Music Therapy - Sharing Music In An Assisted Living Facility

I share music in an assisted living community with a resident who has played and taught violin his entire adult life. It never ceases to amaze us the response music evokes on the residents we visit. Anyone else doing music for elderly residents with memory loss? If so any strategies you are using that seem to be effective?

https://youtu.be/JdQbO36YsEc

I play once a month in a memory unit. The response varies. There's one old gal who knows the words to every song and sings along loudly. Others doze off. Sometimes they laugh at the corny jokes, other times they go right over their heads. But it's always rewarding.

I play guitar and harmonica and do mostly old Tin Pan Alley-type material. Two songs that always go over big are Over the Rainbow and Que Sera Sera.

I played at a home one time in rural SC. I was playing fiddle with some friends. One lady got loud staying "Stop that! Stop that! I'm a good Baptist. Stop that!". She was subdued. A tune or two later, another fellow who was sitting slumped over in what looked like an adult high chair. He rose up in mid-tune and said, "Swing! Everybody swing!" then slumped back down. His wife came up to us after we were done and told us he'd had a stroke three months prior and these were the first words he had said since the stroke event. You never know what is going to happen.

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Originally Posted by jaycat

I play once a month in a memory unit. The response varies. There's one old gal who knows the words to every song and sings along loudly. Others doze off. Sometimes they laugh at the corny jokes, other times they go right over their heads. But it's always rewarding.

I play guitar and harmonica and do mostly old Tin Pan Alley-type material. Two songs that always go over big are Over the Rainbow and Que Sera Sera.

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Thanks for sharing some of your music story, I can relate and will look to add these two songs to my list!

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Originally Posted by Bob Buckingham

I played at a home one time in rural SC. I was playing fiddle with some friends. One lady got loud staying "Stop that! Stop that! I'm a good Baptist. Stop that!". She was subdued. A tune or two later, another fellow who was sitting slumped over in what looked like an adult high chair. He rose up in mid-tune and said, "Swing! Everybody swing!" then slumped back down. His wife came up to us after we were done and told us he'd had a stroke three months prior and these were the first words he had said since the stroke event. You never know what is going to happen.

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Great to hear about your music, the stories we can tell!

I used to go about once a week with accordion - always a popular instrument among an older age cohort, and ideal for the environment for its portability and projection. Did some hospice work as well, with lever harp. The value of music in these settings is powerful medicine.

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Originally Posted by catmandu2

I used to go about once a week with accordion - always a popular instrument among an older age cohort, and ideal for the environment for its portability and projection. Did some hospice work as well, with lever harp. The value of music in these settings is tremendous.

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thanks for sharing, great and encouraging post.

Regarding suggestions - if you're a folk musician, avoid the murder ballads, keep it light. Seems there are always some folks who are triggered by provocative lyrical content. Often, someone in an audience with be absolutely attentive to the lyrics.

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Originally Posted by catmandu2

Regarding suggestions - if you're a folk musician, avoid the murder ballads, keep it light. Seems there are always some folks who are triggered by provocative lyrical content. Often, someone in an audience with be absolutely attentive to the lyrics.

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I played with a bluegrass group at another nursing home... they insisted on doing Will the Circle Be Unbroken, complete with the coffin, grave, all that stuff. That's why I stick to lighter fare when playing on my own.

One of the first times that my trio played in an assisted living facility, about halfway through a lady in a wheel chair yelled loudly "I'm ready to go to my room NOW!"

About a year later, we moved my mother into that same facility, and she was given the room right next door to that wheel chair lady. I found out from the CNAs working there that she had been the choir director for some church for 40-some years and didn't think that anyone's musical ability could match her tastes. And you could hear she shouting out her door for the CNA staff to come and assist with this and that. So, I didn't take it personally.

I agree with the "keep it light" suggestions. We were doing ragtime and swing tunes that many recognized from their youth. I also added in songs from movies (e.g., "Bare Necessities" and "Wanna Be Like You" from The Jungle Book movie) and children's tunes (e.g., "Alligator King" from Sesame Street) which went over well.

great posts, thanks for sharing your time and experience.

