Singing songs, when carried out in the right way, heightens mood in those with dementia, reduces both apathy and anxiety, lessens agitation and tendency to wander and activates pleasure centres in the brain, helping people relate to and manage their emotions better, a variety of neurological research is now showing.1 In effect, it both soothes and energises. Now a project is underway that could make this gift available to dementia sufferers across the UK. And it doesn’t require previous professional expertise because that comes ready provided.
“Music is the ultimate organiser,” says Andy Tubman, a music therapist whose more than 20 years’ experience includes working with elderly psychiatric patients with dementia. “It engages the brain’s language centres, motor centres, planning and speech centres. Everything is engaged, enabling the neural network to expand and increasing brain plasticity.”
Tubman is co-founder, with Rachel Francine, of Musical Health Technologies, producers of SingFit PRIME, an award-winning music pro- gramme tailored to participants’ tastes and cognitive abilities, which can be facilitated in care homes and hospitals by those with no prior musical experience or expertise. SingFit PRIME is currently in use in more than
450 senior living communities, specialised nursing facilities and hospitals in the US. Studies undertaken by these facilities show that, when the programmes are used in a consistent way, participants (half of whom have dementia) experience a 43 percent elevation in mood and a
40 per cent reduction in anxiety medication, along with increased focus in communication and social interactions.
These highly encouraging results have attracted the attention of researchers at Glasgow Caledonia University, led by Professor Gianna Cassidy, a music psychologist and lecturer in interactive entertainment design. The SingFit method is now being trialled in the UK by her team as part of the Music for Dementia 2020 initiative, inspired by the government-backed Challenge on Dementia 2020 (known as the 2020 Challenge). This set out more than 50 specific commitments across four core themes of risk reduction, health and care, awareness and social action, and research to make England the world leader in dementia care, research and awareness by 2020.
The initiative has set the challenging goal of providing, by the end of 2020, improved musical care in the UK for all 850,000 people with dementia (a figure set to rise to
over a million by 2021.) It grew out of a report from The International Longevity Centre UK and Utley Foundation on Dementia and Music, which found huge benefits from music for people with dementia but highlighted that only five percent of the 20,000 care homes in the UK were providing good quality arts and music activity for residents.4 The study with Glasgow Caledonia will investigate the benefits of the SingFit PRIME programme, initially at three care homes, as a group solution for improving the health and daily lives of people with dementia and their carers.
“In the US, most of our trained facilitators are staff but we have one group where the facilitators of the programme are volunteers, and they have specifically mentioned in feed- back the benefits to themselves as well as to those that they are working with,” says Francine. “One can only imagine how much magnified this effect will be when family participate, as it provides a natural way to have a normal interaction with their loved one.”
Tubman adds, “When people have dementia, everyone tends to put on kid gloves and baby them. Whereas SingFit is a robust programme, for body, mind and spirit. It requires work, instead of sitting slumped in front of TVs. It is a joyful way to exercise and engage with the world.”
The programme takes the form of playlists (12 are provided every quarter), each with a theme, such as food, and containing eight songs (selected to suit participants’ tastes), a storyline and simple questions, designed to last, overall, for 50 minutes. Participants hear the words of each line of each song sung for them, directly before they sing it themselves. Also supplied are printed books for facilitators, containing the questions, along with egg shakers (egg-shaped hand percussion instruments containing loose seeds or beads) and scarves, to help generate healthy movement while singing, through shaking and swaying. Speakers are provided, into which to plug the tablet containing the programme.
In a three-hour online training, facilitators are shown how to use the technology and the playlist, to arrange the room and the seating in the best way to encourage engagement, and how to ask the questions in an inclusive rather than exclusive way. For instance, the question, “We just sang about peaches. Do you like peaches?” might be directed to someone with severe memory problems, whereas someone with more cognitive ability might be asked, “What fruit do you like and why?”
In US studies, when the programme is used at regular times at least three to five times
a week with those with cognitive decline, there is significant increase in focus and wellbeing and reduction in wandering. “It makes sense,” says Tubman. “Wandering is a behaviour expressing an unmet need. People can’t pay attention; they can’t stay still. But when there is melody and they are listening to favourite songs and they start singing and moving to the beat, needs for attention, connection and purpose get met.”
Some of the US community homes use the programme seven times a week, with even better results, and some divide the day’s programme in two, with a 25-minute session in the morning and another in the early afternoon, as this has been found to extend the positive effects on behaviour. It also softens the late afternoon period of agitation that tends to occur in dementia. In a survey of more than 1,400 facilitators, 92 per cent said that the programme made their work more fulfilling and 100 per cent said that it positively benefited the participants.
The team is also working on a related project, which is called SingFit STUDIO, to be used by health professionals in one-to-one sessions to address, through an enjoyable musical workout, the needs of those with conditions such as chronic respiratory disease, hypertension and ADHD. “There really is a call for music as medicine throughout the life cycle,” says Francine. “It is a cross-generational activity. I know there is a big focus right now in the UK on loneliness. Music is a great way to address it.”