Without a song or dance, what are we?

One of the first blogs I ever wrote on D4Dementia, back in May 2012, was about music for people with dementia. It charted my dad’s love of music, how it became a vital communication tool in the latter years of dad’s dementia, and how I’d been so inspired by the effect music had on my dad that I trained to become a professional singer and completed 35 gigs in care homes.

I guess back when I was doing those gigs, I was effectively part of what a recently launched report on dementia and music calls “a multitude of different individuals and organisations” delivering live music in care homes. The patchwork picture painted by that phrase is very apt given the findings of the aforementioned report - from the Commission on Dementia and Music set up by the International Longevity Centre and supported by The Utley Foundation - that music for people with dementia is, “Defined by sporadic provision which is currently delivered only to the few.”

But why does that matter? Evidence has emerged over the last few years that shows a multitude of benefits associated with music for people with dementia, including:

• A positive effect on the brain by potentially helping with the recall of information
• Minimising distressing symptoms
• Tacking anxiety and depression
• Retaining speech and language
• Enhancing quality of life (through social interaction, improved wellbeing and decreased stress hormones)
• Having a positive impact on the person’s relatives, friends and care workers when they join the person in music-based activity
• Minimising anxiety and discomfort in end-of-life care

I recognise so many of these benefits from my personal experiences. Music gave my dad so much joy, satisfaction and pride. He would sing his favourite songs from beginning to end, word perfect and with precise rhythm and timing. Most tellingly of all, as I recounted in my 2014 Huffington Post blog 'The Power of Music Therapy', when dad could no longer hold a conversation, he could still sing a song.

For us as a family, singing dad’s favourite songs with him or humming or tapping out a treasured melody gave us a priceless connection with him. It was something we could all join in with (once I’d printed lyric sheets for those of us less well-versed with the songs!), smiling, laughing and sometimes shedding a tear together so bound up were we with the emotions of the music.

Indeed, it was the amazing effect music had on my dad during his years with dementia that contributed to the inspiration I had to begin D4Dementia. I wanted to share some of the positive aspects of my dad’s life, and music is right up there on the positive list. In the nearly 6 years since my dad died, I’ve urged everyone I’ve met who’s involved in dementia care and support to give music a try, and it has undoubtedly become easier to do that.

Initiatives like Playlist for Life have come to the fore, and with internet access improving yearly, being able to utilise digital music archives, watch music performances on YouTube, or obtain lyrics to support communal singing of favourite songs has made music more accessible than ever before.

It is extremely sad then that the Commission on Dementia and Music concluded that:

"Educated estimates suggest that high quality arts and music provision may currently only be available in just 5% of care homes." And, "There may be as many as 320,000 people with dementia in residential settings who do not have access to meaningful arts provision."

There is SO much more that needs to be done to support people who are newly diagnosed with dementia, all the way through to people being supported in end-of-life care, to access the musical intervention that is right for them. It could be anything from informally listening to CD’s or the radio, to playing an instrument, formalised music therapy sessions, live music performances designed for people with dementia, or groups like Alzheimer's Society's 'Singing for the Brain'. 

The report gives a list of recommendations which provide all of us with a focus for raising awareness of the benefits of music for people with dementia, or becoming actively involved in its provision. Indeed, friend and fellow writer, Pippa Kelly, has already blogged about a fantastic idea from soprano Lesley Garrett for the BBC to reintroduce ‘Singing Together’, a programme that once brought young people together around their radios and could now do the same for older people.

I for one wholeheartedly support this idea and hope it is just the start of many more innovative musical initiatives, simply because, as the report says:

“A life without music is unimaginable for many and yet for some people with dementia, opportunities to access music can be few and far between.”

Let’s all be part of changing this current reality so that no one who could benefit from a song or dance in their life is left without it.

Until next time...

You can follow me on Twitter: @bethyb1886
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Singing from the same hymn sheet

Me singing to my dad, July 2011

Improving the quality of life for people with dementia, especially in the more advanced stages of the disease when they may have very limited communication or ability to do anything for themselves, is one of my biggest passions.

