Humour and Older Adults – Part 2/2
Humour, Knowledge, Laughing, NWH2024, Old Humour, Older People, Teaching, The essence of humour
Laughter, the physical response to perceived humour, has demonstrated positive effects on physical and psychological well-being. Studies that focus on effects of humour on health and well-being of older adults are scarce. No studies were found that examine what older adults find humourous. The purpose of this descriptive study was to explore the humour stimulus in a population of older adults.
People or Animals
More than half (59%) of the respondents reported other people or animals as being the source of their laughter. The “people” category included family, friends, children, and people in general. Descriptions of people included such comments as “happy, honest, humble people, adults who are pretentious, people in day-to-day situations, my wife, my friends, and myself.” Other descriptors of this category were “my friend Harriet, the President, funny faces, clowns, andjust being alive and enjoying this world and all it has to offer and life in general.”
Children represented the largest single category (30%). Included in these descriptions were “grandchildren, cute children and babies, my daughter’s college friends, and watching children play.” Animals were the smallest category, representing 14% (8% of the total responses). Descriptions of animals included “funny animals, antics of dogs, and watching squirrels.” Table 2 displays the number of responses and the percentages for each of these categories in relation to the total responses for the category of people or animals.
Situations or Events
Fifty-six percent of respondents reported situations or stories as the source of their laughter, with more than half (51%) claiming jokes as the source. Jokes and stories were reported separately, with stories representing only 15% of this category. Descriptions of jokes included “listening to someone tell a joke, especially if it is animated, simple jokes, one-liners, and clean jokes.” One person stated that she preferred “redneck” jokes. Descriptions of stories included “when someone tells a funny story and they enjoy telling the story.” Twenty-six percent reported television, e-mail, or movies as their source, and only a few reported reading materials as the source (6%). It is possible that those who named jokes as their source may have read them or heard them on television or in movies.
Discussion
Findings support humour as a subjective perceptual experience. The varied responses that led to nine different divisions and two major categories were not surprising based on previous studies that support humour preferences as unique and individual. Also supported is the notion that many older adults appreciate a good joke in general. Jokes can be provided to older adults in person, in writing, and in the media of television, video, and the Internet.
Internal Versus External Sources of Laughter
The sources of laughter in this study were supported in Westburg’s study of hope and laughter in residents and staff in an assisted living facility. Residents reported “real-life” situations, people, and entertainment as their primary sources of humour and laughter. Westburg claims that entertainment and people are external sources, and that real-life situations are internal sources that are more closely related to higher-hope residents identified in her study. Finding humour from an internal source is considered an inner strength that the residents who scored high on the hope scale rely on when stressed by institutional living. None of the residents who scored low on the hope scale reported internal sources of humour. Similarly, Johnson’s investigation of 9 women with breast cancer reported the use of an internal source of humour in that they learned to laugh at themselves. Two respondents in the present study reported laughing at themselves and their own mistakes, and only 13 respondents (9%) identified real-life situations as the source of their humour and laughter, thus claiming external sources as the primary mode for this population. One explanation may be that unlike those institutionalized older adults, this population of older adults is active, mostly in good health, and working as hospital volunteers. They are, therefore, capable of seeking external sources of humour on their own. This may not be the case for persons in the hospital, nursing homes, hospice, or other health care institutions. In addition, institutionalized older adults may be more likely to have brain pathology, which can interfere with both interpretation and expressions related to humour.
Age Differences and the Source of Laughter
The impact of age on sources of laughter was not identified in this study; however, attributes of different types of laughter have been associated with age. Mahony investigated which type of laughter is considered most beneficial to health in both young and old populations. Young and older participants rated 12 laughter terms such as giggle, chuckle, and belly laugh on their contribution to health. They found significant differences in the attributes of what was identified as health-promoting laughter in younger versus older age groups. The differences in mean age of the two groups was 60 years. The younger group indicated that laughter should be strong, active, uninhibited, and loud. The older group was more concerned with social appropriateness and described a gentler, kinder, and less active laughter as the most health-producing attribute. Bethea’s content analysis of how humour affected 46 men and 80 women older than the age of 60 revealed that humour helped them to have a more positive attitude, eased problems and pain, improved relationships with others, and made life less stressful and more balanced.
