We will be delivering the project to a group of around 10-20 residents, with varied needs and abilities. Most members of the group have little to no musical training, while a few have experience playing instruments including the piano and saxophone. Although, we found that the residents at Green Acres were fans of music, with TVs showing Frank Sinatra and Buddy Holly by default, and some sharing passionate opinions about their likes and dislikes (one resident professed her hatred for Elvis Presley whilst another remarked “Everyone here loves ABBA!”). We will also have a small number of residents with mild dementia joining the group in the main lobby. In our discussions with Green Acres staff, we found that the group would be likely to vary week to week in size and personnel, with the residents being free to come and go as they please, but that we could expect a good handful of loyal attendees.
Over the course of the project, we aim to produce a ‘timeline’ of memorabilia produced each week. This could be artwork created during guided listening sessions, pieces used in prompt-based improvisation, or polaroids from the sessions. We will use a clothesline and peg the items on at the end of each session, as part of a reflection session after the main activities. By the end of the project, we hope to have produced a full clothesline with items from the project, which we will offer to Green Acres as a keepsake. We hope that through the activities, we can help improve the confidence of the residents and nurture creativity. We determined that a strictly pedagogical approach to designing the project would not be the best way to achieve this; expecting the residents to build considerable musical skill seemed unreasonable. Instead, many of the ideas behind the project come from creative music therapy.
In the first session, we will introduce the group with a hello song, introduce the project and ask each person for a song or an artist that they like. We will follow this up with a freeform improvisation session using percussion which will help us better understand the level of ability of the individual residents. In following weeks, we will use the song suggestions provided in group singing sessions, where we will hand out lyric sheets and accompany the singers with guitar or piano. Myskyja and Nord (2008) showed that regular group singing among people with mild dementia reduced levels of depression over the course of two months. This study is particularly relevant as it was conducted in a care setting over a similar timeframe to our project, and reducing levels of depression is in line with our aim of building confidence in the residents. Stige (2010), on a questionnaire offered to participants of a senior choir in Sandane, Western Norway, discusses the positive role of the conductor, where their “humour, attention, and positive remarks” provided valuable encouragement to the singers. It is my belief that these sorts of things will also be of significant value as facilitators of group singing in a care home, especially considering that some of the other jobs of a conductor, such as personalised technical feedback, would be inappropriate in the more informal setting.
A useful reference point for this project comes from Anne Davis Basting’s TimeSlips project, a creative storytelling project for people with age related dementia beginning in 1998 across four adult day centres in the US. Our project shares with it the aim of nurturing creative expression in our participants and, interestingly, was also facilitated by undergraduate arts students. In the project, they used images combined with leading questions to prompt the participants to create stories which were written down over the course of the session. Each week began with a reading of the previous week’s story, the purpose of which was to prove to the participants the creativity that they were capable of. Basting reports that the focus ended up less on the product, but rather the creative process and that the stories “read more as a chronicle” of this process. These ideas of process over product, and making full use of the tools available is mentioned frequently in discussion around improvisation, and inspired some of the thought behind our project. (Nachmanovich 1990)
Though the storytellers in TimeSlips were all dementia patients, I find some of the details of this project to be applicable to our own. For example, adding to the clothesline every week (like the reading at the start of each TimeSlips session) will bring continuity and a sense of ritual to the project, which should help those with dementia or other age-related cognitive impairment follow the project over the ten sessions. I also liked the detail that the facilitators thanked the storytellers after each session, acknowledging the cognitive effort needed to sustain an hour of creative storytelling.
Considering the fluid nature of the group, and their varied levels of ability, we are adopting a flexible approach to the structure of the project, particularly with the improvisation activities. However, based on our feedback for the presentation, part of this will necessarily be coming up with lots of potential ideas to try out with the group, so that if something doesn’t work well, we’ll hopefully have something else that will. Additionally, we have taken care to design activities which are accessible to all members of the group. According to John Stevens on teaching improvisation: “the method, or process that you are teaching has to simple enough to communicate easily to the group as a whole… But it also has to be demanding enough of concentration to satisfy those who are more developed musicians” Bailey (1992)
I expect the improvisation work to progress from very structured (such as call and response rhythm activities), to much freer (improvising from prompts) as the residents become more comfortable creatively expressing themselves. Something I would like to do is have some willing members of the group draw whilst the music is going on as a form of guided imagery. We could then use these drawings as prompts for improvising in later sessions and add them to the timeline. The reason to divide the sessions into group singing followed by improvisation is to use the singing as a warmup, to ‘loosen up’ the participants before embarking on the more creatively challenging activities. Projects like TimeSlips give me the impression that with the right guidance it is possible to get lots of creativity out of our residents, even those with dementia.
