mindsong taking music therapy to the elderly mentally ill

Introduction mindsong taking music therapy to the elderly mentally ill mindsong is a social inclusion project set up by Three Choirs Plus, the community and outreach arm of the Gloucester Three Choirs Festival. In this pilot project it has taken music therapy to elderly mentally ill (EMI) people in Gloucestershire. Most EMI individuals suffer from dementia while a few suffer from enduring mental illness, often with some memory problems. The Alzheimer s Society has recently reported that there are at least 700,000 people with dementia in the UK and that this figure will exceed one million by 2025. In Gloucestershire there are around eight to ten thousand dementia sufferers at present. Two thirds live in the community and the rest occupy the majority of care home places. An increasing body of research is showing that, for people with dementia, music therapy can improve quality of life, emotional wellbeing and sense of identity. It may also have a positive effect on memory and health. This pilot sought to deliver music therapy in an affordable way by running group, rather than, individual sessions. The aims of the pilot were: To provide enjoyment and emotional/psychological benefits to participants To provide linkage with the 2007 Gloucester Three Choirs Festival To raise awareness of the value of this therapy to the EMI To ensure a sustainable legacy for EMI sufferers in Gloucestershire Achieving our aims 1. Allowing elderly mentally ill (EMI) people to experience the power of music through music therapy, using a registered music therapist supported by volunteers. Between 30 and 40 older people attended weekly music therapy courses at three centres (nursing homes in Gloucester and Cirencester and an NHS EMI Day Unit in Cinderford) over a twelve week period. Sessions at the day unit were attended by patients with enduring mental illness but not dementia. Participants at all centres showed obvious enjoyment of sessions, and increasing willingness and ability to respond to making music. Sessions at nursing homes in Gloucester and Cirencester were so valued that an anonymous donor has funded another twelve weeks of music therapy at one home, while the other is buying in another course. Documentation of sessions made use of sound recordings and photography. Feedback from participants and care staff used questionnaires while the therapist recorded her own observations. A clinical review of the pilot is now being undertaken by Gloucestershire MusicSpace; findings will be available in due course. t

(2) Following the success of mindsong the music therapy department at the University of the West of England is planning placements with Gloucestershire MusicSpace to enable their students to gain experience of working with the EMI. Jane Crampton, the head therapist at Gloucestershire MusicSpace is herself also now studying for an MA, working on music therapy and the EMI at Bristol. Volunteers Fifteen volunteers took part. Music therapists normally work on a one to one basis with clients and do not use volunteers. Managing a group and also a rota of volunteers was a new learning experience for the therapist. Volunteers seemed of most use with the frailest participants, and where volunteer continuity was greatest. Enabling volunteers to develop awareness of the value of music therapy to the EMI through their personal participation in the pilot has been a significant gain. Ten attended a feedback session, and almost all want continuing involvement. Volunteers also stewarded the exhibition, using their experience to inform visitors about the project. This autumn the ongoing role for volunteers will be defined. A course training volunteers to run/ assist with singing groups is planned. It is expected that these will require a slightly higher level of mental functioning from the EMI; they can run alongside music therapy sessions or at other venues including within the community. 2. Raising awareness of the value of music therapy to the EMI Exhibition The exhibition made use of modern media material, with colour photographs projected as multiple images onto the pillars of the cloister together with a soundtrack of music made during therapy sessions. A series of large black and white photographs and information posters completed the exhibition. The whole provided a dramatic display which, a visitor wrote, meant more to me than Anthony Gormley or other video work (previously shown in the same space). Booklets giving more detail about mindsong and music therapy in dementia were available to purchase; approximately 180 of these were sold. Information was also available about the Alzheimer s Society and its services. During the Festival, performers, audience members, and the general public visited the exhibition. Some of the ladies who had participated in the project visited, singing along with the recording, and dancing in the cloisters. The opening was attended by representatives of the County Council, NHS Primary Health Care and Partnership Trusts, Alzheimer s Society, Age Concern, Gloucester Three Choirs Festival executive and Three Choirs Plus, in addition to representatives from Hereford and Worcester and participants in the pilot. This was an important opportunity to network with health and social care professionals and voluntary agencies.

