Making Singingfor Health HappenReflections on a ’Singing for the Brain‘Training Course

Alistair Bamford and Stephen Clift

Sidney De Haan Research Centre for Arts and HealthThe Sidney De Haan Research Centre for Arts andHealth is committed to researching thecontribution of music and other participative artsactivities in promoting the wellbeing and health ofindividuals and communities.

Current objectives include:

• Undertaking scientific research and evaluationon the potential benefits for wellbeing andhealth of active engagement in music making.

• Documenting and providing the researchevidence base for establishing ‘Singing onPrescription’ for its wellbeing and healthbenefits

• Working in partnership with health and socialcare agencies and service users in the SouthEast to promote the role of music and arts inhealthcare and health promotion

• Contributing to the wider development of thefield of Arts and Health research and practicethrough membership of national and regionalnetworks, publications and educationalactivities

The Sidney De Haan Research Centre for Arts andHealth is part of Canterbury Christ Church University.

http://www.canterbury.ac.uk/centres/sidney-de-haan-research/

Sidney De Haan Reports: 2© Sidney De Haan Research Centre for Arts and HealthAuthors: Alistair Bamford and Stephen CliftPublished January 2007ISBN: 1899253 48 3

In association with West Berkshire Alzheimer’s Society

Making Singing for Health HappenReflections on a ‘Singing for the Brain’Training Course

Alistair Bamford and Stephen Clift

Sidney De Haan Research Centre for Arts and Health

Sidney De Haan Research Centre for Arts and Health

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CONTENTS

Explanatory note on this report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2

Acknowledgements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2

Section 1Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3

Section 2Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5

Section 3Singing for the Brain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7

Section 4Making Singing for Health Happen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9

Section 5Additional Observations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13

Appendices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .161: Session outlines

2: Feedback Sheets and Course Evaluations

3: Supporting documentation and reference materials

Notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .21

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Explanatory note on this reportSinging for the Brain is a pioneering project developed by Chreanne Montgomery-Smith, West BerkshireAlzheimer’s Society, to provide opportunities for people with Alzheimer’s disease and their family carers tocome together and sing. Making Singing for the Brain Happen was a training course devised by WestBerkshire Alzheimer’s Society for volunteers who wished to organise and run Singing for the Brain groups.Alistair Bamford was invited by Chreanne to attend the course and write an account of personal reflectionsbased on his observations and the documentary and feedback processes set in place by West BerkshireAlzheimer’s Society. The work undertaken for this report is part of a project to develop a resource packageon music and older people funded by Arts Council England South East.

AcknowledgementsThe authors wish to express their considerable thanks to Chreanne Montgomery Smith and all facilitatorsand participants on the Making Singing for Health Happen course.

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Singing for the Brain is an arts and health projectthat offers people with dementia and their carersthe opportunity to participate in group singing. Asuccessful pilot project led to the identification ofthe potential for further such projects, as a resultof which the training programme Singing for theBrain: Making Singing for Health Happen was setup. Volunteers were invited to attend five trainingdays held between October and December 2005,led by creative music practitioners. Each trainingday looked from different perspectives at issuesrelating to using the voice, making music, and thechallenges of dementia. The volunteers wereencouraged to identify their own strengths andareas of interest, in order to form teams that couldthen set up new Singing for the Brain projects.Some decided to focus on music and leadershipskills and ideas, others felt able to offer asupporting role as singers, and others hadadministrative, financial and other experiencenecessary to the running of projects. As a result ofthe training programme these volunteer teamsaimed to set up at least five and possibly as manyas ten new projects.

Singing for the Brain invites participation in anactivity that has physiological, emotional and socialbenefits. This includes not only fulfillingexpectations (i.e. singing), but opportunities forhabitual behaviours to be adjusted to meet widerexpectations (e.g. silence, stillness). In addition toacknowledging participants’ rights to an aestheticexperience, provision of regular structuredopportunities to sing, as part of a care plan, mayhave a potential economic benefit through delayingor ameliorating the condition of dementia. Whileresearch has yet to show conclusively that suchactivity can delay mental deterioration, the simpleact of participation in a group activity will tend tobreak down isolation and help with depression. Thetraining project Making Singing for Health Happenlays the groundwork for such benefits throughinvestment in the volunteer trainees, and givesthem the opportunity to explore and develop newroles in person-centred dementia care.

This report refers briefly to the phenomenon ofmusic and the voice, both culturally and in thecontext of dementia. It gives an overview andassessment of Singing for the Brain and thetraining programme Making Singing for HealthHappen, and identifies key issues for thoseinterested in this work. It is not intended as asurvey of the field of music and dementia, butrather as a commentary on Singing for the Brain,Making Singing for Health Happen and directlyrelated issues. It is therefore relevant primarily tothose involved in this work, and may also containobservations of interest to musicians, researchers,funders and others with a more general concernwith creative music work in the community.

SUMMARY

Section 1

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Section 2

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The Nature of MusicThere is no simple or single way to define music. Itis simultaneously about both performance andlistening, or active and (supposedly) passiveparticipation. It holds in balance physical,psychological and emotional processes, andcultural and historical issues and values. In additionto the familiar models of music as performanceand music as therapy, a ‘third way’ is emerging inwhich music fills an uncertain but definite middleground allied to a wider Arts and Health agenda:Singing for the Brain is a part of this. It is notablethat although this third way has grown out of thelimitations and frustrations felt with the morefamiliar models of performance and therapy, it maybe subject to more scrutiny than those models (1).

Music as Product and ProcessMusic is readily viewed as a product relating toeconomic and social activity (2), rather than as avehicle for active participation whether as listener,performer or, as with Singing for the Brain, insome other way. There is pressure for performers,from rock musicians to orchestral players, to have aparallel view: the process of rehearsal is gearedtowards a finished and polished product (i.e. aperformance or recording) sometime in the future(3), with any frisson from music-making inrehearsal being an incidental bonus. Even so, therehearsal is also in itself a manifestation of musicas a communal or shared activity, in the present,and this perhaps comes as close as any musicalexperience to the nature of Singing for the Brain.