Gender Differences and the Source of Laughter
Martin and Lefcourt indicated that there may be gender differences related to the types of laughter identified in men and women as health promoting. Martin and Lefcourt’s quantitative measure of a sense of humour found that men laughed longer and more frequently than women even though correlations between total scores were of equal magnitude. Mahoney, Burroughs, and Hieatt explained that differences in the types of laughter identified as health promoting may actually be related more to gender than to age as their older respondents were 75% female. Even though this study had a population of 74.6% female, findings indicate that gender differences related to the source of humour require further research.
Differences in Health Status and the Source of Laughter
The work of Boyle and Joss-Reid on the effects of humour on health discovered that individuals who are basically healthy appear to use and view humour differently than those who have a medical condition. Humour and health were not positively associated in the individuals who reported medical problems. On the other hand, Kuiper and Nicholl claimed that the perception of health rather than actual health determines responses to humour. People who recognize humour more readily in their surroundings have a different perspective and take themselves and others less seriously, resulting in more positive attitudes and less fear about physical health and illness. Participants in this study reported to be in good health; however, 40% reported to have been diagnosed with a major illness in the past. Only 20% reported that they were currently being treated for a major illness. Implications for Research and Practice This study provides new insights about humour in older adults by investigating the stimulus for their laughter. Despite the popular belief in the health benefits of humour and laughter and the proliferation of therapeutic interventions based on these ideas, the empirical evidence for these claims is weak, inconsistent, and inconclusive. One explanation may be the individual nature of what people find humourous and the need to consider that inclination when designing an intervention. Nursing must continue to find ways to use humour as a therapeutic tool to decrease stress and promote health in older adults. Humour can be an effective clinical tool to relieve pain and discomfort and decrease stress and anxiety but only if the intervention is perceived as humourous by the client/patient. Humour can have negative effects on health and serve to increase stress levels if what is intended to be humourous is not perceived as humourous by the individual. Nurses must continue to learn more about the risks and benefits of humour and laughter on health for older adults. In doing so, nurses must be able to identify appropriate sources of humour for the individual in this population before we can begin to use it as a therapeutic tool. Nursing assessment could include investigation of what makes the person laugh so that the nursing care plan could incorporate humour that is individualized and effective for that client. The use of animals as therapy for older adults has grown during the past few years; however, this study indicates that animals can produce laughter for some individuals. The humour-producing qualities of animals may have implications for additional therapeutic value not yet recognized.
As a pilot study asking the broad question “What makes you laugh?” data were divided into (a) people and animals and (b) situations and events. The findings from this study indicate that children have a large impact on creating laughter for this population. Studies that examine the identified source of humour in older adults need to include age, gender, and health status as potential intervening variables. Future research studies need to focus on Westburg’s hope scale as it relates to these two categories. Persons living with painful chronic or terminal diseases, depression, and stress will benefit greatly from more knowledge about what types of humour will be therapeutic for them. Studies incorporating Bethea’s findings of laughter and pain applying the different categories from this study could provide knowledge regarding the use of humour to increase comfort and decrease pain. Mahoney work with gender differences and laughter fosters the need to investigate gender differences related to the different categories in this study. For example, does laughter caused by observing other people have the same or different effect on the health status of women as compared to men? The population for this study was healthy older adults living in a southwestern Florida community. The same research question “What makes you laugh?” needs to be asked of older adults living in assisted living and nursing homes, those with acute or chronic health problems, and those who are at the end of life. The source of laughter may vary greatly for each of these situations and greatly affect how nurses use humour in these different environments with older adults.
Read Part 1 here.
Source: Journal of Holistic Nursing, Volume 24 Number 3, September 2006, page 188-193