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With a song in their hearts: helping dementia patients through group singing

15 March 2024

Churches have a part to play, finds Sarah Meyrick

Diana Pattison

The Music Box in use at a church Dementia Café project in Bromley

The Music Box in use at a church Dementia Café project in Bromley

THE link between music and well-being is well established. Academic studies support what people have always known instinctively: music can help to lower the heart rate and blood pressure; it can relieve muscle tension, help with the management of pain, and ease depression and anxiety by triggering endorphins. And, for people with dementia, there is another clear win: music can have a positive impact on people’s cognitive capabilities, improving attention and concentration, memory, and speech.

A number of charities that support people with dementia — such as the Alzheimer’s Society and Dementia UK — have programmes that offer music therapy. There are also smaller, informal groups and initiatives.

Someone who believes that the Church has a part to play in fostering well-being through music is Adrian Bawtree, who, before taking up his current post as director of music and organist of Rochester Cathedral, worked for a charity, Sing For Your Life. The charity encourages group singing by people with dementia, and runs what it calls “silver song clubs”, in community settings and residential care homes.

Mr Bawtree soon realised that the need outstripped the available resources. “There are around 17,000 care homes in the country, and a million people living with dementia. We know from the research that it’s the participation that creates the benefit. It’s not just about sitting and listening to music: it’s about taking part. I wondered: how do you roll out a programme to a million people in a cost-effective way?”

And there was a lack of facilitators. “So, we set up a thing called the Music Box, which was essentially a karaoke machine. I played in about 200 songs overall, from well-known folk songs to more modern songs. Essentially, it meant that care staff could say, ‘Let’s all have a sing in the living room at three o’clock,’ and we could we train them up so that they could use it. And it was really successful.”

There were still only so many boxes available. “We were always looking for volunteers to come alongside us. You need people who are used to standing up in front of other people: retired teachers, for example,” he says.

“And then it dawned on me that, in church choirs, there are confident singers and confident personalities; so we should be enlisting their help. The more I thought about it, the more I saw a synergy between what happens in church and what happens in a care-home [singing] group.”

Churches have a “pastoral mandate” for this sort of activity, he says. Many can also offer somewhere to serve refreshments. “You have the people who are able to deliver, whether it be playing the piano or playing the guitar or just singing well — you’ve got the whole plant, and you’ve got the pastoral and spiritual dimension as well.” He is “absolutely convinced” that it is in the power of most churches to deliver this sort of activity.

The feedback from his Singing for Well-being groups has been encouraging. “One person said to me that this was an opportunity for a normalising experience, for both the carer and the person living with dementia. Another said, ‘Thank you for the session. I get my husband back.’ It’s really quite profound.”

He remembers a Christmas singing session that he offered at Rochester Cathedral for a carers’ organisation. “Afterwards, somebody said to me, ‘We came last year. My father can’t remember what he had for breakfast, but he does remember the singing session last year. That’s why we’re back here today.’ Something really extraordinary happens with singing and music-making.”

Mr Bawtree emphasises that you don’t need to be a professional to run a session. “Ten or 11 years ago, I would bounce around like Tigger, waving my arms around and saying ‘Come on everybody, let’s sing a song,’ and, while that was fine — it got everyone going — I realised that was actually the wrong approach.

“So, the next time, I didn’t say anything. I just went into the middle of the group and started singing ‘My Bonnie lies over the ocean,’ without even inviting people to sing. And they just joined in. And that’s what we’re talking about: you’re not running a choir practice — it’s just a group sing. Getting people singing, you start to see the benefit almost immediately.”

Mr Bawtree says that he is “fascinated and mesmerised” by the power of music. “Clearly, something is happening to the neural pathways. We know that the brain reorganises itself, if there’s a damaged part, and it creates neural pathways around the damaged part. I was talking to a professor of psychology recently who’s working [in this area] and his words were, ‘We know that when people sing, the brain lights up.’”

As an illustration, he recalls a trial when one of his Music Boxes was placed in a continuing-care ward. “Things got a little testy in the unit daily at roughly three or four o’clock in the afternoon,” he says. “They did a three-month trial of what happened with the music intervention, and they recorded something like a 50-per-cent decrease in their prescribing anti-psychotic drugs, because they were able to put a song on. That was an amazing result.”

An example from his early days of working with people with dementia stays with him. “There was one lady who just sat in her chair. I noticed that, from halfway through, she was tapping her index finger. Afterwards, I said, ‘I’m really sorry, I couldn’t get everyone involved.’ And they said, ‘What are you talking about? That’s the most engaged that lady has been in three weeks.’”

Another time, a patient started banging a drum when the singing began. “All the staff came out to see it, and they were in tears because this was the first time this lady had engaged with anything, group-activity-wise. I could see the effect it had on the staff, too.”

