Music and singing in care homes

• Doing it yourself Open

  Singing and playing or listening to others, moving to the music or even just tapping your toes to the beat, provide a feeling of wellbeing, from watching the activity to full participation. It is important to have discovered what genre of music that each individual has an interest in, and to deliver appropriately.

  There are many forms of music and singing available, including classical, folk, traditional, jazz, soul, pop. The power of music, especially singing, to unlock memories is an increasingly key feature of dementia care. It seems to reach parts of the brain in ways other forms of communication cannot. Even if people with dementia can’t talk, they may be able to sing, whistle, clap or tap their feet. It helps them, and their carers, to feel life is worthwhile.

  The following suggestions can be adapted to suit the needs of all individuals, regardless of their physical or mental health and wellbeing. A risk assessment should always be completed.

  Practical tips:

  • Deliver music and singing sessions in a creative, imaginative and enthusiastic manner
    • Dress to suit the occasion
    • Encourage staff, volunteers and family members to join in
    • Create a lively atmosphere and make sure that you ask participants to give a list of songs that they would most enjoying singing with a group
  • Provide advance notice to participants so that a potentially new experience is offered in a non-threatening way
  • Add value to the activity by making the environment special to create the right atmosphere
    • Decorate the area to suit the mood: sixties jazz theme, country and western, etc.
    • Have food and drink to fit the theme
  • Structure the time of the session appropriately
    • Forty-five minutes is regarded as a good length of time for participants to feel that they have been active without becoming over-tired
  • Remove distractions that can break up the flow of the session
    • Participants may have a regular routine and may become anxious if tea-breaks don’t happen at the same time
    • Pre-warning about a change of routine or planning the session times to coincide with the breaks may be wise
  • Ensure that the sessions are held in an accessible space where people can watch at a distance initially
  • Playing background music before a session can be helpful in getting everyone prepared and in the right mood to sing
    • Replaying the music used in the sessions during the week can also be helpful
    • Could lead to discussions about costumes and music
    • Singing whenever the mood strikes is a great way of extending the activity
  • Props can be effective
    • Scarves, ribbons, flags, percussion instruments and balloons can all be incorporated into music sessions to support spontaneous movement and inclusivity
    • People with little movement or comprehension can be a valuable part of the group just by holding a ribbon or feather
  • Ensure that sufficient staff support is available to assist with the care aspects such as helping participants to join the group, providing refreshments, going to the toilet and other personal needs

  Some ideas:

  • Musical quizzes
    • Play familiar tunes and see if the residents recognise the tune
      • Start singing a song and see if others join in
    • Play introductions of songs from a CD and then:
      • Guess the name of the song or piece of music
      • Guess the name of the band or singer
      • Guess when it was first heard
    • Have pictures of famous singers - find out what can be remembered about their music
  • Create a choir or orchestra
    • Ask residents to select songs or musical pieces they’d like to perform
    • You can use an overhead projector to list the lyrics with either an accompaniment or play music from a recording
    • Singing together can be a good bonding experience, letting everyone feel emotions, happy and sad, in a safe and supportive environment
    • Have a percussion section
      • Include drums, maracas, egg shakers and tambourines for variety
      • Let the participants guide the direction, pace, tempo and rhythm that the drumming takes
    • Put on your own choir or musical performance within your care home
      • Invite others to join in, i.e. family members
      • Make it a regular event
      • Source the songs and music
  • Other ideas
    • Hold a Karaoke session
    • Discuss musical genres or particular singers
    • This might trigger memories of childhood musical sessions or performances

• Working with others Open

  Here are some ways in which other organisations can support the art activity. Start by searching locally for what’s available.

  Some organisations specialise in one-off or regular sessions with trained professional musicians or music therapists who work with residents and staff to bring music into the care home. A therapist may work with an individual, for example, creating a playlist of music and songs which has significance for that person, making it available on an iPod so it can be accessed easily. Musicians may facilitate small groups, exploring songs and music which are themed to a season of the year, for example, or which reflects common life events such as weddings or parenthood. This will bring up memories for residents and encourage reminiscence. Sometimes sessions will involve music that’s familiar, but there are also opportunities for improvisation.

  People living with dementia who are non-verbal are often still able to use musical skills they had before the condition developed. They will sing and play instruments and derive enjoyment from the experience. Singing in groups reduces the isolation that some people experience in a care home and can increase participants’ confidence, even those who’ve never sung before.

  The musical therapist may suggest putting on a musical in the home. Residents can be involved in the show in different ways, from taking part in singing to selling tickets. Families and friends can attend a performance or get actively involved in making costumes or helping with the make-up for singers.

  There are opportunities to bring music into the home in other ways. For example, a local school or choir or a musical ensemble may be willing to give a concert or a local festival to run a musical event in the home. Live streamed events such as opera (and ballet) from the Royal Opera House or classical music from a regional concert hall may offer residents new musical experiences. Care home residents can attend concerts in churches, theatres and other local venues; some offer reduced seat prices for seniors. Check first that they are accessible.

