Could music projects cut the cost of dementia care?

Sheer embarrassment was dementia care worker Lynda Kelly’s overwhelming emotion the first time she sat in on a  orchestra music therapy session at the residential home where she works; but the lasting change she saw in the residents in response to the musicians was so great that she is now running weekly improvisation sessions at the home.

Kelly, the activities coordinator for Acacia Lodge – a 60-bed residential home in New Moston, Manchester – reports seeing a mute female resident with advanced Alzheimer’s sing Swing Low, Sweet Chariot at top volume with all the words in one of the first Camerata sessions. Two other former non-speakers now communicate with staff as though they had never stopped and many more display greater confidence, increased activity levels and more cooperation with their carers.

“The first music session I went to, I did not know where to put myself with embarrassment – I was not used to seeing people sing and express themselves like that,” says Kelly, who has since then been involved in three music and dementia projects with the chamber orchestra over the past three years, including a 10-week course for Acacia Lodge residents. “But the impact has been amazing and I realised within two weeks that music was getting to them in a completely different way.”

Manchester Camerata orchestra’s Music in Mind (MIM) projects, which involved 7,200 people in care homes and community projects acrossGreater Manchester last year, have had such dramatic effects on participants that academics at Manchester and Lancaster universities are backing a research student to create the world’s first in-the-moment, multi-sensory assessment tool to quantify that effect.

Manchester Camerata’s head of educational outreach, Nick Ponsillo, says: “This is all about helping people with dementia to communicate and to feel part of the community, but we need to know that we are really getting to the guts of a patient’s experience.”

The Camerata – whose reputation with audiences is built on concerts of Mozart and Beethoven in venues such as the Bridgewater Hall – now hosts Manchester University PhD student psychologist Robyn Dowlen to carry out research in collaboration with Lancaster University. She is attempting to measure the effect of music on people who may not be able to communicate it in words.

This is about coming up with the proof that there is more to music in a dementia context than just entertainment. According to the Alzheimer’s Society, there will be 1 million people with dementia in the UK by 2025 and one in six people over the age of 80 currently have it. Alzheimer’s is a massive health and social care challenge to which management approaches are needed in a cash-strapped world.

Camerata’s projects – led by a professional music therapist and specially-trained musicians from the orchestra – involve working directly with patients with degenerative brain disease and their carers. It is about encouraging them to sing, play instruments and create music – and even to perform in public, in sessions before Camerata concerts.

Dowlen’s supervisor, Prof John Keady, who leads the dementia and ageing research team at Manchester University, is excited about the MIM projects, which he sees as confirming his view of dementia as a loss of self and social identity, rather than the more common view of it as a loss of creative and cognitive skills.

He hopes that Dowlen will be able to produce a means of measuring an individual’s experience of connection, so that the circumstances can be reproduced when people engage in other activities.

Evaluation of MIM projects in Rochdale and Tameside by New Economy paints a consistent picture of better communication, happier and more cooperative patients, and even suggests that music participation may lead to a reduction in the amount of NHS treatments and anti-psychotic medication required. Numbers are small, but it is an area researchers want to investigate.

Keady is even asking himself whether the right kind of music projects actually cut the cost of dementia care.

Ponsillo has noticed a change in attitude from health and social care sectors since work on projects began in 2010, from lack of interest to a desire for collaboration. Rochdale has had projects in two care homes and two community centres last year, and Tameside Public Health is currently funding 30-week projects in four care homes – plus music training for carers to help them continue the work themselves – despite enduring budget cuts. Four other projects are also ready to start next month in central and north Manchester.

Angela Wild, programme officer for Tameside Public Health and dementia champion, is clear: “This work is leaving a lasting impression. The money Tameside is spending on 30 sessions is money well spent. Everyone should be doing it.”

Ponsillo has just returned from Japan, where he was invited to address cultural organisations keen to learn from the Camerata’s experience about how to set up music schemes for people with dementia, given the ever-growing elderly population.

Creative music projects can clearly benefit those with dementia, but other performing arts are making an impact too. West Yorkshire Playhouse has won awards for its work in the field with drama, and Liverpool-based Indian traditional dancer Bisakha Sarker has witnessed powerful effects with movement.

Given David Cameron’s launch of the prime minister’s challenge on dementia 2020, the public health minister, Jane Ellison, is keeping an eye on what is happening in Manchester. She said: “For many people with dementia, music and other arts-based activities can make a real difference to their sense of wellbeing and quality of life. We are working to create more dementia-friendly communities. Manchester Camerata’s work is great example of what can be done to help people live well with dementia.”

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