Music is difficult to define, but at a fundamentallevel music clearly involves the processing ofsound through time, and time through sound, insuch a way as to invest it with emotional andassociative values. As an active experience(whether as engaged listener or performer) itstimulates brain activity and, as performance,physical (muscular and aerobic) involvement. Music

can mirror and amplify the feelings we have withinus, it can lead us through feelings that we may notbe able (and may never have been able) to put intowords, and it does not demand an outwardresponse from us (4). In addition to considering thedifferences between the experience of recordedand of live music, there is an important distinctionto be made, particularly in the context of dementia-related memory loss, between music as a vehiclefor memory (e.g. songs from the past, withassociated memories), and music as aphenomenon in the present. The modern world isincreasingly disconnected from the process ofmaking music, and therefore from the core natureof music. As Rosen (2005) notes:

Before 1900 in Europe and America, it was athome that music was most often experienced,by family members who played someinstrument or sang, and by, willingly orunwillingly, the rest of the family andfriends... More exceptionally, music could beheard in some public places - concert hall,opera house, or church. The public realm wasessentially a complement to the private. It setstandards and added glamour. By the twenty-first century, all this had changed. Bothprivate and public music are being displacedby recordings. Few people make music athome anymore... (Charles Rosen ‘Playingmusic: the lost freedom’, New York Review ofBooks 3/11/05)

The Case for Music andDementiaIt is felt generally that musical awareness, and thepotential to respond to music, survives when otherfaculties for communication, self-expression andphysical activity have been diminished orseemingly lost in people with dementia (5). Aswith the wider question of how music works, thereare theories and research but limited useful

INTRODUCTION

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Section 1

conclusions as yet. This is a growing area forqualitative and quantitative research, but thosewith experience of practical music-making in thisfield would generally agree that it has clear short-term effects (perhaps analogous for more ablepeople with concert-going, sitting down to listen toa recording, or rehearsing/performing), and lessclearly definable but definite longer-term potential.For example, participants demonstrate a capacityto remember or re-enter the atmosphere of onesession in subsequent sessions, to respond morequickly and with greater understanding from onesession to the next, and to learn by retaining andadding to material taught from session to session.It is characteristic of this work that it offersparticipants a musical experience that is valuable initself, and also allows people with dementia todemonstrate abilities and to build newrelationships:

He seemed to be able to slowly learn thingsagain. I would take the song sheets homeafter the sessions and we would sing them athome. It enlivened him and he really enjoyeddoing it. (From transcript of BBC News itemon Singing for the Brain, quoting JeanBundock’s experience with her husbandBill)(6)

The Phenomenon of the VoiceUsing instruments places the experience of musicmaking in the most literal sense outside the body.This has positive aspects to it, ranging from thefun of seeing how objects can make sounds, to asense of making a musical contribution in a group(7). However, there are distinct physiological andpsychological benefits to using the voice, whichmay be greater than the benefits of usinginstruments, or even unique to the phenomenon ofthe voice. These include:

• physical relaxation

• improved breathing and posture

• facial and other musculature activity

• shared activity

• cultural, social, emotional and spiritualassociations, and

• benefits for the heart, immune system andother physical functions (8).

More immediate outcomes can include reducingagitated behaviour, increasing communication, andstimulation through participation in an activity.

Sharing ExperienceMusic and dementia activity focusespredominantly on the direct experience of theperson affected by dementia. However, crucialsecondary benefits of music-making shared bycarers and cared for include the respite offered tothe carer; the potential for the carer to see thecared for in a different light; the degree of time andinterest invested in the carer him or herself; andthe wider social experience of meeting otherpeople outside the home who have parallelexperiences. In this sense the music is a pretextfor respite, relaxation and social interaction (9).

Section 2

Section 3

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How it BeganSinging for the Brain began in Spring 2003, as thebrainchild of Chreanne Montgomery-Smith. As akeen amateur singer, working with elderly peopleand with family experience of dementia, shesensed the potential of singing to enhance thewellbeing of dementia sufferers in ways describedin this report. She organised a pilot project of threesessions led by Professor Nicholas Bannan, formerDirector of Music Teaching in Professional Practiceat Reading University and now at the University ofWestern Australia. This pilot led to an ongoingproject directed by freelance voice specialist LizMcNaughton (10).

It all began with Gladys, an 85 year-old inresidential care. She often could notremember her name and lived in a fog. I wasthe activities person (amongst other things)and had borrowed a poor quality music quiz. Itried this out on three successive Wednesdayafternoons. In the first session there wasbewildered attention with some smiles andvery little participation. The second time therewas recognition, more smiling and still only alittle participation. The third session everyonesang! Gladys knew the words to every songand beamed from ear to ear, continuing tobeam every time we met. She was veryproud! I was thrilled! (Chreanne Montgomery-Smith, article forJournal of Dementia Care, February 2006)

A Model ProjectLiz McNaughton’s group has been running for overtwo years, meeting weekly in a church hall inNewbury. Average attendance is about 35 people,consisting of approximately 20 people withdementia, plus carers and volunteers. This isapproaching the maximum number that can beaccommodated in the hall, and with whom theleader can be expected to maintain immediate

personal contact. It is funded through the WestBerkshire branch of the Alzheimer’s Society, ofwhich Chreanne Montgomery-Smith is Support &Development Officer. As a result of the success ofthis project as judged by the numbers attending,the feedback received, and suggestions andrequests from others who had heard about theproject, it was felt that there was considerablescope for further groups.

Who Singing for the Brain is forFor this model project participants live within ten tofifteen miles of Newbury. Most comeindependently with a friend, family or professionalcarer, although one group is collected by minibus.There is no set age or ability range, but a groupwill to some extent be self-selecting and defining.For example, while dementia can affect youngerpeople and some younger people do attend, theaverage age of the people with dementia involvedwith this project is probably around 65; a degree ofphysical mobility is required; for some newmembers there may be a barrier to overcome withthe perceived stigma of being ‘like that’; and somepotential participants may feel uncomfortable withtheir expectations of what a session mightdemand of them (11).

SINGING FOR THE BRAIN

Section 3

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Singing for the Brain’s StatedAimsIn an unpublished article co-written with NickBannan (see note 3) Chreanne Montgomery-Smithidentifies Singing for the Brain’s aims as:

• To improve and maintain neurological pathwaysthrough gentle aerobic activity;

• To help carers and persons with dementia seeeach other in happy circumstances where bothhave been stimulated to enjoy communication;

• To lift or prevent depression through the use ofelements which will surprise, reassure, support,inspire and mediate reframing a negative lifeviewpoint into a positive one;

• To become something GPs can recommend topatients, as they do exercise, and thus helpthem to feel diagnosis is worth doing;

• To help families with dementia ‘come out’ andfeel part of society where they have a right toartistic and social stimulation;

• To encourage carers and people with dementiato be pro-active in looking after themselves, tonetwork with others in the same boat whomight exchange help;

• To give families a view of themselves asmanagers of their life not victims of fate.