We played in a retirement home for years pre-covid and I imagine we will do again sometime. It was great fun and the residents really enjoyed it. One lady used to get up with us and whistle a tune, others would sing along or shout out requests.

Someone from the group would always show up and want to sing Swing Low, Sweet Chariot but we’d quickly pivot to something else.

The group could handle just about any tune and genre but mostly Hank Williams, Johnny Cash, Bill Monroe, Flatt and Scruggs, etc type songs. Merle Haggard was a hit every time and one of the guys had played with Charley Pride. Ragtime, swing, and bluegrass were well received. We always ended with Happy Trails as a rousing sing-along…I sure miss it.

I work musically with both the geriatric and mentally handicapped (it's part of how I earn my living)

It never ceases to amaze me how someone who cannot remember what they had for lunch half an hour ago is able to sing all eight or ten verses of a german folk song word perfect, and even, on occasion, sing a harmony part to boot! Just singing together creates not only a sense of community (important in an old peoples' home, where very few residents are there of their own volition and feel isolated among a group of strangers), but also underlines the sense of one's own identity, which is increasingly lost with advancing dementia.

Therapeutic music can sometimes literally have magical results - I regularly engage in "Musical dialogs" with residents and clients; if they play an instrument, with that and either mandolin or recorder, if not, I give them a frame drum and a beater and accompany them on the recorder. It is surprising where such free improvised sessions can lead. I remember one resident who was severely disabled by a childhood bout of poliomyelitis, both mentally and physically - in his sixties, he was unable to walk without a walker and afflicted with an intense tremor which affected his whole body. Nonetheless, he was of a remarkably sunny disposition and enjoyed being present at group singing sessions, although he was unable to participate. One day, for whatever reason, I asked him if he would like to join in our "giving a concert for one another" (my term for musical dialog in a group situation). Of course he wanted to so I gave him a frame drum and a beater, and grabbed a recorder. What ensued was the most apocalyptic, arythmic, thunderous cacophany imaginable, and I switched my descant recorder for a sopranino in order just to be heard over the din. I struggled to find a beat in his beating, and somehow "felt" a sort of 2/4 structure, which I tried to emphasise, playing simple arpeggios and "march figures" - my "partner" promptly stopped his chaotic cacophany and slipped into a regular beat so that we were accompanying one another in a truly musical way. After several minutes we drew to a mutual close - I had tears in my eyes and he a smile that reached from one side of the room to the other. Obviously, the physical and neurological damage wrought by the polio cannot be cured, either by medical or musical means, but the effects of having to live in a body and with a mind as damaged as his is can be affected positively by the simple act of beating a drum and blowing into a recorder, and, most important of all, listening to one another.
It doesn't always work out as well as the scenario I've described, but it nearly always produces some sort of a result, and is certainly a worthwhile endeavour.

Evidently the regions of the brain that conduct emotional response, sensory processing, linguistic functioning and so forth are last to be affected in diminishing capacities associated with dementias. Musical and aesthetic faculties are among the last to shut down - often persisting long beyond other progressively diminishing cognitive function in the disease process.

This is congruent with our findings when we perform music among this cohort: accentuated emotional responses, recognition and recall of melodic and lyrical content, sudden vitality in otherwise unresponsive persons, etc. It's a sad state - folks in settings with typical social and sensory isolation who still have vital aesthetc awareness and need. Unfortunately this is all too common in our culture: leaving care of our impaired elders to the mechanisms of agencies that are woefully unequipped to provide adequate care.

