Pia Kontos, Associate Professor
Research Scientist, Toronto Rehabilitation Institute UHN
Pia Kontos is a Research Scientist at Toronto Rehabilitation Institute-UHN, and Assistant Professor at the Dalla Lana School of Public Health, University of Toronto. Her current research program represents a convergence of several key interests or themes: The use of critical social theory and qualitative research methods to examine the norms and assumptions underpinning care practices in long-term care and rehabilitation settings; a philosophy and approach to person-centred care that emphasizes embodied selfhood (non-verbal self-expression), individualizing care, and psychosocial interventions in the clinical area of dementia; and the development, implementation, and evaluation of arts-based approaches such as research-based theatre, improvisational drama, and film to bridge her social science research on person-centered care with practice in long-term care and rehabilitation settings. She has presented and published across multiple disciplines. Recent publications of her research appear in: The Gerontologist; The Journals of Gerontology Series B: Psychological Sciences and Social Sciences; Dementia: The Journal of Social Research and Practice; Implementation Science; Qualitative Health Research; and Sociology of Health and Illness. She has also contributed to several edited volumes: Contesting Aging and Loss; Ageing and Place: Perspectives, Policy, Practice; Thinking About Dementia: Culture, Loss and the Anthropology of Senility; and Old Age and Agency.
She recently received a CIHR grant to conduct an evaluation of the art of clowning as an innovative approach to person-centred dementia care.
Alzheimer's disease is a progressive brain disorder characterized by impaired memory, thought and speech, and currently affects approximately 300,000 Canadians. Once institutionalized, behavioural problems (e.g. agitation) have been found to occur in up to 90% of residents with dementia, and are commonly treated with combinations of environmental (e.g. room isolation), mechanical (e.g. wrist straps), or pharmacological (e.g. sedatives) restraints.The philosophy underpinning more humane approaches to persons with dementia is referred to as person-centred care, in which non-pharmacological interventions are recommended before resorting to various forms of restraint.
Arts-based approaches to person-centred dementia care are particularly effective. A novel intervention is the art of clowning, which involves multiple artistic modalities such as song and music, theatrical devices (e.g. puppetry), humour and emotions (e.g. slapstick, laughter), and movement and physical performance (e.g. dance). However, the art of clowning has not benefited from recent advances in person-centered care, specifically work that emphasizes the importance of attending to the bodily expressiveness of persons with dementia - captured in the notion of embodied selfhood. The purpose of this study is to enhance clowning in dementia care with the embodied selfhood philosophy and approach to person-centred care, and to evaluate the enhanced clowning program in a long-term care facility. A 12-week clowning intervention will be tailored to the study unit to optimize implementation and impact. We will collect information from residents, health practitioners, and administrators using questionnaires, an observational protocol, in-depth interviews, and video in order to explore changes in health care practitioner and resident outcomes that result from the intervention, why the intervention worked or failed, the needs for refinement, and the factors important for replication.