Some General PrinciplesSinging for the Brain sessions are guided by thefollowing general principles:

• Sessions take place weekly during term time, inorder to be perceived and remembered asregular events;

• Participants are asked to attend at least threesessions, in order to have time to becomefamiliarised with what goes on;

• The actual session is preceded by a personalwelcome, with tea or coffee and biscuits to beenjoyed for settling in and as a social occasion(12);

• Participants are given name labels (while thismay not be ideal, given the size of groups it isprobably necessary);

• Carers usually sit next to the person they havebrought. This is understandable, although thereis potential value in altering peoples’perceptions of themselves and each other byseparating them for some of the time;

• Each session includes a range of activitiesincluding vocal warm-ups, discussion andrequests, and singing a variety of familiar andnew songs covering a wide emotional range.There may be a theme or other way of linkingmaterial. While looking for a degree of variety,consistency and fluency is neverthelessimportant;

• The leader stands in the middle of a circle,possibly supported by volunteers eitherstanding or placed strategically around the circleto reinforce activities and support participants(particularly with a large group);

• The songs are generally unaccompanied,although there is scope for using handpercussion and perhaps a guitar or ukulele (13);

• Particular characteristics of songs give scope forparticular treatments. There may be rounds,partner songs or other characteristics of thechosen material; there may be scope for actionsreflecting lyrics, or dancing, or a sequence ofrelated gestures; call and response or echoes;word changes to reflect issues and individualsconnected to the group; pertinent discussion;and so on;

• Word sheets are likely to be used at least someof the time (14);

• Sessions need to be imaginatively andsensitively constructed, ending in a ‘coolingdown’ song (15)(16).

Section 4

9

IntroductionSinging for the Brain and the training projectMaking Singing for Health Happen have comeabout through the awareness, imagination anddetermination of one person, but it coincides withcomparable projects elsewhere in the country (17),and with a general move in favour of person-centred, non-drug-based initiatives to ameliorateand enhance the lives of people with dementia andtheir carers. While it should retain and develop itsown distinctive character, there is scope for sharingexperiences and ideas with other projects (18).

The Need for such a TrainingProgrammeThe idea for this course came from the success ofthe Newbury Singing for the Brain programme. Asa result there was an interest in setting up furthergroups in the area, with the associated question ofhow they should work, and the plan was devisedof inviting volunteers to a series of five day-longworkshops, held fortnightly from 12 October to 7December 2005. Funders for the initial pilot and forthis training programme included the BerkshireFoundation, Newbury PCT Health Promotion andthe Anne McCulloch Fund, Newbury Working ArtsTrust, the West Berkshire Community EducationFund and a major private contribution. Potentialparticipants were invited via the tutors’ personalcontacts, targetted emails, production of a flier andmailings, local press, word of mouth, local choralsocieties and doctors’ surgeries.

The course was intended to equip participants withan idea of what roles they feel they could play innew Singing for the Brain programmes, such asleading, supporting the musical content, orfacilitating in other ways such as helping withrefreshments, publicity, funding and financialmanagement, and administration. It was hopedthat groups interested in working together would

emerge during the course, and then be givensupport in developing programmes in WestBerkshire and beyond. This reflective report wascommissioned as an integral part of the trainingprogramme. In addition to offering a constructivelook at philosophical and practical matters itsummarises what took place in the trainingprogramme, and pulls together key issues toinform future practice.

Course ParticipantsThe number of participants varied between 25 and31 people per session. Given the difficulty ofmanaging to get to all sessions, the open nature ofthe sessions in terms of content and potentialoutcomes, and the intensity and challenges of theproject as a whole, this is in itself an indicator ofthe course’s value as a training opportunity, and asan experience in its own right, offering participantsnew perspectives on music, on themselves, andon the people they care for (19). The genderbreakdown was approximately four-fifthsfemale/one fifth male. The average age wasperhaps 50 from a range of approximately 30-60years old, with a cross-section of social andprofessional backgrounds: current and retiredteachers; personal and professional carers; twochoral conductors; an IT consultant; a linguisticanalyst and a clergyman. Most completed a Tutor’sInformation Sheet before the course and commonmotivations for attending the course included aconcern for, and usually direct contact with, peoplewith dementia, a determination and desire to makea difference, and a belief in and experience ofsinging, generally with local choral societies.Despite a love of music, and sometimes significantexperience of leading in other walks of life, therewas on the whole a very limited understanding andexperience among the participants of leadingmusic-making activities.

MAKING SINGING FOR HEALTH HAPPEN

Section 4

10

...I thus gave a lot of thought as to whether toembark on the scheme initially. Thebrochure...seemed well-produced, carefullythought out, and gave information that‘recognised’ people were involved. I was alsoimpressed by the rapid response to myapplication, the clear instructions to the venueand the request to complete a tutor’sinformation form. All of this implied bothefficiency and serious intent; I was verymotivated to sign up. (Participant’s CourseEvaluation)

I’m from a day centre and I used to work in aresidential home and I have had experience ofpeople with Alzheimer’s and dementia. Iwould just like to learn a bit more about whatSinging for the Brain does, I’m interested.Obviously I need you to teach me to sing[laughter]. (Participant, Session 2, 26/10/05)

I passionately believe in the value of singingfor well-being.(Participant’s Tutor’s Information Sheet)

The SessionsThe intention of the course was not to offer asingle viewpoint, but rather to stimulate andchallenge participants by looking at music anddementia issues from different perspectives. Whilethis is not the shortest route to clarity andconfidence, it seems important as a way ofempowering participants to develop their ownpersonal perspectives in the medium to longerterm. Different practitioners led each of the fivesessions, with visitors making some additionalbrief presentations addressing relevant personal,medical and practical matters. Participants weregiven files containing brief introductory notes, plusinformation about the Sidney de Haan ResearchCentre, consent forms for videoing the sessions,and blank paper for notes (20). All the proceedingswere filmed using one fixed and one hand-heldvideo camera, and there is also some additionalrecording on video and DAT. Brief interviews withparticipants were videoed during the course of theproject.

The first two sessions were held in the GreenRoom at New Greenham Arts Centre (which wascramped and acoustically poor), the third and fifthsessions in the main theatre there (acousticallyfairly neutral but with much better physical space),and the fourth session in a recital hall-type theatreat Reading University (acoustically better but verycold). Refreshments and lunch were provided. Therewas no charge to participants: while it would havebeen possible to recover some costs by charging,or for costs to have been less by providing less,this seemed an important gesture of appreciationfor the participants’ willingness to give up a lot oftime for this project, and it also meant that a lot ofinformal but invaluable talk and team-building tookplace during breaks. Brief descriptions of eachsession are given in Appendix 1.

