'Even if it's just one note, it's got to be absolutely beautiful'
Linda Rose is the founder of Music for Life and a member of the reference group for the Music and Dementia project. Kate Page (née Newell) is project manager of Music for Life and Wigmore Hall trainee animateur. Kate is also a co-researcher on this project. They were interviewed in May, while they were in the Netherlands to talk about setting up the project Music and Dementia.
Longer version interview with Linda Rose and Kate Page 2010
Q: Linda, you are the founder of Music for Life. How did you first conceive the idea of music for people with dementia? Is it original, or did initiatives like this already exist?
Linda: No, it didn’t exist, but it’s a project which evolved. It started by developing work that was already happening at the Guildhall School for Music and Drama in London, a performance and communication skills course in which students were encouraged to work in schools. And I was doing some work with older people at the time, for the first time. I’d been working as a teacher and education advisor before that. And it struck me that there was a whole sector of the population that was not being addressed at that time, we’re talking about 1990, 1991. The population was clearly ageing, but there was hardly any work going on in that area. And so I managed to set up a module to work with students working in a setting with older people in a day care centre.
Q: At that time, was it already about working with people with dementia?
Linda: No, it didn’t begin in that way. A key turning point came in the mid-nineties, when The Community Care Act came into force in the UK. This meant that more people were staying in their own homes, and going into residential care at a much later stage, when they were much more confused and frail. And that presented all sorts of challenges for managers of homes, and of course also for our musicians.
Q: Was it challenging for the team of musicians? Could you name five of the most important skills musicians need for this work?
Linda: It was very challenging for the musicians. One of the things they needed to understand was the pace at which they needed to work, which was much, much slower. Many of the musicians were used to working with children, and here the pace had to be very, very slow. Also it was very important to make sure musical textures weren’t cluttered when three or more musicians were playing. People could focus maybe on one or two musicians playing. They had to be careful about dynamics, be aware, because maybe people’s hearing might be impaired. They had to understand the kind of space you could use, be aware of how near you could go to a person without worrying them, use a lot of eye contact.
Q: This would not be for all musicians I imagine, you need to be a special kind of person
Linda: You do, it’s about the person behind the musical skill. But quality also matters, because the music has to have great musical integrity, all the time. In the early days we had musicians who were less experienced than those we have now. But it is essential to have absolute top quality musicians who also have great improvisation skills. Even if it’s just one note, it’s got to be absolutely beautiful, the best they can do.
Q: How do you measure the effects? Is there an evaluation with the musicians, or with the residents? How does this work?
Kate: A project is eight sessions of one hour every week. The workshop itself is one hour, but we’re in a home for three hours. We have an hour’s preparation and an hour’s debriefing. And there’s always an evaluation debrief about a month after the project. So we do start to get a bit of a sense over time as to what that culture shift is in a home. And just how far it is spreading to other staff.
Linda: Yes. And there’s a lot of contact with the staff development workers. A lot of informal feedback as well as formal feedback. And in a way, we’ve described this as a kind of ongoing conversation, the project itself is a piece of action research all the time.
Q: How are staff selected?
Kate: We talk to the manager about what support we need, and there is a certain amount of support and collaboration that is needed from the staff to really make it work. But we do like it if staff can self-select, so we have people that really want to be there. But then of course care home managers might have their own ideas like, say, someone new has come into the setting and they want to use it as an opportunity for that person to really get to know the clients. So yes, it’s kind of a mixture of all these things.
Linda: In the debriefings there’s a lot of discussion about work with the staff, because we want to build relationships with them and help them build relationships with the residents. So, it’s a very, very important part of the work.
Q: If a home should decide to take on this project, do they need specific facilities?
Kate: We set quite a number of constraints for a home, actually. Basically we need to have a controlled environment and a protected space. And we have to make sure the people in the room aren’t interrupted during the session. We know when we’ve succeeded in protecting the space when there’s quiet around it.
Linda: Yes, it’s not a thoroughfare, you don’t want doctors or manicurists or anybody knocking on the door saying, I need to see this person now. The managers absolutely have to protect the session and nobody must interrupt. There has to be a consistency of staff; if five staff are selected for the project or volunteer for it, those five staff have to commit to eight sessions. We also need safe locked storage for equipment, very important, space to debrief, space for the musicians to debrief, for the staff to debrief, uninterrupted. And availability of staff for two full hours. Which is a big ask for a home, actually.
Q: Musical workshops have been given in the UK for over 20 years, and now they are going to be set up in the Netherlands as well. Will they be different here from those in the UK?
Linda: We expect they will. But Kate and I don’t know what the context is here yet, what the structure of the homes is like. We don’t know, for example, to what level person centred care is a philosophy, is fundamental in the homes in the Netherlands. Musician training and development is something that is obviously going to be looked at. In the UK there’s a kind of apprenticeship scheme, and our more experienced musicians will support and mentor the new musicians coming in. Logistically how that will work across the two countries, we will have to look at.
Kate: Yes, we’re essentially building a new team, from the ground. So there will be lots of things that from the outside will look different, but I would hope that the values and the integrity of the project would transfer and remain central to the work, even if that manifests in a slightly different way. We know from the people that we’ve met, that we share those values. And if it’s in a different format because things are structured differently here, then we will set it up in a way that suits the context here best.
Interview by Annejoke Smids, 21 May 2010