by Douglas Noble, Strategic Director for Wellbeing, Live Music Now
At Live Music Now (LMN) we are working to evidence how carefully delivered music can provide significant benefits for older people, care staff and care settings, contributing to person-centred care. We recommend that regular participatory music programmes be considered essential for all UK care homes.
This comes from the headline finding and rallying call to action for the Adult Social Care Sector (ASC) in our Live Music in Care Report (Tapson, Noble, Daykin and Walters 2018) published with the University of Winchester.
Since 2015, Live Music Now have been leading a national campaign and research initiative, supported by 35 national organisations in social care and arts sectors, and funded by the Baring Foundation, to establish evidence for, and encourage growth of, music as support for people living and working in care.
There is a growing, persuasive and authoritative body of evidence to support the use of music to enhance the health and wellbeing of older people in care including those living with dementias. This is helping to establish music as an investment in quality of person-centred care. However, our work with the care sector told us there was no research about the impact of music on whole care environments.
So, we set out to test this through music programmes in 5 care settings, with trained early-career professional musicians from the LMN scheme. Over the course of each 10-11-week residency, we empowered both residents and staff to use music themselves as part of their daily routines, so that it could continue after our involvement concluded. There is a short film showing work in one of the settings.
The Evaluation Framework was developed through Co-Creation meeting with representatives of participating ASC providers MHA Methodist Homes and The Orders of St John Care Trust, led by the Centre for Arts as Wellbeing, University of Winchester. This developed the question:
Can 11 weekly music sessions, provided for staff and residents in care homes, support the care home environment to be a place where residents and staff are happy to live and work?
The project went further than previous research, breaking new ground by:
- Considering the impact on staff and whole settings, not just residents;
- Emphasising co-designing with the care professionals and residents in each setting;
- Exploring new ways to support care staff to lead music activities, and how this can impact on their wider caring role and job satisfaction.
We observed a level of commitment from care staff seldom demonstrated in previous literature and saw individual shifts in behaviour from reluctance at the start, to great enthusiasm. This highlighted the relevance of the environment to working attitudes.
‘It has turned our staff into leaders. It has allowed the team to come out of themselves and show their strengths.’ Manager in a LMN Live Music in Care Setting
From the evidence, a number of headline learning points for this area of work can be drawn out:
- Participating and delivering a music intervention can provide positive social experiences as well as creative engagement, fun and a sense of achievement for residents in care homes;
- Musicians can play an important role in nurturing the wellbeing of elderly people in care;
- Regular music making can enhance the working and living environment for care home residents and staff;
- Music interventions can play a crucial role in awakening a sense of identity and empowerment for care home residents, facilitated by musicians and care teams working together;
- Strategic planning at the outset establishes an essential structure and definition of tasks that provides a framework for the music programme.
‘We [activities coordinators] and the care team talk about it and send pictures to each other as we are excited about it even if we are not there as we are really proud of what is happening.’ Care professional in a LMN Live Music in Care Setting
There is an ongoing change in culture and what happens in the settings. There ar threads of impact and activity to the benefit of the residents, staff working in new ways through music and other creative activities and staff empowered and showing new understanding around their work and roles, what’s in their care tool-kit and what they can bring to it. Examples of this legacy in the settings we worked in include:
- A bi-weekly residents' ‘choir’ and regular concerts, led by the Activities Coordinators and involving staff from across the setting;
- Regular music from volunteer singing group coming in to support staff;
- Care and activities staff using singing day-to-day to support ‘transactional’ activities for people living with dementia, including mealtimes, personal care and moving around the home;
- A growing home ‘song book’ (currently 2 volumes) which is looked after by of the residents who plays the piano for regular Monday singing sessions;
- A care team member staff taking part setting up an aromatherapy spa, an outside passion, and skill, that the project gave her the confidence to bring into her work in the setting; and
- Weekly ceramics session led by a professional potter with residents making work for a public exhibition.
‘The benefits for Residents werereducing social isolation, building relationships, influencing independence, long lasting change in behaviours, gaining new skills and confidence. The benefits for the Home and Team were empowerment, ownership, inclusion, compassion, team retention, new skills and confidence.’ Manager in a LMN Live Music in Care Setting
This was an ambitious, ground-breaking piece of work, piloting an innovative approach to working in close partnership with care settings and their staff teams to bring about lasting change in culture and practice in those settings. We worked very carefully to meet them where they were at, to support and grow a culture of music and creativity in their day-to-day care tool kit.
The objective, robust and rigorous approach has added to the evidence base on work in this area which can benefit the wider arts and health and ASC sectors. We can only achieve this by working closely in partnership with the care sector at all levels, strategic management and front line, as well as Academia, doing things jointly we would not otherwise do, co creating, evaluating objectively and learning from our partners.