We’re not trying to make people do things inthe same way, we’re just trying to provideprops for them that will allow them toparticipate. (Nick Bannan, Session 1, 12/10/05)

What we need to produce the voice is reallybasic breathing, and I’m actually very keen onpeople getting the whole, it’s not justdiaphragm and lungs it’s the whole of thebody from top to toe going, it’s the vocalfolds...and the resonances, and it’s also thearticulators, so it’s jaw, tongue, teeth... (Liz McNaughton, Session 2, 26/10/05)

Participants’ FeedbackAt the end of each session a Feedback Sheet wasdistributed for completing and handing back beforeleaving. At the end of the project an overall CourseEvaluation was distributed to be returned by mailor email. A breakdown of information provided bythese means is given in Appendix 2. The responsesdemonstrate both the strengths and theweaknesses of using questionnaires to try andquantify the success or otherwise of a project (21).For the individual sessions they are consistentenough to seem representative of participants’views as a whole, but this is less certain with onlyfour Course Evaluations returned. The responsesare overwhelmingly positive, with the followingwords (and synonyms) recurring: confidence,

Section 4

11

enthusiasm, privileged, fun, fulfilment, animation,safe environment, excellent, inspiring. This reflectsthe value of the course for the participantsthemselves, with words such as - watching,experiencing, trying out, thinking, listening, andmaking connections - also indicating theparticipants’ seriousness in learning about andpreparing to take part in future Singing for theBrain projects.

Participants were appreciative of the short talks,which helped to break up the days and offerdifferent perspectives. This may also reflect at leastin part that the information about dementia wastangible and controllable in a way that theexperiential musical agenda was not, and to someextent the desire for such knowledge may maskunderstandable musical insecurities. It was hard totell how far participants felt confident orknowledgeable enough to express more criticalcomments that may have occurred to them, andthis may partly explain the lower number ofresponses to the later sessions after efforts byAngela Turton to ensure that people did providefeedback for the second and subsequent sessions.As the feedback that was received indicates, therewere mixed feelings about aspects of the thirdsession, and the experiential nature of the fourthsession was also more difficult to respond to. Forthe final session the lower number of responsesmay reflect the following:

• the session was in itself a review

• there was some anxiety about what had notbeen learned by the end of the course

• people were already thinking and planningahead rather than thinking about what hadbeen, and

• there was an overall Course Evaluation to becompleted

(see Appendix 1 for more details of each session).

The low number of responses to the overallCourse Evaluation was disappointing, and thenearest to a generalised conclusion that seemed toemerge is that overall the course was moreeffective at developing an awareness of issuesthan in developing skills. A broad conclusionregarding feedback is to consider ways of

incorporating it more fully into the sessionsthemselves. This might include:

• inviting participants to keep a journal;

• including feedback sheets in the files given toall the participants

• a mail box at sessions to leave anonymouscomments in

• discussing the previous session at thebeginning of the following one, and

• inviting discussion on the actual nature offeeding back

The value of feedback is, after all, an appropriateissue in the context of leading Singing for the Brainsessions. It might have been interesting to haveoffered a more flexible rating scale of 1-10 ratherthan 1-5, and to have used this rather than a ‘poor-excellent’ verbal scale on the Feedback Sheets.The Course Evaluation form could have been betterlaid out, and perhaps a small incentive such as CDvouchers for a winner picked at random could havebeen offered to encourage responses.

Michael’s day [Session 4] was wonderful forus, but much of his approach would take toolong to implement in a session where I feelthat variety and relatively short items areneeded. The instruments sounded lovely, butlooked expensive, particularly the harps...(Comment from a Course Evaluation,December 2005)

What Happens Next?In the course of the training programme groupswere formed that allowed for a balance of aimsamong the people taking part (e.g. administration,supporting activities, leading activities), togetherwith geographical proximity to each other and ahost day centre. Since the training project endedparticipants have been visiting and taking part inthe Newbury Singing for the Brain project, andfunding has now been secured for a further fivehalf-day mentoring sessions in which to explorespecific skills and activities prior to leading orsupporting new projects. These mentoringsessions took place in March 2006, with newprojects due to begin at the Ormonde Centre

Section 4

12

(Newbury) and in Purley, Hungerford, Hook,Basingstoke, Wokingham and Tilehurst in April orshortly after. There are also due to be projectsstarting shortly in at least two residential homesand one nursing home, including one inWarwickshire.

A handbook/songbook and CD of suggested songsto use is being produced to support these sessionsand projects. A 15-minute DVD drawn from videofootage of the Making Singing for Health Happentraining project is also in the final stages ofproduction and should be available in April. Inedited form this DVD cannot be a valid documentof the whole training course, but it will be a usefulsummary, reminder and inspiration for courseparticipants.

Media interest has included BBC and Frenchtelevision, and while this risks being anunnecessary distraction it could also be anincentive for potential funders. One significantfunding organisation has already approachedSinging for the Brain as a result of this publicity. Abalance needs to be maintained between allowingSinging for the Brain to grow in response to needand funding possibilities, and consolidating amethodology and nurturing the new projects.

Section 5

13

In the course of the training programme a widerange of practical queries arose. Key issues arereviewed below, together with some additionalcomments.

Legal IssuesIn the context of standard Singing for the Brainsessions activities are in full view of a large groupand no personal care should be involved, andtherefore Criminal Record Bureau checks are notnecessary. However, several participants on thetraining programme are interested in Singing forthe Brain in the context of their professional orpersonal involvement with residential homeswhere circumstances may be different, in whichcase further advice may be needed.

As there is no performance or recording aspect toSinging for the Brain there is no need to beconcerned with the Performing Rights Society andcopyright in songs used, assuming that they havebeen taken in the first place from legitimate (i.e.published or copyright-cleared) sources.

The Alzheimer’s Society and/or other sponsoringbodies can provide model forms for RiskAssessments, and also advice about VolunteerAgreements to help protect team members. Fireregulations require knowing who is present; andkeeping a register covers this, as well as helpingmonitor the effectiveness of a project. It should benoted that before any filming or photography cantake place for any reason (including presscoverage), there are strict ethical rules requiringwritten prior permission from or on behalf of theparticipants.

Physical Facilities andResourcesWhile acknowledging that it may be hard to meetall requirements in full, venues should haveparking, disabled access and toilets, effectiveheating, facilities for offering refreshments, floorspace for perhaps 30 people in a circle, room forobservers to sit outside the circle, and reasonablycomfortable and appropriate seating. The dementiaclients will usually have a carer with them who isresponsible for physical needs, but it makes senseto have a team member with a mobile phone andfirst aid knowledge, and to know what first aid andother medical resources are on hand or nearby.

