Communicating through Music

Henrietta Bredin on how Music for Life can help overcome the isolation of dementia sufferers

The Spectator, 12 December 2009

I am looking at an elderly woman, tiny in a huge armchair. She has not spoken for months, she has not maintained eye contact with anyone for even longer and she has developed a nervous compulsion to keep one hand always up to her chin, covering her mouth. A woman in a pink overall is sitting next to her, gently stroking her hand, and a young man with a violin is kneeling at her feet. With infinite patience, the violinist starts to play a simple tune, making it even quieter, more exploratory, when she appears to flinch at the sound of the first notes. Very very slowly, almost indiscernibly, the woman's tight, clenched muscles relax slightly. The little tune trickles on. Her hand uncurls and comes away from her mouth. Tremulously, uncertainly, her lips part and an irresistible wavery smile begins to spread over her face, a smile of astonished delight and total engagement.

This is Music for Life in action, a project which uses music to reach out to people with dementia. It was founded by Linda Rose in 1993 and is now managed jointly by the Wigmore Hall and the charity For Dementia. It is, I think, a unique example of a concert hall involving itself in music therapy on such a scale, and it's certainly a model that could be followed by other performing venues and organisations.

What inspired Linda Rose to establish Music for Life was the realisation, after completing a music therapy course at the Guildhall, that the training was almost exclusively geared towards young people. 'It struck me forcibly that the older sector of society was not being helped in the same way and that there was an ageing population with problems that were very under-publicised at the time.' From small beginnings, starting in a home run by Jewish Care, the project began to grow. By the end of the '90s, Rose realized that changes had taken place. 'People were coming into residential care when they were older, more frail, both mentally and physically. That set quite a challenge for our musicians, and it put them under considerable strain, particularly working with people with dementia. So we started looking at ways in which the staff in residential homes, and psycho-geriatric wings in hospitals, could support the work we were doing.'

Padraic Garrett, manager of a dementia care development project for Jewish Life, knows exactly how crucial it is to maintain this two-way approach. 'People with dementia become increasingly isolated and withdrawn. Staff can work with them day after day without managing to break through that and make real contact. With the work that Music for Life does there can be astonishing moments of connection and it helps staff enormously if they witness that, if they can be reminded that there is a person there. It genuinely does make their highly demanding, sometimes exhausting, work seem worthwhile.'

So where does the Wigmore Hall come into all this and what is their involvement? It was a case of pieces of jigsaw fitting together for education director Ursula Crickmay. 'We're a performing venue so we don't have a company of performers on site but we work with an extraordinary range of musicians, who have all sorts of different skills. I'd heard about Music for Life and when Linda invited me to a session I thought that what they were doing was extremely powerful and was very impressed by the level of improvisational skills and intuitive communication between the musicians. I thought that we could work together to create a training programme for professional musicians to work with people with dementia. Over a period of three years, we gave training to over 45 musicians and at the end of that time it was clear that Music for Life had become a hugely important part of the Wigmore's activities so we decided that we should offer them a permanent home here. The third member of the partnership is For Dementia, who have particular expertise in staff development so that we can build on that at the same time.'

A typical project consists of eight sessions, each of which is prepared in great detail, with immense care taken to ensure that the space is as calm and organized as it can possibly be, that participants are seated where they will feel most comfortable, facing away from a window if they are particularly light sensitive, or near the door if they are likely to want to get up and wander about. There will be 3 musicians and generally 5 members of staff; 3 actively involved and 2 observing. They will change around during the course of the session. This work is not about entertainment (although it can be very entertaining); it is about reaching out to people through music, in an intensely intimate and gentle fashion. There are some simple instruments to hand, chosen so that they are manageable but not just toys, and a conductor's baton is often used. Oboeist Julian West had just finished a morning's work when I met him and it had been a demanding one. 'Someone who had been extremely withdrawn suddenly picked up a baton and pointed it at me. There was absolutely nothing equivocal about that gesture. I was expected to play, and I did.'

West first got involved through a harpist friend and colleague. 'She kept talking about Music for Life and I knew her as a person of great integrity and musical ability so I was intrigued as to what she was getting out of it. I went along to a session and I was completely bowled over, I felt a real ... I can't explain; it's one of those things that defies analysis.' He pauses, searching for words. ' The whole nature of the work is incredibly personal, you have to open yourself up, become almost as vulnerable as the people you're working with, which can be quite frightening. The depth of the relationship between dementia sufferers, care staff and your fellow musicians is unlike anything I've experienced professionally. And it's almost the opposite of what you learn to do as a performer, when you have to get out there, play the right notes, strive for perfection and polish, acquire a sort of veneer. You have to be tough as nails, and with this work that's the last thing you need to be.'

Witnessing the smallest glimpse of the work of Music for Life moved me to tears and I can imagine the effect it would have on those directly involved. A relative, a member of staff, someone who'd been looking after the woman I saw on a daily basis, helping her to wash, feeding her, trying to communicate, would remember that moment, would know and take strength from the knowledge that it was possible, however fleetingly, to reach through the fog and bewilderment and find her; find the person she really is.