Main image: Representatives of MHA’s Music Therapy team, including Lead Music Therapist Ming Hung Hsu (second from left), accept the Laing Buisson award from Michael Portillo at the gala event in London
Coming to the forefront of public awareness in recent years is a serious health matter that somehow seems to be of concern to just about all of us: the reality of dementia. Eric Thorn investigated this disease alongside the astronomical benefit afforded to sufferers that has derived from interaction with music, and notably music therapy. Here, he shares some of his basic notes on this important issue.
Back in the mid nineteen-sixties, when many of our MEN readers identified with me in enjoying school days in an education system that now seems discarded to another era in history, the topic of dementia was a virtual taboo. All that I can recall, when I was growing up, was that on the rare occasions that dementia was mentioned it was hurriedly swept under the carpet with discarding comments along the lines of, “Oh, that’s an old people’s disease!” and “Never let me hear you mention words like that again in this house!” Strange!
For the purposes of clarification, it should be noted that the word dementia is actually used to describe a set of symptoms that can include memory loss and difficulties with thinking, problem-solving or language. These symptoms occur when the brain is damaged by certain diseases, including the most well known, Alzheimer’s disease.
Alzheimer’s disease, named after the doctor who first described it (Alois Alzheimer), is a physical disease that affects the brain. The last estimate that came to my attention indicated that there are more than 520,000 people in the United Kingdom with Alzheimer’s disease. That estimate could be well under-representative plus, of course, it is only a UK figure. It is difficult to imagine just how many sufferers there must be around the globe.
During the course of Alzheimer’s disease, proteins build up in the patient’s brain, forming structures called plaques and tangles. This leads to the loss of connections between nerve cells, which eventually die with a loss of brain tissue. Patients with Alzheimer’s also experience a shortage of some important chemicals in their brain. Such chemicals assist in transmitting signals around the brain, so when there is a shortage of them, the signals are not transmitted as effectively.
Probably the most common symptom of any dementia is that of short term memory loss. I shall never forget the time when my dear late mother (may she continue to rest in peace) first started to forget who her own son was. But all that was laid to rest as soon as her daughter-in-law, my beloved wife MiMi, started to play from her selection of musical instruments. It was as though the tunes weaved a magical tapestry that enlivened Mother’s little grey cells, for she soon recognised me and began merrily singing along to the tunes.
What temporarily resuscitated Mother’s short term memory was something that has today become recognised as an important and vital aspect of care for most, but not all, dementia sufferers: music therapy.
Ever since it was first professionally observed that music by and large seemed to generate a positive response from persons with a known history of dementia, the hidden depth of the power of music and singing has increasingly been exploited to the full. So much so, in fact, that the early pioneers of music therapy became recognised in their own right and music therapy declared a profession.
Four or five decades ago the then “new fangled music therapy” trials that were on-going were often eyed suspiciously. However, as we review the situation now, it has become evident that such therapy has matured into an essential ingredient in the programmes of a growing range of projects.
Persons of all ages and all cultures both in the UK and a growing number of other countries are increasingly being offered the now proven benefits of music therapy.
Day centres, care homes, schools, people in sheltered housing and retirement villages are just the tip of an iceberg of places where people are that already benefit from the amazing invisible, yet obvious, power of music and its healing properties.
Music is unique in that it genuinely transcends to overcome any human made barriers. It is the eternal universal language. It underlies the eternal healing therapy that wins through with flying colours in situations still not fully understood by medical science; where no clearly defined medication has yet been discovered.
Emphasising the proven success of music therapy, one care home group (Methodist Homes) won the Laing Buisson Excellence in Dementia Care Award for its music therapy programme.
MHA employ a lively and growing team of music therapists. Many of the MHA care homes around the United Kingdom regularly enjoy a visit from one of the music therapy team. Usually, the therapists cover a local area of MHA homes and visit a different one each day of the week. The therapists undertake a programme of one to one therapy with different residents in turn, following which most, if not all, of the residents join together with the music therapist for a short enjoyable sing along time.
A representative from the Derby head office of MHA reported how delighted they were to have won the Laing Buisson Excellence in Dementia Care Award for its work with music therapy. Some 13 (thirteen) candidates were shortlisted for the title, making it the most hotly contested award.
In music therapy sessions, therapists directly interact with people living with dementia through joint music making as well as the exchange of verbal, facial, vocal and bodily expressions. Through this interaction, music therapists regulate residents’ emotions to alleviate symptoms and identify their possible causes.
Additionally, during the interaction, music therapists observe the remaining cognitive functions of the residents. Therefore, feedback from music therapists can help other health professionals to make decisions on care and medication, and to continue managing symptoms in day-to-day life.