Good acoustics can make an immense differenceto the success of a session, providing anencouraging bloom for the sound of singing.

Transportation is a crucial issue: in addition topeople coming independently with carers, theWest Berkshire Alzheimer’s Society should shortlyhave a new worker with a role in helping to arrangethis, and care homes and local authorities usuallyhave existing systems for transporting olderpeople.

Volunteers’ RolesIssues that need to be covered include: generaladministration, co-ordination, point of contact andfinancial management; fundraising; publicity;representing the project to potential funders,potential participants, the press etc; setting up,decorating and tidying the hall; keeping a register;preparing and issuing name labels; providingrefreshments; leading activities; supportingactivities; and deputising for each other in the caseof lateness, illness etc.

Qualities that volunteers can bring to a projectinclude a willingness to take on tasks; teambuilding and teamwork; relevant professional and

ADDITIONAL OBSERVATIONS

Section 5

14

personal experience (e.g. financial, caring);appreciation of dementia; musical experience;enthusiasm; humour; flexibility; and confidence.

Role ModelsThe session leaders demonstrated great strengthsand abilities, which will have informed and inspiredparticipants. However, it is a very great step forparticipants to make to lead their own activities, interms of developing and linking ideas, andpresenting and sustaining activities across asession, and from one session to the next. It wasthis fluency that marked all the leaders’ work.Coupled with this, leaders showed a clear,confident and consistent understanding of theirown perspectives on creative music making withgroups.

It was notable that when participants were invitedto lead activities they almost without exceptiontried to go too far, and too fast, rather thanunderstanding or trusting through experience thatin many respects more profound results areachieved through simpler approaches. This raises amajor question as to whether Singing for the Brainis in fact an appropriate activity to be led byvolunteers, but at the same time it will be byactually leading sessions (singly or jointly) that thevolunteers discover their own ideas, preferencesand confidence (22). The model for the way aheadthat Singing for the Brain is suggesting, using thegroups of volunteers brought together throughMaking Singing for Health Happen to set up andrun new projects, is facing this question head-on:

Leaders, in my view, should be identified intheir role as people who are responsible,committed and trained in skills required forthe professional job they do. I think quality ofprovision is very important; not only could afailure in this be detrimental to theorganisation behind the scheme, andpotentially very damaging to the vulnerableclient group; I also feel volunteering wouldfall away if groups are not managed withsome concern for quality... (Comment from a Course Evaluation,December 2005)

Opportunities to ExperimentOn balance, and despite some concern amongparticipants that this should not be the case, theemphasis of the training course was on seeingpractitioners unfolding their own ideas, rather thancreating opportunities for potential leaders to trythings out. Each prospective leader will need todevelop his or her own way of working, rangingfrom planning repertoire that feels comfortable andappropriate, by way of exploring the bravuranecessary to ‘front’ a session, to gaining vocalconfidence, and a flexibility of approach that cancontain the unexpected challenges that sessionswill throw up. The mentoring sessions in Marchwere a belated opportunity to address this, andfuture training programmes need to incorporatemore opportunities from the beginning forparticipants to try things out, and to begin buildingtheir own repertoires of ideas. Liz McNaughtonshould be credited for inviting participants toobserve and take part in her Newbury group, andthis sort of practical exposure should be a moreintegral part of future training programmes. Thisneed could be addressed in part by showing film ofactual sessions in progress.

Big gesture for everyone joining in at theend...responses can be by half the group, asmall group or an individual, easy to make upwords as there are just four beats you’ve gotto fill...making up words makes the songpersonal for the group, talking about the typeof week they’ve had provides you with freshsubject knowledge about the people in thegroup... (Angela Turton, Session 3, 9/11/05)

Section 5

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Instruments and ImprovisationUse of the voice demands particular physiologicaland emotional capacities, with associated possiblecomplications. These range from issues relating tomemory, pitch and articulation, to assumptions thatsinging must be equated directly with songs ratherthan as one among a number of possible elementsinvolved in making music. In contrast, usinginstruments offers a way of placing music makingoutside the physical body, through ‘doing to’ ratherthan ‘being’ the instrument (23). They also offerways to develop songs, such as supportingharmonies, articulating accompanying rhythms, andbuilding textures. Use of instruments was asignificant element within the training course, butparticipants could have been offered more modelsfor their integration with the voice. Similarly,improvisation was a thread that ran through thetraining course, but more clear-cut models couldhave been offered for facilitating this.

Imagine a radio broadcast - let’s have aboutfive or ten seconds of complete silence beforethings happen so that we can really enter theworld the group’s going to create. (Nick Bannan, Session 1, 12/10/05)

lll

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APPENDIX 1: Session outlinesSession 1

Nick Bannan was leader of the original pilot project.As a university professor specialising in musiceducation he offered an appropriately fluent,engaging and challenging session, combiningbackground and theoretical issues with practicalmusic-making exercises and ideas. Hispresentation and practical work were (rightly)geared towards the participants here rather thantowards a possible client group, although as anideal it might have been helpful if he had been ableto return towards the end of the course to run acomplementary session focusing on client groupneeds. He noted a major distinction to be drawnbetween goal-orientated projects looking to thefuture for fulfilment (e.g. a choral societyrehearsal), and a principle of participatory music-making in the present that is embodied in Singingfor the Brain (24). He also raised the question ofwhether participants would, by the end of thistraining course, feel armed with ideas, inspiration,and confidence.

Session 2

Liz McNaughton is the other practitioner with long-term experience, as leader of the Newburyprogramme, of Singing for the Brain. She hassummarised her rationale for this work in anunpublished article ‘Singing for the brain -workshops for those with neurological diseasesand their carers’, that formed a basis for herpresentation, and otherwise she demonstrated thesort of work she does. This is closely focused onthe voice, including vocal health, warm-ups, anddifferent types and treatments (25) of songrepertoire. Like Nick Bannan she showed a perhapsdeceptive fluency and ease with her material:while this was closer to what participants mightaspire to achieve than some of Nick’s practicalwork - partly because she worked from a narrowerrange of musical ideas and treatments - it will bevery difficult for someone who does not have adeep understanding of his or her beliefs andmethods to aspire to replicate such a session.Nevertheless, again like Nick Bannan she didcreate some opportunities for participants to begintrying out ideas, such as leading warm-ups, forthemselves. There was also a brief but relevant

presentation by Angela Kerr, Education & TrainingOfficer for the Parkinson’s Disease Society, whosuggested that music is an ideal way to help co-ordination, confidence and expression.

