Dibokkeshi: Connecting Dementia and Theatre

Naoki Sugawara, the leader of the theatrical company Oi- BokkeShi, has loved movies since he was a junior high student. That’s when he had the thought, "Someday, I would like to make a movie."

"In high school there was no movie club, so my start was joining the theatre club,” Sugawara said. “I was not good at talking with people, so I thought being behind-the-scenes would be good, but once in a while I auditioned for nonspeaking parts if I could. It was fun to play parts that were similar to the regular me, like a shut-in boy just sitting in the living room holding his knees and being quiet. If I didn’t win those parts, I wouldn’t have become an actor.”

Sugawara, who wanted to study theatre in college, attended an open house at J. F. Oberlin University in suburban Tokyo. He had an eye-opening experience at the playwright Hirata Oriza’s theatre workshop.

“The part we were to play was someone that asks, ‘Are you traveling?’ to someone that just happened to be sitting in the same carriage on the train, but us high schoolers couldn’t say that line very well,” Sugawara recalled. “Then, Mr. Hirata said, ‘Maybe it’s easier to start the conversation by talking about hobbies?’ so we had the opposing actor read a soccer magazine. That way, you could start the conversation with small talk like, ‘What do you think about the next World Cup?’ and then move to the question ‘Are you traveling?’ In that moment, the technique of ‘change the environment to bring out a natural performance’ left a deep impression on me, and I decided to go into theatre.”

After graduating from Oberlin with a degree in integrated cultural studies, Sugawara worked a part-time job and continued to work in theatre as a freelance actor. He got qualifications to be a level 2 home caregiver when he got married and had a kid in the latter half of his 20s. Then, at his workplace in a nursing home in Chiba, he sensed what he calls “the good compatibility of acting and caregiving.”

“There are no better actors than the elderly. They have such a sense of presence,” Sugawara said. “Listening to each of their life stories is one of the charms of the caregiver’s job. Facing scenes of death, and coming into contact with people with dementia, people who are almost bedridden due to gastric fistula, and people who can’t talk after having a stroke, I couldn’t help but face basic questions like ‘What is life?’ ‘What is aging?’ ‘What is communication?’”

After the Great East Japan earthquake in 2011 – a triple disaster that involved Japan’s worst-ever, 9.0-magnitude quake, tsunami and meltdown at the Fukushima nuclear plant, the loss of more than 15,000 lives and the displacement of half a million people – Sugawara moved to sunny Okayama Prefecture. While continuing his caregiver job, he searched for what he terms “a way to express what I felt on the ground at my caregiver job using theatre.

“For those with dementia, the core symptoms expressed are disorientation; not knowing when it is, where they are, and who the person in front of them is,” Sugawara said. “Also, they may be seeing a different world than the rest of us, and if they keep having experiences where this is denied or disregarded, then their self-esteem and self-worth is damaged. Behavioral and psychological symptoms may appear, such as violence, wandering, and acting out.”

Nurturing feelings of curiosity and respect

Aware of the challenges and frustrations that those with dementia face, Sugawara had a thought: “If the caregivers become actors, empathize with the world that the people with dementia see, and do a performance, then maybe we can reduce dementia sufferers’ behavioral and psychological symptoms.”

And so, in 2014, in the town of Wake, Okayama, Sugawara started OiBokkeShi, a theatre company that puts on performances based on the themes of aging, dementia, and death. The thought behind the name is, as Sugawara explains, to “create a culture that faces aging, dementia, and death through the arts.” He has since held his theater and aging workshops all over Japan.

Wake, located roughly 300 miles west of Tokyo in central Japan, would seem to be the perfect setting for such a theatre. With a population of roughly 15,000, Wake is famous for its Wamojiyaki festival that takes place every year during the mid-August Obon holiday. Similar to the Mexican Day of the Dead, Obon rituals commemorate deceased ancestors, whose spirits, it is believed, return home to visit their relatives.

Wake is also home to Fuji Park, the largest wisteria park in Japan, with 100 varieties gathered from all over the nation. Pink and white flowers bloom in late April and early May, and a 1,500-foot, purple tunnel envelops visitors with a sweet scent from the three-foot, trailing bunches of flowers.

Sugawara’s first step was to set up a workshop in Wake for dementia care using theatrical techniques. “I have the participants play the part of the person with dementia and the nursing home staff. They act out a scenario where the person with dementia’s words and actions are corrected, and another one where they are accepted. They should experience the differences between them. When regular people try to act like people with dementia, they tend to feel pressure while trying to think of what the person with dementia would say next or how they should react, and they can’t play the part very well.

