Music in Mind

Manchester Camerata

Music in Mind is a creative music therapy initiative run by Manchester Camerata, one of the UK’s leading chamber orchestras. The aims of the project are to improve the quality of life for people with dementia, improve communication and relationships and improve care practice through music-making.

Music in Mind has been funded on a project-by-project basis since 2012 by a number of different bodies including the Henry Smith Charity, Rochdale CCG Social Investment Fund and Tameside Public Health. The projects run in both care homes and community settings over 10 to 20 week periods depending on the appropriate timescale and venue for the participant group. As a cure for dementia is years away, we need to support people with dementia to age well. We have chosen music as the tool to do this because it has an ability to communicate where words cannot. Music taps into both sides of the brain meaning that someone can still engage with music when one side of their brain has shut down. Workshop sessions are focussed on developing communication, interaction, relationships and physical mobility through musical improvisation.

Description of the arts activity

Music in Mind uniquely brings together the clinical expertise of a Music Therapist and a musician from the orchestra. They deliver sessions for eight to ten people with dementia which last up to an hour. The participants sit in a circle with a range of quality percussion instruments in the middle and the Music Therapist will start the session with a ‘welcome song’ before encouraging the participants to choose an instrument to play. Each session then unfolds naturally as the participants experiment with rhythm, pitch and texture. This organic approach ensures that every member of the group is involved as even someone with very limited motor skills is often able to tap a drum or shake an egg shaker. Having the opportunity to speak to someone else through music can be extremely significant for someone who has lost the ability to communicate.

Carers actively take part in the sessions and receive training throughout the project about how to interact with a person with dementia using music. Many carers have started running their own music sessions outside of Music in Mind and we are in conversations with them about developing a CD/ electronic resource which will support this process. We hope to reach a large number of carers across the North West through in this way.

Details of the project participants

We decided to develop a project for people with dementia as an Alzheimer’s Disease International report (2013) highlighted that people with dementia require more personalised care compared to other resident groups, and that alternative ways of developing person to person interactions are needed. The current clinical guidance on dementia recommends the therapeutic use of music and/ or dancing (National Institute of Clinical Excellence [NICE] 2011) for noncognitive symptoms and behaviour that challenges. Reducing the inappropriate prescribing of antipsychotic medication is an aim in the Prime Minister’s Challenge on Dementia 2020 (2015), and is one of the areas in which Music in Mind has made a difference (see more in the evaluation section below).

Project management

The project is currently managed by Lucy Geddes, Camerata in the Community Manager. This includes securing project funding and/ or partnership organisations, securing venues, and liaising with staff, practitioners and evaluators. The Music Therapist takes responsibility for how the participants interact with each session, whilst the carer is responsible for their overall wellbeing.
The project is free to all participants; we only ask that the venue commits to the same session time each week. Our independent evaluator seeks ethical approval in order to collect and disseminate data about the participants.

Evaluation methods and findings

Over the last four years we have developed an evaluation methodology that can be adapted to different project settings. We do not ask a carer to speak on a person with dementia’s behalf, instead they make a considered judgement about how they believe the participant has responded to a session. This is captured by either completing a weekly observation form or through interviews. Interviews are also carried out with the musicians, manager of the care setting and family members.
Evaluations have been conducted by Coventry University, University of Manchester, New Economy Manchester and HKD Research Ltd. Findings highlight an improvement in mood, increased social interaction among clients and an increase in confidence to express oneself.

Evaluation criteria has now developed to include impacts on people displaying behaviours that challenge, and also impacts on the use of GP, in and outpatient services:

  • ‘At one care home all of their participants regularly accessed outpatient services prior to taking part in Music in Mind. However, none of the participants need to do so during or after Music in Mind.’
  • ‘[Participant name] has had music therapy, they now don’t need to be medicated.’
  • 67% were noted to experience reduced levels of anxiety, frustration or anger
  • ‘a resident had been extremely difficult to handle… her first session was the first time she had engaged properly with anything since her arrival [in the care home] and she became one of the most helpful and articulate members of the group.’
  • Manchester Camerata aims to build on this research base and shape decisionmaking around care practices for people with dementia. We have received a large amount of recognition from universities, local authorities and the media, as well as a report in an academic journal (Dementia, the International Journal of Social Research and Practice, Editorial, January 2013) and presentations at conferences:
  • Alzheimer’s Society 2012
  • Age Friendly Manchester 2013
  • British Council Study Tour Japan 2015 and 2016
  • NHS R&D 2015 and 2016
  • RNCM Symposium 2015
  • Enterprise Music Scotland Conference 2016
  • The First International Research Conference on Arts & Dementia 2017

See below for online articles:
http://www.bbc.co.uk/news/uk-england-manchester-28453017

https://www.theguardian.com/social-care-network/2016/feb/29/music-projec...

Supported using public funding by the Arts Council England