Session 3

Angela Turton’s background is as a teacher trainingspecialist and freelance musician. She alsoprovides administrative support for Singing for theBrain, offering a particular awareness of funding,media and technology. As a competent guitaristshe offered a different model for leading a session(26). She suggested a more contemporaryrepertoire embracing not only contemporaryChristian songs but rock, pop and rap, andalternative approaches such as exploring use ofmicrophones and introducing elements of theatreand performance. She drew repeatedly on teachingideas, and made many valid points - for examplewith a thoroughly prepared hand-out with songtexts and suggestions for how they might be used;about the wide age range of people with dementiaand the need for a continually evolving and relevantrepertoire; and trying new approaches to musicand performance. Nevertheless their value was attimes obscured by her presentation, whichprojected a degree of personal discomfort thatinterfered with conveying her messagesuccessfully, tended to be instructional rather thancollaborative, was at times inconsistent with hermessage, and was not always sensitive to learningspeeds, or to musical or personal uncertainties.Situations were set up in which participants feltvulnerable to failure, and participants were nothelped to believe that the ideas being offeredwould be appropriate to use with people affectedby dementia. Comments overheard included ‘Itmakes people feel vulnerable’ and ‘I don’t likegetting it wrong, making mistakes’. The FeedbackSheets (see Appendix 2) indicate participants’anxieties, but almost half rated her as ‘Excellent’. Abrief talk by Helen Finch, Age Concern InformationOfficer, about her mother’s love of musiccontinuing to be expressed through her dementia,offered a pertinent and moving reminder of whythe course was taking place.

Session 4:

Michael Deason-Barrow is a former professionalsinger whose explorations of music have been

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increasingly concerned with its spiritual capacity. Aspecific outcome of this is the Tonalis MusicCentre (27), of which he is founder, and he alsohas a particular interest in music therapy. He has astrong, clear, gentle authority that seemsappropriate to working with dementia clients,despite not having personal experience of workingwith this group. The idea of music as a vehicle forthe spiritual was a courageous and justified issueto include within this training project, although itcame into some conflict with the limited timeavailable. Michael brought up issues of Self,Identity and Personhood as affected by dementia,and offered different ways to think about andexperience music, and different ways to makemusic, with a particular focus on the use ofinstruments. Nevertheless, a lot of the musicresulting from his approaches was slow andweighty rather than energising, and while this maybe appropriate to developing and deepeningconnections through music it requires a spirit oftrust and openness that may be difficult to realisewith a group of the size and frailness characterisedby Singing for the Brain. The session was thereforeultimately an experience for the participants ratherthan direct preparation for leading a Singing for theBrain project (28), and this perhaps gave rise to alimited degree of frustration as participants werebeginning to feel that their learning time on thiscourse was rapidly running out. Michael brought alot of books, music and instruments forparticipants to look at (and in some cases buy),which was greatly valued.

Session 5

This was the final session, led by choral conductorand animateur Norman Morris. Norman’s openingquestion was ‘Where do we go from here?’ Hebegan with a series of activities coupled with thedemand to decide which activities would beappropriate for a Singing for the Brain group, orhow exercises might be adapted. Both the qualityof his direction and the pressure to extrapolatefrom these activities created a very positive groupdynamic, coupled with participants’ knowledge thatthey needed to begin focusing very strongly onwhat happens after this training programme. StuartBrown of Making Music South East gave apresentation on the work of Silver Song Clubs andSing for your Life Ltd (29), and on related health

services and funding issues, and offered practicalassistance towards the funding of future Singingfor the Brain groups. There were furtherpresentations by Judy King (Family SupportWorker, Stroke Care Newbury) and Ros Edwards(Community MS Occupational Therapist, WestBerkshire) that reiterated the positive potential ofmusic to alleviate the condition of their clients. Forthe second half of the day participants were invitedto lead the whole group in activities. Norman thenmade a very cogent and positive summary of eachof the five training sessions, and concluded withthe thought that ‘having been given to by thecourse, it is up to us now to give back to thecommunity’.

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APPENDIX 2: SessionFeedback Sheets and CourseEvaluation QuestionnaireSession feedback sheets asked:

• What was most useful?

• What was least useful?

• What else would you have liked in the day?

• What is the most important thing you will takeaway with you after today?

• Any other comments or suggestions?

• How do you rate the day? poor, satisfactory,good, very good, excellent (please circle)

Session 1: out of 6 returns 3 rated it ‘very good’ and 3‘excellent’

Session 2: out of 24 returns 4 rated it ‘very good’ and 19‘excellent’ (1 gave no rating)

Session 3: out of 16 returns 1 rated it ‘poor’, 1 rated it‘satisfactory’, 4 rated it ‘good’, 3 rated it ‘verygood’ and 7 rated it ‘excellent’

Session 4: out of 7 returns 2 rated it ‘very good’ and 5 rated it‘excellent’

Session 5: out of 16 returns 1 rated it ‘good’, 6 rated it ‘verygood’ and 7 rated it ‘excellent’ (2 gave no rating)

The Course Evaluation asked questionsand invited comments as follows:

1. Has your understanding grown of the

a) therapeutic social needs of the long-termneurologically impaired?

b) the therapeutic social needs of carers?

c) the aims of Singing for the Brain?

2. Has the presentation of differing styles added toyour knowledge of possible models?

3. Have your skills improved (by):

a) vocal care warming up participants?

b) using movement?

c) planning variety - emotional and musical?

d) ways of harmonising?

e) ways of energising and cooling down?

f) engaging, leading, supporting?

g) team working and building? Can you seeyourself as a team member?

4. How do you rate your confidence developmentover the course? Has it grown a little, moderately,or a lot?

5. Has your enthusiasm for Singing for the Braingrown as a result of the course?

6. Would you be interested in helping the spread ofSinging for the Brain in non-musical ways - egpublicity, research, resource-building, bookinginstruments out, running a library etc?

