Dementia care


I have seen people with dementia tap their finger or toes to music.


It’s not just Vera Lynn songs! I have nothing against Vera Lynn, indeed, she was born not very far from where I live. However, I feel an internal scream whenever I walk into care settings playing her songs. There is obviously some value in playing old tunes but for many people with dementia they will have been born towards the end of the war, especially those with young-onset dementia.


As NHS England’s national clinical


director for dementia Alistair Burns says, ‘having indiscriminately piped music in the background of, say, a care home would not be appropriate.’1


Our choice of music, therefore, needs to be much more nuanced and, wherever possible, personalised for each person based on their likes/dislikes and life history. As Burns notes, there is ‘evidence that retaining memory for music enjoyed between the ages of ten and 30 is much more enduring’. Rekindling these can have a beneficial effect.


The soundtrack of our lives


We can all think of music which rekindles memories from our lives: songs sung at school, hymns, our first kiss, our wedding day, funerals of loved ones and so on. Purple Angels is a project set up by Norman MacNamara , who lives with dementia. It provides free MP3 players for people with dementia in care homes, hospitals and the community, with personalised playlists selected by their carer. When my friend Marilyn’s husband,


David, went into a care home with Parkinson’s-related dementia during Covid, we discussed how isolated David was. Marilyn sent me the playlist and it was beautiful to hear the emotional touchstones through her and David’s life together. Marilyn told me: “I would never have thought of this calming accessory without the kind intervention of Norm. Selecting the music was therapy itself for me, especially as there were months when David and I couldn’t see each other. “He recently began suffering from bouts of agitation in which he became distressed


and violent and on one occasion when I knew he would be heavily sedated, I begged them to give him the MP3 player instead and, miraculously, it calmed him immediately.”


The power of music in dementia care Working with Pam Schweitzer and her reminiscence project ‘Remembering Yesterday, Caring Today’ years ago, I was struck by a gentleman who could not name the year he married until his wife reminded him. Nevertheless, when we came to the singalong section of the session, he managed to sing every word to Get Me to the Church on Time from My Fair Lady. This article is primarily about music,


yet there are so many opportunities to connect with people living with dementia through sound and rhythm more broadly. I remember a former actress called Gwen, who sat in on one of my training sessions I was delivering in a care home. I was using a sound effects quiz to


demonstrate our auditory semantic memory. I inadvertently played a sound effect of donkeys. Gwen said suddenly: “The donkeys used to come to the gate of our garden – I remember them and giving them carrots.” We were all awestruck at this simple demonstration of how the auditory cortex works.


Later, when Gwen heard the sound


effect of a train leaving a station, she said poignantly: “Mother used to take us on the train to the seaside after father died to help cheer us up.” We were all left in tears, touched by her feelings, and connecting with her memories that had been triggered through a simple sound.


How to use music in dementia care Participating in music can be a passive, yet enjoyable, experience that boosts wellbeing, e.g. listening to music on the radio, CD or a live performance. This does not mean, however, having the playing hard house music! Fantastic projects like M4DRadio play online music that is tailored to, and appropriate for, people living with dementia to rekindle memories.


There also many musicians, entertainers and choirs that are willing to visit care settings to provide entertainment. Other projects include Live Music Now, Music for


I have nothing against Vera Lynn, indeed, she was born not very far from where I live. However, I feel an internal scream whenever I walk into care settings playing her songs


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Tom Kitwood’s ‘flower model’ of caring for, and supporting people with, dementia


Dementia, Intergenerational Music Making, Songhaven and HealthPitch. Meanwhile, there can be many active ways of engaging and participating in music, such as playing instruments, home-grown shows, singalongs, visiting musicians, musical quizzes and more.


Spontaneous music, singing and sound-making In his book, Connecting through Music with People with Dementia: A Guide for Caregivers, Robin Rio says by using ‘music to provide comfort and meaningful experience’ we can ‘develop a sense of comfort with making sounds and singing, playing rhythms on percussion, and using recorded music effectively.’


Many of us will have worked with people with dementia during personal care and/ or times of emotional distress, e.g. ‘I want to go home to my Mum’. Such situations can be difficult for staff. This is where music is a useful tool to change mood. Playing calm, relaxing music during personal care may help relieve feelings of anxiety for the person with dementia. Additionally, we can hum or sing songs that are familiar to the person, such as lullabies, church music or other familiar songs. Rio says the sound of a ‘live’ voice is


preferable over a recording and that staff does not need to be perfect singers or musicians. ‘It is the caregiver who needs to become desensitized to any anxieties or embarrassment associated with singing or making musical noises’, he notes.


Benefits of using music for dementia care organisations There is growing research evidence that music can benefit the symptoms of


www.thecarehomeenvironment.com February 2022


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