(3) A visitors book was signed by some 117 people. Comments included: Hugely encouraging warmed my heart A marvellous concept splendidly realised. Excellent Very life-enhancing exhibition Retired psychiatrist for older people very well done Came as daughter is a music therapist and wanted to report back. Looks very worthwhile Inspiring work I hope someone does this for me when I m old (student) On every occasion the residents (Cirencester) enjoyed it more. A worthwhile exercise (Care home manager) Wonderful work! Success to all your endeavours Outcomes from the visitors book were Dementia Care Trust: Interest in input ( singing for the brain ) to two day centres/ luncheon clubs in Gloucester Contact details given: potential volunteers. Others wanted more information or to share their experiences of using music with the elderly. A local care coordinator wanted to explore introducing music therapy into two nursing homes in Gloucester where she worked. Young visitors were particularly enthusiastic. One girl in her 20s about to start the music therapy course was very excited about the project. Hopefully this will extend to her training and professional development. Through our partnership with Art Shape, the exhibition is being shown at the Guildhall this September. It is planned for it to tour further via Arts and Health South West. Opening service Extensive mention of mindsong was made during the Opening Service of the Festival with references in both prayers and the address. This event was also attended by civic dignitaries, whose support would be valued. Festival Programme This contained an overview of the mindsong project, and an informative but highly readable review of music therapy and dementia by Rachel Darnley-Smith, a distinguished academic music therapist who specialises in this area. Both articles were reproduced in the exhibition booklet (vs). Media publicity During the pilot three local papers carried reports with photographs of the project. During Festival week, photographs of the exhibition opening and details of opening hours appeared in The Citizen. Unfortunately the latter appeared late in the week when things were drawing to a close. Radio Gloucestershire promoted the project with interviews etc. Forest of Dean Radio wants to follow a music therapy course at a local care home to be broadcast as a series of four programmes. Village Agent Awards One of the volunteers has been nominated for a county award celebrating the contribution that older people contribute to the community by their voluntary work. She has been asked to show the exhibition DVD at the presentation.

(4) 3. Legacy: Developing a sustainable service. Links with Care Homes The two participating care homes are both buying in further music therapy from MusicSpace. One provider has other care homes in the county and has expressed an interest in developing this in other homes. An activity coordinator is interested in buying in music therapy for two nursing homes in Gloucester. Links with other agencies Linking up with other agencies provides scope for further development. The partnership with Gloucestershire MusicSpace has been close and mutually beneficial. Input from the Gloucestershire Arts Development Officer has been tremendous and has led to a productive partnership with Art Shape Ltd through their New Horizons project which targets the same client group. As a result of the success of mindsong I am sitting on a committee (Local Area Agreement for provision of health and social care services) promoting health by provision of Arts and Culture for the over 75s in Gloucestershire. mindsong is to share funding with Art Shape to deliver this. 4000 has been allocated to take music therapy to four further care homes around the county. There may also be opportunities for volunteers to receive training via Art Shape. I have also become a Gloucestershire County Council representative for Arts and Health South West. This is an Arts Council South West initiative, which will offer an opportunity to network with others. The Gloucester branch of the Alzheimer s Society and the Dementia Care Trust are also interested in our work and possible future partnership. We shall meet shortly to discuss this. Conclusion mindsong has exceeded the expectations of all who have been involved. I believe that a sustainable service will now develop. I think it important that the mindsong brand remains the social inclusion outreach arm of the Gloucester Three Choirs Festival, through Three Choirs Plus, and is not completely devolved to other agencies. A continuing partnership with Gloucestershire MusicSpace and Art Shape will be essential for further development and sustainability. Partnerships with Hereford and Worcester Three Choirs Festival organisations could offer exciting expansion throughout the three counties. The future management structure needs to be considered. With the amount of activity, more help will be needed, particularly with volunteer development. Future roles for volunteers remain to be defined, but they are likely to play an important part in facilitating singing groups. Note1. I usually use the term elderly mentally ill (EMI) in this report. This term covers older people with dementia and also those with enduring mental illness (often with memory problems). In practice, the great majority of EMI suffer from dementia. It was not part of the project to obtain a medical diagnosis for individual patients; selection of suitable participants was undertaken by care staff at the units. Note 2. Formal references are not given. Please refer to Rachel Darnley-Smith in mindsong exhibition brochure (appended) for music therapy in dementia references.

(5) Acknowledgements Gloucestershire Community Foundation and Gloucestershire County Council co-funded this pilot; without their financial assistance the project could not have taken place Bernard Day, Chairman, and the Executive Committee, Gloucester Three Choirs Festival for agreeing to this particular social inclusion project. Helen Owen, Gloucestershire County Council, Arts Development Officer Jane Crampton, Head Therapist, Gloucestershire Music Space Annie Tyhurst, music therapist Rachel Darnley-Smith, Senior Lecturer in Music Therapy, Roehampton University Harriet West and Lucy Sharp, Artshape Ltd Alison and Brian Ley, Directors, and Rhoda Bamford, Catherine Burton, Peter Wallace and Ros Wise, Three Choirs Plus Paul Hedley, Festival Secretary Volunteers: Katy Bagnall, Lis Bennett, Judy Capps, Jill Colborn, Roger Drury, Millie Goodall, Ken Helps, Marian Knowles, Janet Marshall, Heather O Donoghue, Shirley Owen, Pam Read, Jane Rothery, Ann Standring and Ros Wise. Thank you all Anthea Holland Outreach Manager, Three Choirs Plus 24 September 2007