7. Have you set a date with a team to meet andplan to go forward?

8. Have you got enough information to proceed? Ifnot what else do you require?

9. Would weekend courses have been helpful?

10. Would you have been put off by a charge tocover food and consumables?

11. Do you know of any venues that might be moresuitable?

12. Would you like to talk to Chreanne?

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APPENDIX 3: SupportingDocumentation and ReferenceMaterialsThis report is an analysis of the training projectrather than the wider field of music and dementia.A wealth of information was offered during thecourse, in the form of handouts, recommendationsfor further reading, sources for music andinstruments, relevant websites and contacts etc.Some of the suggestions are touched on in thisreport but no survey is offered of relevant literatureon singing and dementia. Bannan andMontgomery-Smith (see note (3) below) offer agood list of sources cited in their article. ChreanneMontgomery-Smith is the best initial point ofcontact for course documents (e.g. copies ofhandouts, questionnaires) and for tracking downother literature. Her contact address isalz.support@pop3.hiway.co.uk.

The whole course was videoed, on one fixed andone hand-held camera, and there are also aconsiderable number of brief interviews withparticipants recorded during the course of theproject. There is also some additional footage onvideo and DAT. At the end of each sessionfeedback sheets were distributed, with somepressure to return them; and a course evaluationform to assess the whole project was distributedat the end of the final session. A brief DVDdrawing on this footage is available from ChreanneMontgomery-Smith, offering a reminder of thetraining course as participants prepare to embarkon their own Singing for the Brain projects.

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21

NotesIntroduction

(1) What sort of scrutiny, funding strictures andjustifications would be applied if a particularinitiative took place with healthy and ableparticipants? For example, how do the costs andoutcomes of Singing for the Brain compare withthose for a choral society, or a school educationalproject, or with the investment required for one-to-one music therapy? The emergence of CommunityMusic Therapy (see Pavlicevic and AnsdellCommunity Music Therapy 2004) is onemanifestation of an appropriate response to thisthird way, somewhere between performance andformal therapy, as is the work of programmes suchas the Arts & Health initiatives at Canterbury ChristChurch University, the presence of musicians inhospitals (e.g. Chelsea & Westminster Hospital, StMary’s Hospital Paddington), and the developmentof specialist disability music posts at arts funders(e.g. Arts Council England) and organisations (e.g.the London Symphony Orchestra). The core issue,however, is perhaps money: the concern is notwhether music can or cannot achieve certainoutcomes, but that one set of agendas (e.g.performance training, or capital costs for artsvenues) has to compete with another (e.g.providing access to music for those who areisolated through lack of health or wealth) forlimited funds.

(2) The Independent carried a supplement recently(3 February 2006) called simply ‘Music’, in whichthe music covered represented an economicallyand socially powerful but stylistically relativelynarrow spectrum. The dominant themes were thebalance between major and independent labels,with some parallel coverage of legal matters, theinternet, dance, and recorded versus liveperformance. In writing that ‘The NationwideMercury Prize celebrates the wealth and breadth ofBritish music’ Alexia Loundras demonstrates howeasily a core sense of what music is about risksbeing usurped, even though it is not the role ofcommercial music to stand aside for a moreacademic or empathetic understanding of whatmusic is or means. Even the process of creativityis corralled into a straightjacket of product: ‘Thegreat thing about the Mercury Prize is that it’s

based on creative not commercial criteria’ saysBeggars Group boss Martin Mills... ‘We atindependents have the luxury of releasing musicwe love and then seeing how we can reach thepublic with it’ (quoted by Alexia Loundras).Contemporary Western society contains pressuresto commodify music, shifting it from being anactive and involving process (whether as listenerand/or as performer) to a product that is consumedin effect passively. Classic FM is one goodexample of this, and there is a wider generalphenomenon of background music whether asmuzak in a shopping mall, or having television andradio playing constantly in a residential home.There has been commentary but far less researchinto the negative effects of this, although there areplenty of examples of it being exploited to achieveparticular ends such as speeding up workers(‘music while you work’), encouraging faster eatingin restaurants, or selling more groceries.

(3) Nick Bannan, as leader of the first trainingsession, gave significant emphasis in the sessionto: ‘The different goal orientation that Singing forthe Brain involves in comparison with conventionalchoral work. In singing with people withAlzheimer’s, every session is a performance;progress from one week to another takes placeagainst the background of potential deterioration infaculty; the singing happens for its own sake, inthe moment, rather than as a preparation for asubsequent event.’ (Unpublished article ‘‘Singingfor the Brain’: reflections on the human capacityfor music arising from a pilot study of groupsinging with Alzheimer’s patients and carers’,Nicholas Bannan and Chreanne Montgomery-Smith, February 2006)

(4) Among the challenges for a workshop leaderworking with people with dementia is coping withthe possible lack of apparent response from someparticipants. Strokes and Parkinson’s Disease areamong the many conditions that can impair powersof facial expression, speech, or physical responsessuch as applause.

(5) There are many terms that may seeminterchangeable or ambiguous, and others that arenot wholly satisfactory. The phrase ‘people withdementia’ is used to distinguish the participantswhose condition makes them potentially suitable

22

candidates to take part in Singing for the Brain. Thequestion of appropriate terms is a general issue forpeople working in this area. Other examplesinclude: Patient; Resident (when in residentialcare); Service User; Client; Participant; Member.The way ‘Them’ can be used, as opposed to ‘Us’,is sometimes troubling: while it is oftenunderstandable, as a general principle effortsshould be made to emphasize similarity rather thandifference.

(6) As quoted in Bannan and Montgomery-Smith(see note (3) above).

(7) Among the greatest challenges for someparticipants is getting beyond the self-judgementthat they can’t sing. This may arise from a sense ofdeteriorated or damaged vocal abilities as a resultof age or physical incapacity, or it may have rootsas long ago as being told at school, by parents orby friends not to sing. With the increasingdominance of recordings as the primary form ofmusical experience, rather than practical music-making at school, in the home or elsewhere, this islikely to become a greater challenge in the yearsahead as people have less sense of themselves asmusic makers, and as recordings offer their highlypolished representation of what music is.

(8) The ideal music and dementia activity may be acombination of vocal and instrumental activity, withscope to listen, to participate, to create, andperhaps even to dance.

(9) Singing for the Brain also sees the potential forideas such as Drama for the Brain, Art for theBrain, Cooking for the Brain, Walking for the Brain,and so on. Nevertheless, music and the voice haveuniquely rich connections with the human psycheand with the capacities of people with dementia,and Singing for the Brain therefore offers a verydistinctive experience.

Singing for the Brain(10) The pilot project and, to a lesser extent, LizMcNaughton’s Newbury group are described inBannan & Montgomery-Smith’s article cited in note(3) above. Chreanne Montgomery-Smith is alsopreparing an article on Singing for the Brain for theJournal of Dementia Care.

