Chronic disease is no laughing matter – or is it?


A surprisingly ‘infectious’ therapy is helping put a smile on the faces of older Australians undergoing treatment.

Key Points


  • Kidney disease increases with age
  • Laughter therapy is proving beneficial to dialysis patients
  • Laughter lowers depression and produces happy hormones

It’s said that laughter is the best medicine. That’s good news for older Australians who have or are likely to get chronic kidney disease (CKD).

CKD increases with age. In 2017–18, people aged 65-plus comprised 70% of CKD hospitalisations. CKD hospitalisation rates for males and females were highest in those aged 85 and over (19,100 and 11,000 per 100,000 population, respectively)—at least 1.6 times as high as those in the 75–84 age group (11,100 and 6,900 per 100,000, respectively).

Dialysis treatment for patients can be tedious and lonely. It means spending four to five hours a day, three times a week, attached to a dialysis machine.

People on dialysis, like lots of people, do not always embrace exercise, so researchers looked at finding fun ways for them to exercise.

Dialysis clinics usually treat anywhere between 10 to 20 patients at a time. Patients sit in a circle, hooked up to machines, around a nursing station and eye each other for four or five hours per session.

For that reason, a Melbourne dialysis clinic offered an opportunity to test out the benefits of laughter therapy.

With the help of a small grant, Deakin researchers brought in laughter therapists to every dialysis session at Monash Health clinics for one month. Most patients and nurses enjoyed the experience, which led Paul Bennett, RN and Associate Professor in Nursing at the University of South Australia to broaden his research.

How does it all work?


Sessions are conducted by trained laughter therapists who know how to develop a rapport with patients. A session typically runs between 30 and 45 minutes.

“You start off with warm-up exercises, deep breathing exercises and a type of meditation, because laughter is a lot about breathing, it’s using your lungs to full capacity,” Professor Bennett explained.

“Then you go through laughter exercises, which can be anything, such as an alphabet laughter. That might take a minute and then you repeat that again.

“You might do a riding your bicycle laughter where you’re pretending, you’re riding your bicycle and you’re laughing at the same time. In between these defined exercises, you do this chant, which is ‘ho ho, ho, ha, ha, ha’.”

While the practice begins as forced laughter, where you know that you are not really laughing because something is funny, Professor Bennett says after an extended period, the laughter becomes natural and contagious.

Laughter releases stress-relieving hormones such as dopamine, serotonin and oxytocin triggering mental health benefits and, potentially, an improved quality of life.

The results indicated depression decreased in the laughter group. What’s more in other chronic diseases laughter can increase pain thresholds, improves stress and can actually improve blood pressure and pulse for people with heart failure.

Laughter also has some protective effect on natural immunity.

Professor Bennett believes laughter therapy is one of many important interventions but concedes acceptance of the complementary therapy among the medical community remains challenging, but having seen the benefits first-hand, is committed to championing its impact.

“I’ve seen the benefits and the impact it can have on people, particularly those with chronic kidney disease and on dialysis,” he says.

“One nurse said: ‘that old guy hadn’t smiled or laughed in 10 years and here he is having a good time’. That’s the sort of story that you see and experience that has led me to continue this research.”

Professor Bennett encourages all people to seek out a laughter group in their own city or town and give it a go.

“It’s not for everyone but we know from our patients and some of our staff that about 80% of people love it once they start doing it.”

Source: The Australian Institute of Health and Welfare