should have costumes that look and smell clean. Caring clowns should also use caution with any loose costumes or accessories so as to avoid getting caught on any medical equipment.
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TIP: Costumes can be store-bought or hand-made. Clown and costume stores often have fabulous clown costumes that come with a high price tag. You can even order a costume with colors and a design of your choice through some clown suppliers. However, if your caring clown program decides to supply costumes or have clowns provide their own, there are many ways to provide colorful clown costumes at a cheaper price. The key to having a great costume is creativity. Check out second hand or thrift stores. You can often piece together great costumes for only a few dollars. Jalapeña has a clothes rack full of polka dotted, striped and/or brightly colored tops and bottoms to let her clown trainees borrow until they have created their own costumes. She also always has her clown trainees promise to donate some of their clothing in return for any costume items they purchase from a thrift store such as the Volunteers of America or the Salvation Army. That way they are replacing an item that not many people would wear (perfect for clowns) with an item that is much more up to date and in style. |
Caring clowns often spend more time interacting directly with their audiences than circus or stage clowns do. That is, after all, primarily what caring clowns are there to do. Skits and walk-abouts, literally the activity of entertaining while the clown “walks about,” are often very short and do not require participation from the audience. After a quick introduction and comment about the ‘beautiful blue peacocks growing in the vase,’ the caring clown may do some funny little activity, or ‘skit.’ Some examples of activities that caring clowns can do, other than simple magic tricks, include blowing bubbles, dusting the equipment and visitors, or singing a silly nonsense song.
Cookie the clown carries her baby blue jay in his nest to share on her hospital visits. When a patient wants to see him, she holds out the nest that has a blue letter “J” in it! She also has a collection of prize honeybees in a jar, which she shares with extra special patients and well-behaved staff. These, of course, are cut out letter ‘Bs.’ Notice that none of these activities, or skits, require audience participation. The caring clown does not ask or expect anything from his or her audience. You can never be sure of what a hospital patient or nursing home resident will be able to do physically or mentally prior to entering a room, so go in without any expectations.
Caring clowns are encouraged to borrow ideas from other clowns and to personalize these ideas to fit their personal style. This includes everything from make-up and costumes to skits. Although not originally her idea, Patty Wooten, also known as Nurse Kindheart, an elderly, nurturing clown, and Scruffy, a Hobo Clown, carries a wonderful stethoscope that she encourages other caring clowns to use. She has attached the bottom of a plunger to the end of an oversized stethoscope. Other clowns have borrowed this idea and painted the plunger a bright neon color, added red noses to the earpieces, or replaced the plunger piece with a teacup. When Shobi Dobi listens to someone’s heart, she secretly presses on a noisemaker in her vest. She said that it is lots of fun to listen to a dad’s ‘snoring’ heart and then to hear a child’s ‘giggling’ heart.
Many of these ideas and skits can be used in a nursing home, although the setting is slightly different. Sometimes caring clowns will make fun of the medical staff or the rules of the hospital or nursing home saying things such as: “Due to managed care, I am only allowed to blow 3467,341 bubbles in the next 30 seconds. This has been the proven number of bubbles that effectively causes 46 giggles to flow freely through the room.” Prescriptions are handed out freely and red-nose transplants happen quite often. Prescriptions can include giving two smiles and a receiving a hug or sharing three giggles, etc.. Red-nose transplants are, exactly as they sound, the clown transplanting a red nose from his or her pocket to the patient’s nose.
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TIP: Talk to as many hospital and caring clowns as possible to learn more skits. Read The Hospital Clown Newsletter in order to obtain more ideas and contacts with other clowns who visit hospitals and nursing homes. Watch videos of clown skits and see how you can adapt the skits to your environment. Watch children play and learn from them. Watching their play is a wonderful way for your caring clown to learn how to view the world and to enable you to create your own skits. Don’t forget to check your library for books on clowning. Even books on circus clowns might have a skit or activity that you can alter and apply to your caring clown. The Internet is also a wonderful place to research skits and activities for caring clowns. |
Puppets and Caring Clowns
Some caring clown programs require that clowns visit in pairs. Some clowns prefer to visit alone, but have found puppets to make great partners. Often when children refuse to talk to adults or even the clown, the puppet is a great way to engage the child. The puppet can mirror the child’s emotions and behaviors. So, if the child is shy, the puppet can hide its face in the clown’s hair, peeking out briefly and then hiding again. Do not worry about being a ventriloquist. Most children, and adults, are looking at and interacting with your puppet, not watching your mouth. The important thing is that you and your puppet are there, interacting with someone, not that you have perfected your ventriloquist skills. If it really bothers you, you can always hold the puppet out in front of your mouth until you have mastered the art of ventriloquism.
The key to having a great puppet is practice and creativity. First, practice interacting with your puppet in front of a mirror until it begins to look real. Will it have a special voice, or will it be your normal voice? 
Determine what its personality is and how it would act in certain situations. Think about your puppet’s appearance. Does it look fine, just the way it is, or does it need clothing that would be appropriate for the setting you are going to visit. Maybe a bandage or a miniature stethoscope for your hospital visits. Practice with your puppet at family gatherings and ask for suggestions on how to make your puppet appear more real.
