A smile, an unexpected laugh, a knowing glance: sometimes the simplest gestures can create precious opportunities for connection and human interaction. It is from this very awareness that Smile Therapy was born: an activity that uses the universal language of humour, play and artistic improvisation to support the emotional wellbeing of people experiencing situations of vulnerability. For many years, the Fondazione Dottor Sorriso ETS has brought its experience primarily to paediatric hospital settings, where its professional clowns work alongside children, families and healthcare staff, helping to make the experience of care more reassuring and welcoming. In 2025, the Foundation chose to explore a new area of intervention: older people living in residential care homes. In collaboration with the Consorzio Italiano per la Ricerca in Medicina, a pilot study was launched to assess the effects of clown therapy on older people living in residential care. Residenza per Anziani Arzaga in Milan was selected as the setting for this pilot project, marking the beginning of a collaboration that created an important opportunity to bring together the worlds of research, care and artistic expression. The pilot programme ran from February to October 2026 and involved a group of residents whose cognitive abilities were sufficiently preserved to enable them to participate in the home’s cultural and socio-educational activities and to express their preferences independently. The sessions were led by a group of clowns with diverse backgrounds and experience in education, the arts, creative practice and clown therapy. Before the project began, they took part in specific training, delivered with the contribution of the Foundation and RSA Arzaga’s professionals, to gain a better understanding of the characteristics and needs of the older people involved. Over the course of the project, the sessions created moments of play, improvisation, music, smiles and spontaneous interaction. Beyond the scientific findings of the study, which are still awaiting evaluation, the experience proved particularly enriching for the clowns themselves, both on a human level and in terms of their artistic exploration. But it was precisely during this experience that an important reflection emerged. As they visited the different units of the Residence, the clowns also met residents with more significant physical and cognitive impairments, who were often unable to take part in the usual recreational and social activities. Through a glance, a gesture or a more explicit request, these residents expressed their desire for attention, closeness and human connection. These encounters opened up a new perspective: bringing Smile Therapy to those who, precisely because of their greater vulnerability, have fewer opportunities to take part in community life. In these contexts, clown therapy can take on an even deeper meaning. The aim is not necessarily to make someone laugh, but to create a genuine connection, one that can adapt to each person’s pace, abilities and ways of communicating. A familiar melody, a simple game, a funny expression or simply an attentive presence can become ways of connecting with someone even when words become more difficult. Smile Therapy does not replace medical care or care and educational interventions. Rather, it is intended as a complementary activity aimed at promoting psychological wellbeing, emotional expression and the quality of human relationships. Above all, the experience at RSA Arzaga reminds us that the need for human connection, attention and the feeling of being recognised does not diminish with advancing age or increasing frailty. It is from this awareness that the desire to continue the journey we have begun takes shape, envisioning a new phase of the project that also includes our most vulnerable residents, so that a smile can reach those who find it most difficult to take part in everyday opportunities for connection. Because a smile cannot erase difficulties, but it can transform, even if only for a moment, the way we experience them. And sometimes, even before making someone laugh, the most precious gift is simply making them feel seen, heard and welcomed.

Caring for an older person means being present, observing, listening, and recognising even the smallest changes that may indicate a need, a difficulty, or a situation requiring greater attention. Illustration courtesy of Ancelia https://teiacare.com/ancelia/ Today, technology can help care professionals carry out this task by providing them with new tools that complement their professional experience and knowledge of the residents. With this objective in mind, at our nursing home we have chosen to introduce Ancelia by TeiaCare, a technological solution based on artificial intelligence and the use of optical sensors within residents’ rooms, designed to support staff in caring for and monitoring residents. Additional support in everyday care Daily life in a nursing home is made up of many different moments: rest, sleep, movement, time spent in one’s room, daily activities and, of course, the care provided by our staff. In this context, having access to useful information about what is happening can help make care even more timely, attentive and personalised. Ancelia supports care professionals in monitoring certain events and situations that may occur during the day or night, helping them identify more quickly any circumstances that may require attention. Technology therefore becomes an additional tool supporting staff observation: it does not make decisions on behalf of care professionals, but provides them with additional information that can help them assess a situation and, when necessary, respond more quickly and with greater awareness. Technology and human presence: working together to provide better care When discussing artificial intelligence applied to the care of older people, it is important to make one fundamental point clear: no technology can replace human relationships. Care begins with human interaction. It is the experience of our care professionals, their sensitivity, their knowledge of each resident and their ability to understand individual habits, needs and vulnerabilities that make a difference every day. This is precisely why we have chosen to see technology as an ally: a tool that can support those working in our nursing home by providing additional assistance in observing and managing everyday situations. The aim is not to reduce human presence, but to enable our care professionals to devote even greater attention to people and their individual needs. Technology, safety and respect for the individual Introducing technological tools into residents’ living spaces also requires particular attention to privacy, dignity and the protection of the individual. For this reason, the use of Ancelia forms part of the procedures and measures adopted by our nursing home to ensure that technology is used exclusively to support care, while respecting the people who live here. The presence of sensors should not be understood as a form of surveillance for its own sake. Their purpose is care-related: to provide staff with useful information that can help identify situations requiring attention and contribute to greater resident safety. Even when using the most innovative technologies, one principle remains fundamental to us: safety must always go hand in hand with respect for privacy, dignity and the individuality of every person. Every resident is different No two older people are the same, just as no two care pathways are identical. Some residents are more independent, while others require greater support; some sleep peacefully, while others may be more active during the night; some have well-established routines, while for others a change in behaviour may be something that deserves particular attention. For this reason, a model of care that is genuinely centred on the individual cannot be the same for everyone. Having access to information about a resident’s daily routine can help staff better understand their needs and place what happens during the day and night into the appropriate context. Technology therefore adds another level of information to the professional assessment provided by our care team, helping us provide care that is increasingly tailored to each individual. Innovation means making a tangible improvement to the quality of care The introduction of Ancelia represents another step forward in our nursing home’s ongoing commitment to innovation in care. For us, innovation does not simply mean introducing new technologies. It means asking whether and how a particular tool can make a tangible contribution to the work of our care professionals, the safety of our residents and, more broadly, their quality of life within our nursing home. Technology has real value when it can become a discreet part of everyday life and contribute to a system in which professional expertise, organisation, attentiveness and human relationships remain central. This approach also characterises the other services provided by our nursing home, from healthcare assistance to physiotherapy services, all focused on the wellbeing and individual needs of our residents. The individual always remains at the centre Artificial intelligence can process information, identify certain events and provide new tools to support care. But it is people who care for people. This is the principle that also guides our approach to innovation. With Ancelia, we want to provide our care professionals with an additional tool that can help them perform their work even more effectively and contribute to creating an environment in which residents can feel cared for, protected and respected as individuals. For us, the future of care does not mean choosing between technology and human relationships. It means using technology to give even greater value to those relationships, to the professionalism of our staff and to the time devoted to caring for each person. For a nursing home, this is what innovation truly means: using the opportunities offered by today’s technology to make a tangible improvement to the wellbeing of the people entrusted to our care and to the quality of the care we provide.