• Examples of good practice Open

  Here are some examples of how the art activity is used in practice. Search locally for what’s available in your area.

  Alzheimer’s Society Singing for the Brain

  Groups are led by trained singing leaders and are for people from all walks of life and at different stages of dementia and their carers.

  Bright Shadow Zest workshops

  Performance activities such as song, movement, music, story-making, puppetry and other sensory stimuli. These activities are themed e.g. seasonal or based on a location such as the beach, or the circus.

  Imagine Live streaming from the Royal Concert Hall, Nottingham

  Live streamed events in care homes allows residents to continue to enjoy and be part of these experiences and brings new experiences to people who might not have attended such events before.

  American pianist Jenny Lin

  The most recent is a recital by American pianist Jenny Lin streamed in to Milbeck House Care Home in Nottingham.

  Imagine Musical Memories

  The focus is on developing relationships with residents living with dementia through musical memories. Residents are encouraged to sing along and take part by playing percussion instruments. Participants provide musical memories that inform future sessions and shared experiences.

  Ladder to the Moon Vibrant Communities

  Lifestyle Care commissioned Ladder to the Moon to deliver a year-long Vibrant Communities programme at Ashley Gardens Care Centre nursing home in Maidstone. The care home held a glittering Oscars ceremony and film premieres for the stars of home-grown productions of South Pacific and the Sound of Music.

  A choir in every care home

  Led by Live Music Now, which provides national leadership for musicians working in the care sector; Sound Sense, the UK professional association for community music; and the Sidney De Haan Research Centre, which provides research on the medical and social impacts of singing, an online toolkit has been developed to inspire and support the introduction and use of music into the lives of care home residents.

  Live Music Now LMN Musicians in Residence

  A UK initiative with musicians delivering interactive music programmes in care homes and hospitals, and a range of community and healthcare settings.

  Lost Chord

  Interactive musical sessions in care homes designed to stimulate responses from people with dementia through the media of music, song and dance.

  Manchester Camerata Music in Mind

  Music therapy-based project for people living with dementia and their carers. Camerata orchestral musicians deliver this work in partnership with music therapists.

  Playlist for Life

  In partnership with Edinburgh Caledonian University Play List for Life supports access to music on an iPod for people who have dementia.

  Harry & Margaret video shows how Playlist for Life has transformed the life of a resident at Craigielea Care Home, Scotland.

• Resources Open

  A choir in every care home: a review of research on the value of singing for older people

  The review was conducted to support the A Choir in Every Care Home project by providing a review of existing evidence for the benefits of singing and choirs for older people in care homes. (A Choir in Every Care Home)

  Systematic review: music, singing and wellbeing for adults living with diagnosed conditions

  Reviews evidence from grey literature on wellbeing and outcomes for music and singing for adults. (What Works Wellbeing)

  Taking the lead on music for wellbeing: evaluation report

  Evaluates an intergenerational music project designed to increase engagement and leadership skills of young people in youth‐led musical activity and to help older people increase subjective wellbeing and engagement during youth-led music sessions. (Arts Derbyshire)

  'What I want to do is get half a dozen of them and go and see Simon Cowell': Reflecting on participation and outcomes for people with dementia taking part in a creative musical project

  Evaluation of a creative musical project led by Scottish Opera. The project included people with dementia and their cares in the development, writing, design and performance of a musical production. (Dementia)

  The importance of music for people with dementia: the perspectives of people with dementia, family carers, staff and music therapists

  This research study was conducted to develop further insights into the musical experiences of people with dementia and explores the meaning of music in their lives. Six key themes were identified and the psychosocial model of music in dementia was developed. (Aging and Mental Health)

  Evaluation of ‘Music in Mind’

  Interim findings of the evaluation of the third phase of the Music in Mind (MiM) project. MiM, a music therapy group run by Manchester Camerata offers music therapy sessions for people with dementia (PWD) and their carers. The findings of this evaluation seem to be in line with the literature, suggesting that MIM appears to promote general wellbeing amongst participants and have a positive impact on relationships. (New Economy)

  The Power of Songs: An Evaluation of Plymouth Music Zone’s ‘Keep Singing, Keepsake’ Project

  This case study shows an example of evidence in action, highlighting both the successes and challenges faced with a participatory music programme aimed at older people. (What Works Wellbeing)

  Systematic review: music, singing and wellbeing for adults living with dementia

  A systematic review of the subjective; self-reported-wellbeing outcomes of music and singing in adults living with dementia. (What Works Wellbeing)

  What would life be - without a song or dance, what are we? A report from the Commission on Dementia and Music

  This report outlines the value and benefits of music for people with dementia, whilst also looking at the important next steps which can be taken to ensure that everyone with dementia is able to access music. It brings together for the first time a wide range of evidence, including academic papers, oral evidence and projects in action to demonstrate the value of this field of work