A few years ago, I met Alison Woyiwada, an Ottawa music, who suffered a brain injury, and was brought back to being a functioning, communicative person through music. Here's a link to a review of her memoir, Allison’s Brain: a testament to the human spirit.

https://www.glebereport.ca/allisons-...-human-spirit/

I have little experience performing for people with dementia or memory loss, but I watched my daughter's fiddle group in an old age home in a small town outside Ottawa. One old man, who was bent over in a wheelchair and seemingly unaware of his surroundings, sat right up, smiled, and tapped the beat while listening to the girls, then clapped heartily after tunes. The nurses told us that he'd been a fiddler, and that this was the first time that he'd been alert and present in a couple of weeks. Another old woman, who at first seemed removed from what was going on, danced with nurses whenever the girls played a waltz. Being kids, the group would likely have gone over well anyway, but they also were also performing in a rural area where fiddle music had been popular throughout many of the residents' lives. The same type of music might not have gone over so well with many urban residents. I think one should be aware of the music of the residents' lives. Sometimes seniors get stereotyped as having specific seniors' tastes. When I was a young, entertainment for old folks often took on a "Gay Nineties" tone, even after many seniors were too young to remember the 1890's. When it's my turn to listen in a home, I'm not sure how much I'll be entertained by the pop hits of my parents' and grandparents' youths, or even of the generation immediately before mine.

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Originally Posted by bigskygirl

We played in a retirement home for years pre-covid and I imagine we will do again sometime. It was great fun and the residents really enjoyed it. One lady used to get up with us and whistle a tune, others would sing along or shout out requests.

Someone from the group would always show up and want to sing Swing Low, Sweet Chariot but we’d quickly pivot to something else.

The group could handle just about any tune and genre but mostly Hank Williams, Johnny Cash, Bill Monroe, Flatt and Scruggs, etc type songs. Merle Haggard was a hit every time and one of the guys had played with Charley Pride. Ragtime, swing, and bluegrass were well received. We always ended with Happy Trails as a rousing sing-along…I sure miss it.

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great post, thanks for sharing some of your experiences!

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Originally Posted by Polecat

I work musically with both the geriatric and mentally handicapped (it's part of how I earn my living)

It never ceases to amaze me how someone who cannot remember what they had for lunch half an hour ago is able to sing all eight or ten verses of a german folk song word perfect, and even, on occasion, sing a harmony part to boot! Just singing together creates not only a sense of community (important in an old peoples' home, where very few residents are there of their own volition and feel isolated among a group of strangers), but also underlines the sense of one's own identity, which is increasingly lost with advancing dementia.

Therapeutic music can sometimes literally have magical results - I regularly engage in "Musical dialogs" with residents and clients; if they play an instrument, with that and either mandolin or recorder, if not, I give them a frame drum and a beater and accompany them on the recorder. It is surprising where such free improvised sessions can lead. I remember one resident who was severely disabled by a childhood bout of poliomyelitis, both mentally and physically - in his sixties, he was unable to walk without a walker and afflicted with an intense tremor which affected his whole body. Nonetheless, he was of a remarkably sunny disposition and enjoyed being present at group singing sessions, although he was unable to participate. One day, for whatever reason, I asked him if he would like to join in our "giving a concert for one another" (my term for musical dialog in a group situation). Of course he wanted to so I gave him a frame drum and a beater, and grabbed a recorder. What ensued was the most apocalyptic, arythmic, thunderous cacophany imaginable, and I switched my descant recorder for a sopranino in order just to be heard over the din. I struggled to find a beat in his beating, and somehow "felt" a sort of 2/4 structure, which I tried to emphasise, playing simple arpeggios and "march figures" - my "partner" promptly stopped his chaotic cacophany and slipped into a regular beat so that we were accompanying one another in a truly musical way. After several minutes we drew to a mutual close - I had tears in my eyes and he a smile that reached from one side of the room to the other. Obviously, the physical and neurological damage wrought by the polio cannot be cured, either by medical or musical means, but the effects of having to live in a body and with a mind as damaged as his is can be affected positively by the simple act of beating a drum and blowing into a recorder, and, most important of all, listening to one another.
It doesn't always work out as well as the scenario I've described, but it nearly always produces some sort of a result, and is certainly a worthwhile endeavour.

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wow, what a great story! Thanks for sharing, i personally had never thought of a 'musical conversation' with residents, i will now!

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Originally Posted by catmandu2

Evidently the regions of the brain that conduct emotional response, sensory processing, linguistic functioning and so forth are last to be affected in diminishing capacities associated with dementias. Musical and aesthetic faculties are among the last to shut down - often persisting long beyond other progressively diminishing cognitive function in the disease process.