For the improvisation, I think will be useful to also consider a therapeutic approach – a useful resource has been Gary Ansdell’s book Music for Life (1995). Ansdell mostly discusses one on one therapy sessions, but I think many of the ideas can be applied to group work with the right activities. For example, one session we might start a slow pulse with the group, everyone playing on the beat. Then, the music facilitator could go round the room, improvising a short musical dialogue with each participant with the beat continuing in the background. With more able residents, this might look like a call and response rhythm game between the pair, whilst in those with more limited mobility, the interaction might be much more subtle. Ansdell (1995) outlines an experience with an autistic client of his whose responses were limited to only foot tapping and blinking and responding musically to just these minute actions. Hence, in the face of anticipating limited responsiveness from at least some of our participants, it has been useful to refer to creative music therapy.
In later sessions, this could lead to doing the same activity but allowing the residents to work in pairs with each other, shifting the spotlight to each pair around the room. To assess the effectiveness of this activity we would be looking for any moments of shared musical significance such as imitation of a particular rhythm or hitting a note at the same time. By taking note of these instances, we will hopefully be able to measure some tangible progress throughout the sessions.
We plan to end each session with reflection. We will ask the group specific questions about their involvement in the session – what parts they enjoyed and any parts they struggled with. This portion of the session should ideally be both a freeform group discussion, and an opportunity for the residents to reflect on their own personal feelings towards the session. Brynjulf Stige (2003) offers a useful model for “Communal Musicking as a Centred and De-centred activity”, as discussed by Gary Ansdell in Where Music Helps (2010). That is, the idea that during the act of community music making, participants are simultaneously involved in both a shared experience related to the activity itself, and a private one relating to their own life history with music. My hope is that we can conduct our reflection sessions with respect to this duality of experience, creating an environment where participants feel comfortable sharing personal experiences, whilst also obtaining a more general view on the success of the session.
Finally, after further research, I have departed from the heavy focus on reminiscence in our original presentation, instead opting for an approach which aims to bring participants into the present. I first had this instinct during our visits, where I noticed that reminiscence and nostalgia seemed to already play a significant part in the residents’ lives. Bohlmeijer et al. (2007) found that while reminiscence has a moderate positive influence on mental well being in older adults, it had a significantly reduced effect on adults living in residential care. Additionally, Basting A. D. (2006) raised concerns that reminiscence can lead to frustration in adults with dementia. Although, I think it is useful to keep the ‘music through the decades’ theme in the group singing, to provide structure to the project, alongside the scrapbook style timeline.
Bibliography:
Ansdell, G. (1995) Music for Life: Aspects of Creative Music Therapy with Adult Clients Jessica Kingsley Publishers.
Bailey, D. (1980) Improvisation: Its Nature and Practice in Music Da Capo Press.
Basting, A. D. (2006). Creative Storytelling and Self-Expression among People with Dementia. In A. LEIBING & L. COHEN (Eds.), Thinking About Dementia: Culture, Loss, and the Anthropology of Senility (pp. 180–194). Rutgers University Press.
Bohlmeijer, E. et al. (2007) The effects of reminiscence on psychological well-being in older adults: A meta-analysis, Aging & Mental Health. 11(3), 291-300.
Clift, S. (2012) Singing, Wellbeing and Health. In: Macdonald R, Kreutz G. Mitchell, L. (2012) Music Health and Wellbeing, Oxford University Press.
Myskyja and Nord (2008) The day the music died: A pilot study on music and depression in a nursing home. Nordic Journal of Music Therapy. 17(1), 30-40.
Nachmanovich, S. (1990) Free Play: Improvisation in Life and Art, Penguin/Tartcher.
Stige, B. (2003) Elaborations towards a Notion of Community Music Therapy. Doctoral Thesis, University of Oslo, Norway. Unipub.
Stige, B. Ansdell, G. Elefant, C. Pavlicevic, M. (2010) Where Music Helps: Community Music Therapy in Action and Reflection, Ashgate Publishing.