In a hospital, it is good practice for you to be the only one who handles your puppets. Puppets are another example of props that are important to clear with the hospital or nursing home staff. Some hospitals frown on puppets, because of the potential spread of germs. However, other hospitals have means of sterilizing props and will allow you to use them in certain areas of the hospital and then leave them overnight for cleaning.
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TIP: Similar to costumes, caring clown puppets can be store-bought or homemade. Clown and toy stores often have puppets for a range of prices. ‘Puppets’ do not necessarily need an opening for your hand to manipulate. They can be stuffed animals or other props. When Jalapeña is working in a nursing home or another location where balloons are allowed, she invites Pepper, a balloon monkey, to sit on her shoulder. Pepper often causes trouble and messes up Jalapeña’s magic tricks. |
Special Populations
Caring clowns cover a wide range of populations. They clown from pediatric wards to dementia units and from disaster sites to hospice units. Each clown will find a niche that is most comfortable for him or her. Here are just a few examples of special populations and some special considerations for each population. If clowns that are new to the caring clown business are not sure which area they would like to pursue, they can read more, attend conferences, and talk with caring clowns that work with different populations. It would also be great for these newer clowns to tag along with caring clowns in a number of different populations to gain first hand experience with each of these populations.
Hospitals
Hospitals have many strict rules and procedures regarding hygiene to prevent diseases from spreading from patient to patient. It is important to familiarize yourself with these rules and procedures and to follow all of them. You probably will not be allowed to wear your clown gloves or to share your props and magic tricks with a patient. It might seem awkward to have to wash your hands every time you enter a new room. Hand washing is not something one would expect to see a clown to do. But this helps prevent the spread of germs and needs to be done. One way around having patients see you wash your hands is to use the hand sanitizers (such as Purell) that allow you to “wash” your hands and kill germs without soap and water.
There are many different members in your audience at a hospital. While the patient is often the focus of your visit, and will be discussed in further detail in Section 7: The Hospital Visit, take a moment to consider two other groups you will encounter. First there is the family member or friend who is visiting the patient. Sometimes you will be a welcome interruption to the awkward silence that was hovering in the room. Other times, you will be modeling a positive interaction for the visitor to imitate. Remember that the visitor, especially a family member is often feeling worried and helpless. You are giving this visitor, especially a parent of a sick child, permission to play. You are reminding parents that they have the ability to play and have fun with their child, in spite of the circumstances.
Hospital staff are another group that you will encounter in a hospital. They often feel stressed due to the pressure and intense nature of their jobs. Clowns remind hospital and nursing home staff that even though they must take their work seriously, they can still take themselves lightly. Cookie has a wonderful crab hat that she allows doctors or nurses to wear for a bit if they are feeling particularly crabby that day. Jalapeña blows bubbles around the nurse’s station and passes out stickers to staff as well as patients.
Nursing Homes
Nursing homes, or convalescent centers or ‘old folks homes’ as they may be called, have many different types of residents. There will be some residents that have high functioning cognitive abilities, but are unable to care for themselves physically, and some that have fading cognitive abilities, although they seem to be in pretty good shape physically. Clowns can and should visit all of these residents.
There are a few options for clowning in a nursing home. If you enjoy putting on a show, the staff can arrange for you to perform in a social area such as a lounge or the dining area. This way, you are able to reach many residents at one time. There are some things to consider when giving a performance in a nursing home setting. For instance, some of the residents may participate fully with your show, while others may fall asleep and some may not even realize that you are there. Do not take this personally. Maybe they can not hear or see you very well or are not used to so much excitement or are on medications which make them sleepy. You may have worn them out, or come during their normal naptime. It is rarely meant as a personal offense when a resident sleeps through a performance.
Many nursing homes have plenty of entertainers or shows to offer their residents, but not nearly enough individual one-on-one visitors. If you would like to make a special connection with each person, then after your show, or skipping the show entirely, you should plan your visit wisely. Often residents in a nursing home do not receive a steady flow of visitors. It can be a very lonely time for a person. Some residents will respond freely to your attempts to play. Often these seniors are not inhibited by fears of looking silly that might bother younger adults. They might even lead the play. Residents in the dementia and Alzheimer units often love to interact and play with a clown.
For others, when a clown comes in and offers to spend a few moments, the person might not care what you look like, but will just be thrilled that someone is there to visit. The person might want to talk to you about his grandchildren or her previous job. Relax and enjoy the conversation. You might be the only visitor this person has for a while. If you plan to be a regular visitor, you might become like family to him or her. Maybe you can even make an appearance on holidays or at times when other residents have family visitors. Many caring clowns, such as Shobi Dobi, who visit nursing homes call in advance and request a list of residents who rarely or never receive visitors.
Unlike a hospital setting where touching a patient and sharing props are frowned upon, nursing homes encourage touch. Don’t ignore this need for touch. Always ask a person if it is ok before you touch them (“Would you like a clown hug?”). Hold a person’s hand and let him or her decide when he or she is ready to let go. It is also OK to hug a person when you leave. Just remember to be gentle with your hugs and squeezes since bones are often frail and fragile later in life.
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Training Manual |
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