“However, about 1 out of 5 people who have experience working in nursing homes are the opposite,” Sugawara continued. “They say, ‘I was excited to hear what the person playing the person with dementia would say and it was fun.’ I also understand that feeling. I mean, if we perceive the world that people with dementia live in as a different culture [that can be tapped into], then I think that curiosity and feelings of respect for them begin to grow.”

Tadao Okada, a leading actor at OiBokkeShi, is 96 years old and was a workshop participant. Okada, who was 88 years old at the time, was caring for his wife with dementia who was the same age. “He was hard of hearing, and it looked hard for him to walk, so I thought it would be hard for him to do the workshop,” Sugawara says. “But he had a lot of drive! In the last performance, he didn’t need the script and put on a wonderful performance. It seems he was an extra in an Imamura Shohei film [in the past].”

Okada’s lived experience informed the production “Portable Toilet Theatre.” The main character, worried about caring for his wife with dementia, auditions for a play and finds a new purpose in life. It depicts a change in his approach to caregiving. Okada speaks from the heart; it isn’t really acting, and his aimless speech takes up most of the 90 minutes.

“In the past when his wife with dementia would say, ‘I’m going to resign today,’ and try to leave the house, Okada himself used to get angry and say, ‘What are you talking about?’, and they would often argue,” Sugawara said. “But when he started getting into his wife’s world, saying, ‘All right, write your resignation notice,’ he could enjoy being in the here and now with her.”

It has been eight years since Okada started doing plays. “In his real life, Okada now needs nursing care, and it’s hard for him to even go to the local supermarket,” Sugawara said. “But in the theatre his performances have gone up from one time a year to two to three times, his lines have increased, and he can do more and more. It’s my belief that if you share the things you like and build trusting relationships, then various potentials and possibilities will be opened up to you, and you can do things you thought were impossible.”

Theatre can be a rehearsal for real-life communication

Every year more and more people are involved with Oi- BokkeShi. In the production “Happy Song,” performed in November 2020 in Nagi, Okayama, a woman who had been in theatre in Tokyo returns to her hometown during the coronavirus pandemic. The production opens with her meeting a strange old man with dementia. The world of the dementia of the old man and the lives of the other characters mix, creating a performance that brings in a strange new reality and humor. Local people, including local government officials and former public health nurses, also make appearances in the production.

Various generations come together in the OiBokkeShi workshops, which are regularly held in Nagi, and Sugawara believes that this is a very positive thing. “Aging is a topic that can result in confrontation between family members,” he says. “Each person in the family has their own viewpoint, and if we make a play based on those perspectives, then at the end, the workshop participants become like a psuedofamily. They can say what they really think precisely because they’re playing a part. The play becomes a rehearsal for conversations where people with different values each make new values. It might be close to ‘Open Dialogue’ [A method for people with mental illness to repair relationships through multiple dialogues that involve their medical team and the people in their life] in that respect.”

In “The Extra Party,” which opened in July this year, the performers are people living with developmental disorders, cerebral palsy, and dementia, and the cast includes young people. “Emiko, who lives with dementia, was afraid in the workshop that the things she would say would embarrass the people around her,” Sugawara said. “But once she understood that we would accept however she chose to express herself, she was bursting with confidence, and her husband Yasunari, who participated with her, also gave a surprisingly energetic performance. Even if you can’t remember the lines, you can act by expressing emotions.”

These initiatives are attracting attention even in England, where the connection between social welfare and the arts is strong. Sugawara had put on “Wandering Theatre” [a style of theatre usually called “walking theatre.”] Sugawara’s wandering theatre “Night Never Gets Darker” involves actors in an arcade and the audience walks around the arcade like people on a tour, watching the play. This production made a deep impression on an English artist, and they collaborated on “Theatre of Wandering” in September 2021.

“We had workshops in Coventry, England. People, including doctors, police officers, and nursing home residents, discussed how to include people with dementia living in the community,” Sugawara said. “We created the story from these conversations. I am planning a wandering theatre production that will incorporate the stories of workshop participants.”

Sugawara believes that productions like this are mirrors of reality that can help people engage with dementia in their everyday lives and in their communities. “[A production like this] connects to the process of how the various people living in the town get to accept dementia, and an inclusive society is realized on a stage,” he says. “If that feeling is spread to the community through the audience, then fiction becomes reality, and all sorts of difficulties in people’s lives go away,” Sugawara says, his voice tinged with hope.

Someday, Sugawara says, he wants to “build a platform for people interested in social welfare, medical care, nursing, and theatre to connect.”

-Suzanne Hanney, contributing, from online sources

Courtesy of The Big Issue Japan / International Network of Street Papers

Translated from Japanese by Kevin SwordOiBokkeShi website: https://oibokkeshi.net/english/

To read about the presentation in Coventry, England, visit: entelechyarts.org/tow/

To watch a video of the wandering theater, visit: vimeo.com/619082085