(11) It is chastening to find how hard it can besometimes to distinguish between people withdementia and carers on first meeting. This isessentially a criticism of negative expectations, butit does reflect not only the strength of thesurviving capabilities of people with dementia butalso the frequent closeness in age of carer andcared for, and the general vulnerability anduncertainty of embarking on new experiences afterperhaps lengthy and increasing isolation.

(12) The session I attended was scheduled to beginat 11, but ‘formal’ proceedings (i.e. joining thecircle to begin the singing activities) didn’t beginuntil 11.25.

(13) Some songs in Nick Bannan’s pilot projectwere accompanied by Nick on an electric piano atthe side of the group, and there is clearly scope forleaders to develop and vary their ways of workingin line with their own musical strengths.

(14) The issue of words and memory is a difficultone, and as with a lot of the challenging issueswithin this work the answer is probably with thesensitive application of common sense. Forexample, some people simply won’t know thewords to some songs, and it can be distressingand deflating to feel expected to join in somethingunfamiliar. One mantra for workshop leaders mightbe ‘put yourself in a participant’s position’.

(15) Principles such as cooling down songs areimportant aspects of such a project. However, suchprinciples are there in part to be contradicted if it feelsright to do so, if it is not cutting across someoneelse’s plans, and if the leader trusts his or her ownjudgement to carry off something different (forexample, ending with a celebration song).

(16) The social aspect of a session takes place atthe beginning as part of familiarisation. Withsessions in the morning it is likely that people willleave fairly promptly for lunch. If the session wasto be in the afternoon it may be worth rethinkingthis, for example by providing tea after the session.

Making Singing for Health Happen(17) Silver Song Clubs (South East England),Singing for Health (Midlothian), Sing Your Heart Out(Norwich).

(18) For example, mirroring many of the aims ofSinging for the Brain each Silver Song Club sessionaims to include songs or activities intended to:

• initiate one-to-one welcoming;

• invoke memories;

• stimulate fine motor skills;

• stimulate grand motor skills;

• encourage social interaction;

• encourage client leadership;

• provide progressive learning outcomes;

• provide platforms for reminiscence dialogue;

• give free choice;

• cover multicultural material;

• encourage shared performance.

(19) It is worth bearing in mind a hiddenjustification for training courses in many walks oflife. This may not be the actual course content somuch as the principle of investment in theparticipants, leading to an enhanced sense of self-worth. In the context of creative work,volunteering, and the difficulties associated withcaring for people with dementia, this is in itself asignificant reason to support a training project suchas Making Singing for Health Happen.

(20) Some people used these files but otherwisepeople used their own notebooks. A4 soft-backedfiles are unwieldy, and another time it might beworth thinking about A5 files instead.

(21) The most obvious weakness is that noteveryone returned the questionnaires. The principaland self-evident strength is that the participantswere given an opportunity to comment on thecourse. Bearing in mind how positive mostfeedback was, choosing not to comment canperhaps be accepted as a positive endorsement.

Additional Observations(22) In an informal report on a Silver Song Clubsession, which was led by a professional facilitatorwith the support of volunteers, Robin Simpson (18August 2005) expresses concern about finding‘enough facilitators capable of working to this highstandard as the scheme expands’, and makes anumber of comments about the challenges ofsustaining the volunteers’ involvement. However, itshould be noted that these volunteers tend to beparticipating primarily as representatives of theirchoral societies, and only secondarily as anexpression of commitment to music making withpeople affected by dementia.

(23) There is a self-evident cost issue with usinginstruments. A relatively affordable packageincluding instruments such as tambourines, claves,bells and various types of shakers may offer wide-ranging opportunities, but some of the mosteffective instruments such as bell-chimes, bassbars, gongs and lyres can be expensive.

23

Section 6

24

APPENDIX 1: Session outlines

(24) It is a feature of modern life that a musicalexperience is predicated on an idea of perfection,and that this is channelled through a finished orresolved musical product that is prepared for‘consumption’ (eg a recording, or concert followingextensive rehearsal). An alternative view is thatmusic is essentially about process - about beingtaken through time in the moment. This suggestsan intriguing parallel with the perception ofdementia as a destroyer of remembered oranticipated experience, versus the capacity toexperience things in a continuing present.

(25) By ‘treatment’ I mean the various ways aparticular piece of musical material might be usedto involve participants. It may be inherent in themusical material itself, as with rounds, partnersongs and call & response songs; or it may be away of developing a song such as using a vocal orinstrumental ostinato for accompaniment, clapping,physical gestures, singing or devising some otherform of accompanying material.

(26) There is in the end a limited value in havingsession leaders whose focus is on what they cando, as distinct from offering ideas and models forparticipants to experience and explore. This comesback to the need for a balance between new input,and ‘putting yourself in a participant’s position’.

(27) See www.tonalismusic.co.uk.

(28) Michael tended to impose a language ofspirituality on the physical phenomenon of music,as distinct from allowing participants to experiencetranscendent or transfigurative (i.e. spiritual)feelings on their own terms through theirparticipation, whether as listeners or as players andsingers. This does not in itself diminish hisperspective on music, or what he feels music hasto offer people with dementia. However, languageshould not act as a shortcut to the spiritual, or riskshort-circuiting spiritual experiences by explainingmusic’s power too readily as ‘spiritual’. This is a richand complex issue in exploring music generally,and particularly so for people, like many of thecourse participants, who are at early stages oftheir musical journeys.

(29) See www.singforyourlife.org.uk

Sidney De Haan Reports

An occasional series of reports on the work of theSidney De Haan Research Centre for Arts andHealth.

General Editors: Stephen Clift and Grenville Hancox

Report 1

Clift, S., Mackenzie, K. and Bushell, F. (2006) TheMusicStart Project: Evaluation of an Early YearsMusic Initiative. Canterbury: Canterbury ChristChurch University. ISBN: 1899253 48 2

Report 2

Bamford, A. and Clift, S. (2006) Making Singing forHealth Happen: Reflections on a ‘Singing for theBrain’ Training Course. Canterbury: CanterburyChrist Church University. ISBN: 1899253 48 3

Report 3

Bamford, A. and Clift, S. (2006) Music into Upton:Reflections on an Initiative to Bring Live Music intoa Hospital Setting. Canterbury: Canterbury ChristChurch University. ISBN: 1899253 53 X

Report 4

Bamford, A. and Clift, S. (2006) Southampton SilverSong Club: Reflections on Music Making withElderly People Facilitated by Student Volunteers.Canterbury: Canterbury Christ Church University.ISBN: 1899253 58 0

For further information:

The Administrator

Sidney De Haan Research Centre for Arts and Health

E-mail: sdhcentre@canterbury.ac.ukTel: 01303 220870