Sometimes, participants can remember the songs. “All eight verses of “All things bright and beautiful”, “Once in royal David’s city” — those are very embedded in the memories of a certain clientele, he says. “But what I found was, as people got into the session, you could do a bit more. A bit of rock and roll, say. Even if people didn’t know the words or didn’t know the tune, if they could feel the rhythm and feel the beat, they’d happily tap away and engage with it that way. So, people are getting something out of it, even if it’s not drawing on memories.”

 

WORK with dementia patients is also provided by the Anna Chaplaincy. Julia Burton-Jones (Interview, 5 August 2022) is the Anna Chaplaincy lead for Rochester and Canterbury dioceses, and also provides training nationally for the charity. Anna Chaplains have a brief to offer spiritual support to older people who are living in care homes and sheltered housing complexes, their relatives, and the staff who look after them, and to promote the spiritual welfare of older people in the wider community. This doesn’t always involve music — but, as Mrs Burton-Jones says, it is one powerful tool.

“It is well evidenced that music helps people cognitively and socially,” she says. Sometimes this is a matter of drawing up deeply ingrained personal memories; she refers to an initiative set up by the broadcaster Sally Magnusson, Playlist for Life, which encourages people to create a playlist for the comfort of the person with the condition.

Singing feeds people emotionally, evoking feelings that they might otherwise find hard to express, Mrs Burton-Jones says. “But it also enables social connection, and social connections help people. Singing together enables them to participate, like those without dementia, and that gives self-confidence.”

Singing hymns can be a way of enriching people’s lives, she says, and refers to one woman she knows of who “came to life” when everyone sang “Onward, Christian soldiers”.

“Singing is also good for physical health, through your breathing. Someone said to me recently, ‘I feel as if I’ve done a good workout.’”

She also speaks of the benefits for carers. “Singing together is a wonderful way to support the relationship, and to bring on some fun and enjoyment. It takes them back to a time before dementia, and reminds the carer of the fun they used to have. That’s a key to well-being.”

She agrees that churches are often particularly well placed to offer musical activities. “It’s an absolutely obvious way that we, as churches, can reach out to people with dementia,” she says. “At church, we do music, whereas lots of adults don’t normally have the opportunity to sing. We also have skilled musicians, which can be a resource for the community. And we have the buildings.”

For now, even the non-churchgoers among the elderly frequently have a collective memory of hymn-singing — “though that won’t always be the case,” she says. “Often, we find we can reconnect them with their faith and a sense of belonging and trust in God’s love. It’s an absolute win-win.”

 

Adrian Bawtree will be speaking at next month’s Church Times Festival of Faith and Music, held in partnership with the RSCM. Tickets: faithandmusic.hymnsam.co.uk

 

Case studies

John Portman became involved in this work when he moved to Rochester 11 years ago, and joined the PCC of the Rochester Benefice. He suggested that the church could do more to support people with dementia, and the response was “very positive”. Together with other volunteers, he set up a dementia café. Then came a singing group, through the Alzheimer’s Society’s Singing for the Brain initiative. With funding from the Rotary Club, they purchased folders, into which they put the words of 30 songs. They alternate the use of the folders with a Silver Song music box that projects words on to a screen, because they find that this help to prolong concentration.

The Singing for the Memory Medway group has been running on a monthly basis for the past four years. Twenty to 30 people attend each session, a mix of dementia patients and their carers. He estimates that about 200 people have taken part.

“People who no longer have any real conversation, who can’t really even converse with their own spouse, will take part in singing,” he says. “They remember all the words of the songs — it’s absolutely staggering. There is part of the brain which seems to retain that sort of memory. What we do, by starting a song, is a trigger for that.” Songs are chosen with care to appeal to the age group: songs from musicals and songs by bands such as the Beatles.

Anyone can join in, whether or not they think they can sing, he says. And the experience is transformative, for both the person with dementia and their partner. “The singing is important, because people enjoy it and it does trigger memories, but also they are socialising and they’re in an atmosphere which is relaxed and friendly. It also allows the carers to have some respite.”

Diana Pattison, a licensed lay minister from Bromley, has been an Anna Chaplain since 2017. She helped to set up a monthly dementia café, a joint project between St Augustine’s and Holy Trinity churches. The offer is simple: tea and coffee, cakes and biscuits, and a chance for people to talk to one another.

“We do a quiz, and sometimes we do bingo, but we always end with a singing session, using the Silver Song music box,” she says. “We play a mix of songs from the shows, like The Sound of Music, or old songs, like “Daisy, Daisy”. Everybody really enjoys it, and they go home with a smile on their face. We have one lady who has quite advanced dementia, and she doesn’t really respond very much in the way of conversation or activity. But, with the music, she rocks in time.”

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