About eight years ago, my work took me to an International Conference on Aging in Israel. There I witnessed a wonderful experiment by a director of nursing of a nursing home. She was most concerned with the isolation and grim status of her residents.

She produced a six-session workshop with about eight residents who were selected on the basis of their level of cognition. Her creativity for developing amusing programs was extraordinary. By the fourth session residents were laughing out loud and more than that, they made sure that the other residents got there. Observing this was a great satisfaction. It affirmed the breakdown of isolation and the caring of one for another, which was absent before. I would like to see such a program replicated in all of our nursing homes, adult homes and assisted living residences. It is as important as food and other forms of recreation.

Laughter is a serious business. Norman Cousins in his first book, The Anatomy of an Illness got the attention of physicians all over the world. He engendered intensive research on the physiological benefits of laughter. He indicated that "laughter provides an internal exercise - a form of jogging for the innards." Albert Schweitzer, during his work at Lebredine Hospital, always made it a point to have an amusing story to go with the meals the staff took together. He saw humor as "vital nourishment" and noted that the staff was always rejuvenated and performed better with patients. He saw laughter at the dinner table as the most important course.

Freud saw wit and humor as "highly differentiated manifestations of the uniqueness of the mind." He believed that mirth was a highly useful way of contradicting nervous tension and that humor could be used as an effective therapy.

Laughter therapy is not a substitute for good medical interventions but rather as a partner in the total undertaking of care, an enhancement of the qualify of life. Laughter is a subject that is continuously studied with positive links. Laughter and stress reduction, healing, and pain control boosting the immune system and the ability to fight disease are some of the links in question.

Dr. William Frey from Stamford University demonstrated that most of the major physiological systems of the body are stimulated during hearty laughter. Drs. Lee Berk and David Fenton at Loma Linda University Medical Center study heart attack patients. For 30 minutes patients watched humorous videos and the results were extremely positive compared with patients who did not view the video.

Psychoneuroimmunology, the study of connections between the mind and body, is providing the evidence that researchers are observing and monitoring. Drs. Burk and Fenton are continuing their work at the University of California at Irvine. Bernie Siegal and Dr. Tom, among others involved in laughter research, have also noted that humor results are promising - that "laughter is nature's energy."

We have known for a long time that stress can make you sick - can laughter make you well? Life is what happens when you are making other plans. Wit and humor can prevent hardening of the attitudes. Jackie Kwan, a noted clinical social worker, who works with therapeutic laughter techniques says, "She/he who laughs ... lasts." Residents, family and staff should advocate for laughter programs wherever they have influence and concerns about their institutionalized relatives.