Music Therapy can have a direct, sometimes immediate effect, on the patient. Behaviours are moderated and symptoms of agitation can be greatly alleviated during therapy sessions (which usually last for about half an hour). Anecdotal evidence shows that Music Therapy can lessen the reliance on (and intensity of) psychotropic drugs, many of which have life inhibiting side effects such as hypertension and stroke.
The MHA interactive music therapy sessions enable people with dementia to express themselves and engage with their surroundings. Research carried out by MHA together with Anglia Ruskin University shows that it has demonstrable benefits to well being. Family and friends frequently comment on how much more expressive and communicative their loved ones with dementia become once they begin the therapy, and how it eases stress and agitation. There is even evidence to suggest that music therapy could reduce or eliminate the need for medication.
MHA provide their music therapy sessions without charge, funding them from charitable donations. They indicate that they wish to provide even more sessions to people with dementia. The population is ageing and progressively more people will need music therapy in the future.
On December 18, 2017, BBC Radio 4 featured a brief item from the MHA Torwood Care Home in Somerset, and its music therapy programme with one resident and his family. Hopefully, this link will still work, so that you can listen to it for yourself: http://www.bbc.co.uk/programmes/b09jcd4d See also: http://www.mha.org.uk/news_archive/bbc-radio-4-features-mhas-music-therapy/.
Bolder Voices is a choir formed of mainly retired people. Most (if not all) of the members came together from three different groups in parts of North London including Age UK and Elders Voice.
They have been performing for a few years now. Like many others, I first stumbled across this talented group of singers when I saw them on television news bulletins at around the time of the official launching of the current generation of the Freedom Pass. This is the free travel pass issued to senior citizens and disabled people. The Bolder Voices resident composers write their original songs and, on television the choir performed their amazing Freedom Pass song.
Somehow, the Bolder Voices choir managed to catch the observant eye of a director of MHA (yes, the same care home group referred to above). This resulted in the singers being invited to perform at an important one day MHA conference in Westminster.
It came to light that Bolder Voices receive invitations to perform at all manner of venues including Day Centres and Care Homes. They were invited to undertake some six or seven week long projects at some of the MHA care homes. In a nutshell, they visit a designated home on the same day (eg, Monday or Tuesday) each week for the agreed period.
Each visit day commences with the singers having informal chats with a selection of the home residents. Each singer makes copious written notes to record what they learn during their conversations. All this takes places during the morning.
During the week, ploughing carefully through the written notes any interesting facts that jump out are used to form a short list of genuine recollections that might be included in the lyrics of specially composed original songs.
The resident composers then set to work writing complete lyrics and music to produce original songs that are sung on the next weekly visit. Performing takes place during the afternoon; mornings being reserved for further conversations with selected residents. Those of the residents who have had songs written about their verbal reflections are asked for their consent but as a general rule they consider themselves privileged to be featured in an exciting song based on their reminiscences.
The final week of visits from Bolder Voices culminates in the choir presenting what they affectionately refer to as a sharing concert. They present a wide range of lively songs, interspersed with the original songs composed over the past few weeks. Relatives and friends of the residents are all invited, and there is ample opportunity for audience participation.
All of this may seem a long way from music therapy, but actually it is a brilliant form of the therapy. The interaction between participating residents and the choir singers all adds up to music therapy on the fly.
Videos from Bolder Voices may be viewed at http://boldervoices.org/video/ which is their official web site. Do a search for Bolder Voices on You Tube to see more.
In 1969, the Music Therapy Charity was founded by Clive Munchester with the aim of specialising in music therapy research.
As a support organisation, they mainly focus on providing grants. In particular, they have been active in funding training for students on postgraduate music therapy courses, offering scholarships and providing financial support to academic music therapy research.
April 2011 saw the founding of the British Association for Music Therapy. This Association was formed from the amalgamation of two other concerns, the Association of Professional Music Therapists (APMT) and the British Society for Music Therapy (BSMT).
Among other aims, the BAMT promotes the use and development of music therapy for children and adults with a wide range of needs; promotes the profession and practice of music therapy in the UK and acts as a voice for those who could benefit from music therapy and for those who provide music therapy.
The very fact that these, and other, support organisations have been set up helps to illustrate just how much we, in recent decades, have come to a new understanding about dementia.
No longer do we consign dementia sufferers to the Room 101 of our misunderstanding. At last, we have come to accept that this is a serious illness that each and every one of us could be suffering with in the future. Let us pray that will never happen, but let us help all patients as much as we can while we can!
Eric A. Thorn