Over the many years of my father’s dementia we tried numerous different therapies to improve his wellbeing and engagement, and by far the most successful was music. It helped that he had adored music his whole life, right from when he was a chorister at Cathedral School through to my childhood when his strong, perfectly tuned voice would rise above everyone else’s at Sunday church services. For a family so vociferously against chemical cosh drugs, music was the naturally therapeutic choice for my dad.

When my father went into his first care home, like most families we got him a TV for his room, but very soon afterwards it was broken, a godsend for dad as he no longer had to sit and watch mind-numbing rubbish that he had no concept of. He still watched his favourite sports and old films on the big screen in the communal lounge, but his room became a haven of music thanks to his CD player and all the albums he amassed via Christmas and birthday presents.

Our approach wasn’t without its teething problems. We went through a phase of having to continually remind the staff not to put the radio on, as the CD player was there for dad to listen to his music, not for the younger generation to enjoy the local station blaring out modern pop tunes, but otherwise I can honestly say that the CD player was pretty much the finest thing we ever bought dad. In fact it was used so much that we actually went through three machines in the eight and a half years dad was in care.

When my father’s dementia progressed to the point where he had very little conversational ability, and latterly could say no more than a word or two, he would still listen to songs and say the lyrics at precisely the right time, proving that not only did he still know the words but he knew exactly where they fitted within the song. Dad’s expressions and reactions showed how much joy, comfort and pleasure music brought him, and you cannot ask for more than that when you are caring for someone with dementia.

Seeing the effect music had on dad persuaded me to use my singing training to go into other homes, and in 2011 I did 35 gigs in care homes, all of which had at least some audience members living with dementia. My experiences paint a very mixed picture of how different homes and providers approach music therapy sessions. Some welcomed me with open arms, their staff engaged with my show and as a result supported audience members to gain the maximum from having me there. Others used my arrival to simply dump their residents in chairs around the edge of a dimly lit room, with the hardest of hearing placed the furthest away from me, close the door, and leave me with my audience while they went to have a coffee break.

Despite most relatives wanting extensive activities programmes for their loved ones in care homes, and the availability of external entertainers and specialists to come in and supplement that, sadly it is often an under-funded area. The experience I had is that whilst my shows were very well received, activities organisers were unable to re-book me, or indeed anyone else, as either their budget had been cut or they had to fundraise.

Activities like music, art, exercise and reminiscence are vital for people with dementia, and yet they are neither valued nor supported by many care home operators, including some of the biggest companies in the country. It is often seen as easier to just sit residents in front of a TV and leave them there.

There is also a huge lack of understanding about how something as simple as putting appropriate music on can change the atmosphere amongst residents. It infuriates me when care homes play modern pop music to their residents when they could be playing music that will offer residents the chance to reminisce. Hospitals with agitated patients could use less chemical coshes if they were more innovative with music therapies. On one of my father’s hospital admissions we were fortunate enough to be given a side room with a CD player, and having brought in some of his favourite music, the change in his mood was phenomenal.

Music therapy isn’t just for people in the latter stages of dementia either. I am now involved with the Alzheimer’s Society ‘Singing for the brain’ programme, which is a fantastic initiative that provides a supportive and sociable group where people living with dementia can come with their carer and ‘sing to express, not to impress’. The focus is on joining in, feeling engaged and improving wellbeing, not on auditioning for X Factor!

Seeing the faces of everyone in the group light up with different songs and styles of singing is hugely rewarding. It reminds me so much of the work I did last year, and how groups of sleepy, agitated or incoherent residents were transformed into mini choirs when I started singing songs they loved. Some people even got up and danced, and in one home a relative told me that she had never seen such an amazing atmosphere.

In my view all care homes should provide ‘Singing for the Brain’ type sessions as a mandatory service, and the huge availability of digital music and MP3 players should promote further, more personalised, engagement for residents. I have read really interesting stories of iPod’s being used very successfully in care communities in America, and the UK needs to catch up with these technological advances. Given the fees being paid by care home residents across the country, this should be just the tip of the iceberg in terms of innovation in how therapeutic dementia care is provided.

Until next time...

You can follow me on Twitter: @bethyb1886

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