This is congruent with our findings when we perform music among this cohort: accentuated emotional responses, recognition and recall of melodic and lyrical content, sudden vitality in otherwise unresponsive persons, etc. It's a sad state - folks in settings with typical social and sensory isolation who still have vital aesthetc awareness and need. Unfortunately this is all too common in our culture: leaving care of our impaired elders to the mechanisms of agencies that are woefully unequipped to provide adequate care.

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well said and thought provoking.

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Originally Posted by Ranald

A few years ago, I met Alison Woyiwada, an Ottawa music, who suffered a brain injury, and was brought back to being a functioning, communicative person through music. Here's a link to a review of her memoir, Allison’s Brain: a testament to the human spirit.

https://www.glebereport.ca/allisons-...-human-spirit/

I have little experience performing for people with dementia or memory loss, but I watched my daughter's fiddle group in an old age home in a small town outside Ottawa. One old man, who was bent over in a wheelchair and seemingly unaware of his surroundings, sat right up, smiled, and tapped the beat while listening to the girls, then clapped heartily after tunes. The nurses told us that he'd been a fiddler, and that this was the first time that he'd been alert and present in a couple of weeks. Another old woman, who at first seemed removed from what was going on, danced with nurses whenever the girls played a waltz. Being kids, the group would likely have gone over well anyway, but they also were also performing in a rural area where fiddle music had been popular throughout many of the residents' lives. The same type of music might not have gone over so well with many urban residents. I think one should be aware of the music of the residents' lives. Sometimes seniors get stereotyped as having specific seniors' tastes. When I was a young, entertainment for old folks often took on a "Gay Nineties" tone, even after many seniors were too young to remember the 1890's. When it's my turn to listen in a home, I'm not sure how much I'll be entertained by the pop hits of my parents' and grandparents' youths, or even of the generation immediately before mine.

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great post and thanks for the resource link...really enjoyed reading and rereading.

In Post #14, I should have said "Alison Woyiwada, an Ottawa music teacher," as you may have guessed.

By the way, I'm not sure why you posted your original message in the category "Videos, Pictures and Sound FIles" -- an error perhaps. "General Mandolin Discussions" would be a more appropriate category.

From today's news, more on seniors and music:

https://www.cbc.ca/news/entertainmen...tion-1.6401768

Follow the links in the article and connecting articles for more science on the same subject.

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Originally Posted by maplebaby

wow, what a great story! Thanks for sharing, i personally had never thought of a 'musical conversation' with residents, i will now!

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It is well worth looking for ways to interact with residents in care homes, and to try to do more than just sing songs (that is not to denigrate community singing - it plays a valuable role, as I said before).
Another activity that many (not just old or disabled) people enjoy is a form of "musical chinese whispers" - sitting in a circle, I will sing or hum a three or four note phrase to my neighbour, which they pass on to the next neighbour, either exactly as I sung it, or with a variation. The phrase goes round the group and ends up with me again, and I sing both the original and the modified phrase, thanking the participants for their creative input. Sometimes it leads to a discussion of who prefers which version and the like. It is important to discourage discussions of which is "better", old people can become very passionate (like children) about such things!
I also find it helpful, before beginning any activity, to encourage my "clients" to centre themselves - taking a few conscious breaths is as good a way as any I know, and I usually go about it as follows:

"What's the first thing a baby does when it is born?"

Resident: "it cries"

Me: "you'd have thought so, wouldn't you, but before you make a noise, you have to breathe in, so let's all take a breath together before we start to sing"

(It is usually three breaths, which serves to help the residents to settle into "here and now")

One can use this patter again and again with the same group - not to be cynical, but there are sometimes advantages in the memory loss that dementia causes!

For anyone looking for more information, or perhaps to enhance understanding of cognitive effects and processes in dementia, this article presents a good overview.

https://voices.no/index.php/voices/a...view/3139/3263

If you spend much time working with persons with dementia, you'll soon notice just what a powerful impact you can have as a musician. Also, in recognizing the potency of music-based interactions, such information can help guide your practice, as well as help you avoid some of the pitfalls.